Patient reported sexual concerns in routine cancer care.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12128-12128
Author(s):  
Brittany Lees ◽  
Smitha Vilasagar ◽  
Jubilee Brown ◽  
Peter E Clark ◽  
Maxim McKibben ◽  
...  
Keyword(s):  
Sexual Health ◽  
Cancer Care ◽  
Unmet Need ◽  
Well Being ◽  
Cancer Site ◽  
Cancer Center ◽  
Cancer Symptoms ◽  
Health Concerns ◽  
Patient Reported ◽  
Sexual Concerns

12128 Background: Sexual health is an important component of overall well-being and can be adversely impacted by chemotherapy, surgery, radiation, in addition to the psychological effects of cancer treatments. Sexual health is challenging to discuss and may be overlooked or avoided during cancer care. Methods: Patients presenting for consultation in an outpatient multisite cancer center completed electronic distress screening (EDS) between January 2017 and December 2020. The EDS contains 42 questions; demographic information, cancer symptoms and side effects, and psychosocial factors. The EDS is completed by patients before a clinical encounter for early symptom identification and intervention. We conducted a retrospective data analysis of sexual health concerns (>5; scale 0-10) and evaluated patient characteristics and clinically relevant distress (>4; NCCN Distress Tool), depression risk (>3; PhQ2), and anxiety risk (>3; GAD2). Our primary aim was to identify the prevalence of sexual health concerns. The secondary aim was to examine the relationship between sexual health and emotional well-being. Results: 57,375 EDS screens were completed. 13,950 patients (24%) reported sexual concerns or lack of interest in sex (>5) within the last 2 weeks. The frequency of these concerns at specific clinics ranged from 12% to 48%, with the highest rates at Palliative care (39%) and Psycho-Oncology (48%) clinics. Genitourinary (30%), Gynecologic (27%) and Gastroenterology (26%) reported the highest frequency of sexual concerns from cancer site specific clinics. Males reported a higher rate of sexual problems compared to females (30% vs 21%, p < 0.001), but a lower rate of relationship concern distress (12% vs 13%, p < 0.05). Patients with a risk for depression (n = 9,126) or anxiety (n = 10,809) had higher rates of self-reported sexual concerns than those with a negative screen (44% vs 21% depression, p < 0.001; 40% vs 21% anxiety, p < 0.001). Conclusions: Sexual health is a concern for approximately one-quarter of patients presenting for cancer care. Sexual health concerns were prevalent across cancer sites. Patients with positive screens for anxiety and/or depression have nearly double the rates of reported sexual health concerns. Sexual health is a current unmet need that impacts cancer patients and warrants attention.

scholarly journals Interventions to Improve Sexual Health in Women Living with and Surviving Cancer: Review and Recommendations

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3153
Author(s):  
Jenna Sopfe ◽  
Jessica Pettigrew ◽  
Anosheh Afghahi ◽  
Leslie C. Appiah ◽  
Helen L. Coons
Keyword(s):  
Body Image ◽  
Sexual Health ◽  
Sexual Function ◽  
Clinical Care ◽  
Gynecologic Cancer ◽  
Unmet Need ◽  
Well Being ◽  
Future Research ◽  
Medical Subject Headings ◽  
Health Concerns

Sexual health concerns, both physical and psychological, are common and represent an unmet need among women with and surviving cancer. Sexual challenges and conditions negatively impact body image, satisfaction, relationships, well-being, and quality of life, yet are widely reported to be under-recognized and undertreated. To guide clinical care and future research on sexual function in women with cancer, we performed a scoping review of interventions for sexual health concerns, including sexual function, body image, genitourinary symptoms, and hot flashes. Relevant publications between 2005 and 2020 were identified by searching PubMed with a combination of medical subject headings and keywords. Articles were included if they focused on the aforementioned topics, were primary research publications, and included female cancer survivors. Studies focusing on women receiving hormone therapy for breast cancer were also included. A total of 91 investigations conducted in the US and abroad were reviewed. Most commonly, interventions included a component of psychoeducation, although pharmacologic, exercise, and other approaches have been evaluated. Many studies have focused on survivors of breast or gynecologic cancer, among other sampling and methodological limitations. These limitations underscore the need for more work on this vital survivorship issue. Recommendations for future research in this area are also offered.

scholarly journals Enhancing Patient-Provider Communication With the Electronic Self-Report Assessment for Cancer: A Randomized Trial

2011 ◽  
Vol 29 (8) ◽  
pp. 1029-1035 ◽  
Author(s):  
Donna L. Berry ◽  
Brent A. Blumenstein ◽  
Barbara Halpenny ◽  
Seth Wolpin ◽  
Jesse R. Fann ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Clinic Visit ◽  
Self Report ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Control Group ◽  
Cancer Symptoms ◽  
Patient Reported ◽  
Life Issues ◽  
Clinic Visits

Purpose Although patient-reported cancer symptoms and quality-of-life issues (SQLIs) have been promoted as essential to a comprehensive assessment, efficient and efficacious methods have not been widely tested in clinical settings. The purpose of this trial was to determine the effect of the Electronic Self-Report Assessment–Cancer (ESRA-C) on the likelihood of SQLIs discussed between clinicians and patients with cancer in ambulatory clinic visits. Secondary objectives included comparison of visit duration between groups and usefulness of the ESRA-C as reported by clinicians. Patients and Methods This randomized controlled trial was conducted in 660 patients with various cancer diagnoses and stages at two institutions of a comprehensive cancer center. Patient-reported SQLIs were automatically displayed on a graphical summary and provided to the clinical team before an on-treatment visit (n = 327); in the control group, no summary was provided (n = 333). SQLIs were scored for level of severity or distress. One on-treatment clinic visit was audio recorded for each participant and then scored for discussion of each SQLI. We hypothesized that problematic SQLIs would be discussed more often when the intervention was delivered to the clinicians. Results The likelihood of SQLIs being discussed differed by randomized group and depended on whether an SQLI was first reported as problematic (P = .032). Clinic visits were similar with regard to duration between groups, and clinicians reported the summary as useful. Conclusion The ESRA-C is the first electronic self-report application to increase discussion of SQLIs in a US randomized clinical trial.

Leveraging the electronic medical record (EMR) to predict patient reported financial hardship in cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6594-6594
Author(s):  
Sandeep Sai Voleti ◽  
Sikander Ailawadhi ◽  
Carolyn Mead-Harvey ◽  
Rahma M. Warsame ◽  
Rafael Fonseca ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Mayo Clinic ◽  
Cancer Care ◽  
Disease State ◽  
Financial Hardship ◽  
Cancer Center ◽  
Median Income ◽  
Patient Reported ◽  
Race Ethnicity ◽  
Zip Code

6594 Background: Patient reported financial hardship (FH) in cancer care is a growing challenge for patients, their caregivers and healthcare providers. As treatment costs escalate, it is imperative to develop effective strategies to proactively recognize and mitigate FH within oncology practice. Using automated processes to screen and refer patients to appropriate resources is a potential option. At Mayo Clinic, screening for FH involves using a single financial strain question ‘ How hard is it for you to pay for the very basics like food, housing, medical care, and heating?’ completed by all cancer patients annually as part of the Social Determinants of Health (SDOH) assessment. In this study, we describe the prevalence and predictors for FH (denoted by the answer ‘hard and very hard’) in our patient population. Methods: Patients receiving cancer care at the three Mayo Clinic sites (Minnesota, Arizona, and Florida) who completed the FH screen at least once were included in this study. Demographics (age, gender, race/ ethnicity, insurance, employment status, marital status, and zip code) and disease state data for included patients was extracted from the EMR and Mayo Clinic Cancer Registry. Disease state was categorized by type of cancer (hematological or solid malignancy) and cancer stage. Zip code was used to derive median income, rural/urban residence and distance from the cancer center. Multivariable logistic regression models were utilized to examine factors associated with FH. Results: The final study cohort included 31,969 patients with median age 66 years (IQR 57,73), 51% females, and 76% married. Race/ethnicity composition was 93% White, 3% Black, and 4% Hispanic. 52% of patients had Medicare and 43% had commercial insurance. Other notable factors included 48% retired, 41% working/ students, 76% married, and 72% urban residents. Median time from cancer diagnosis was 1.1 year (IQR 0.1, 3.8) and median income was $64,406 (IQR 53,067, 82,038). 31% of patients had hematological malignancies, 20% of the cancers for which staging information was available were metastatic. FH was reported by 4% (n = 1194) of the patients. A significantly higher likelihood of endorsing FH (p < 0.001 for all) was noted in Hispanic (OR 1.64), Black (OR 1.84), American Indian/Alaskan native (OR 2.02), below median income (OR 1.48), rural (OR 1.17), self-pay (OR 2.77), Medicaid (OR 2.29), Medicare (OR 1.43), unemployed/disabled (OR 2.39), single (OR 2.07), or divorced (OR 2.43) patients. Older age, being retired, and living farther from the cancer center were associated with significantly less likelihood of endorsing FH. Conclusions: Our study successfully leveraged the EMR to identify key sociodemographic groups more likely to report FH. An electronic trigger to flag such patients at high-risk of FH and proactively address FH is currently being developed.

Patient-reported priorities for survivorship care and experience discussing available services.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 200-200
Author(s):  
Julia Rabin ◽  
Katharine Quain ◽  
Nora Horick ◽  
Garrett Chinn ◽  
Allison McDonough ◽  
...  
Keyword(s):  
Supportive Care ◽  
Early Stage ◽  
Female Gender ◽  
Cancer Center ◽  
Survivorship Care ◽  
Response Options ◽  
Cancer Symptoms ◽  
Factors Associated ◽  
Care Services ◽  
Patient Reported

200 Background: Despite the recognized need for high quality survivorship care, barriers to identifying and addressing patients’ needs still remain. We sought to evaluate cancer survivor care priorities, awareness of available services, and factors associated with care and informational needs. Methods: A needs assessment survey was distributed to patients presenting for routine follow-up care in adult oncology clinics at the MGH Cancer Center between February and August of 2016. The survey assessed sociodemographic characteristics, and preferences for care and communication. Care priorities were selected from a list of options including open ended response. Discussion of supportive care services was assessed by the item “have any of your providers informed you about the types of supportive care services that are available to cancer patients" with response options of “yes,” “no” or “don’t know.” Results: Among 637 total respondents, 339 patients with early stage cancer completed the survey. The majority of participants were between 50-69 years old (54%), white (89%), female (64%), and college educated (80%). Breast (32%) and hematological malignancies (21%) were the most prevalent diagnoses. Commonly endorsed priorities for care included: emotional concerns related to cancer (40%), strategies to increase self-care (33%), and management of physical cancer symptoms (30%). Demographic and clinical factors associated with endorsing emotional concerns as a care priority included female gender, and moderate or greater levels of fatigue, depression, or anxiety (all p< 0.01). Factors associated with endorsing management of physical cancer symptoms as a care priority included younger age, and moderate or greater levels of fatigue or depression (all p≤0.01). Despite these priorities for care, only 41% of patients reported receiving information from providers about available supportive care services. Conclusions: Cancer survivors’ preferences for emotional support and symptom management are strongly associated with self-reported depression and fatigue. Routine screening for these issues and improvement in communication regarding available services should be prioritized in survivorship care.

Evaluation of scheduled video visits for cancer care at the Sidney Kimmel Cancer Center at Thomas Jefferson University.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 277-277
Author(s):  
Nathan Handley ◽  
Adam Binder ◽  
Megan Sabonjian ◽  
Ana Maria Lopez
Keyword(s):  
Patient Satisfaction ◽  
Cancer Care ◽  
Average Distance ◽  
Cancer Center ◽  
Similar Response ◽  
Broadband Internet ◽  
Detailed Survey ◽  
Patient Reported ◽  
Quality Technology

277 Background: Telehealth is currently undergoing exponential growth as a result of improved access through less costly, more portable, and better quality technology and through increased broadband internet proliferation. Telehealth has been shown to improve access and decrease costs while maintaining quality of care and high levels of patient satisfaction. One approach to telehealth is the video visit, in which audiovisual technology is used to connect patients and providers virtually. We implemented a pilot scheduled video visit program in a large academic cancer center (SKCC). Methods: Oncology clinical teams were trained in the use of JeffConnect, the video visit platform developed at our institution. Clinical teams were encouraged to utilize video visits in instances they deemed appropriate (i.e. post hospital follow-up, post-chemotherapy evaluations). All participating patients received a link to an evaluation following completion of the video visit. A subset of patients receiving more detailed survey questions. We reviewed evaluations occurring between 9/1/2016 and 3/31/2019. Results: Sixty-nine unique clinicians and 759 unique patients engaged in 865 completed telemedicine visits. For these, 118 surveys were completed and returned (14.03% of total visits), a similar response rate for other services. Average likelihood to recommend JeffConnect to a friend or colleague was 9.1 (scale 0-10). The majority of patients reported video visits saved them time (Figure 1) and money. For the subset of patients receiving the more detailed survey (n=30), average distance from SKCC at the time of the visit was 125 miles (range 10-963 miles, median 50) and average financial savings were $61.15 (range $8-$300, median $45). Conclusions: Scheduled cancer care video visits were feasible, resulted in high patient satisfaction, and saved patients time and money. Evaluating patient and clinician perceptions of the benefits of and barriers to telemedicine in greater detail is necessary for broader implementation. Patient-reported time saved by telemedicine. [Table: see text]

scholarly journals Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial

2016 ◽  
Vol 34 (6) ◽  
pp. 557-565 ◽  
Author(s):  
Ethan Basch ◽  
Allison M. Deal ◽  
Mark G. Kris ◽  
Howard I. Scher ◽  
Clifford A. Hudis ◽  
...  
Keyword(s):  
Usual Care ◽  
Cancer Care ◽  
Patient Reported Outcomes ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cancer Center ◽  
Symptom Monitoring ◽  
Outpatient Chemotherapy ◽  
Patient Reported ◽  
E Mail

Purpose There is growing interest to enhance symptom monitoring during routine cancer care using patient-reported outcomes, but evidence of impact on clinical outcomes is limited. Methods We randomly assigned patients receiving routine outpatient chemotherapy for advanced solid tumors at Memorial Sloan Kettering Cancer Center to report 12 common symptoms via tablet computers or to receive usual care consisting of symptom monitoring at the discretion of clinicians. Those with home computers received weekly e-mail prompts to report between visits. Treating physicians received symptom printouts at visits, and nurses received e-mail alerts when participants reported severe or worsening symptoms. The primary outcome was change in health-related quality of life (HRQL) at 6 months compared with baseline, measured by the EuroQol EQ-5D Index. Secondary endpoints included emergency room (ER) visits, hospitalizations, and survival. Results Among 766 patients allocated, HRQL improved among more participants in the intervention group than usual care (34% v 18%) and worsened among fewer (38% v 53%; P < .001). Overall, mean HRQL declined by less in the intervention group than usual care (1.4- v 7.1-point drop; P < .001). Patients receiving intervention were less frequently admitted to the ER (34% v 41%; P = .02) or hospitalized (45% v 49%; P = .08) and remained on chemotherapy longer (mean, 8.2 v 6.3 months; P = .002). Although 75% of the intervention group was alive at 1 year, 69% with usual care survived the year (P = .05), with differences also seen in quality-adjusted survival (mean of 8.7 v. 8.0 months; P = .004). Benefits were greater for participants lacking prior computer experience. Most patients receiving intervention (63%) reported severe symptoms during the study. Nurses frequently initiated clinical actions in response to e-mail alerts. Conclusion Clinical benefits were associated with symptom self-reporting during cancer care.

scholarly journals The Tablet-Based, Engagement, Assessment, Support, and Sign-Posting (EASSi) Tool for Facilitating and Structuring Sexual Well-Being Conversations in Routine Prostate Cancer Care: Mixed-Methods Study (Preprint)

2020 ◽  
Author(s):  
Eilís McCaughan ◽  
Carrie Flannagan ◽  
Kader Parahoo ◽  
John Connaghan ◽  
Roma Maguire ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Well Being ◽  
Routine Practice ◽  
Qualitative Synthesis ◽  
Semistructured Interviews ◽  
Sexual Concerns ◽  
Engagement Assessment

BACKGROUND Long-term side-effects associated with different prostate cancer treatment approaches are common. Sexual challenges are the most frequently occurring issues and can result in increased psychological morbidity. It is recognized that barriers to communication can make initiating discussions around sexual concerns in routine practice difficult. Health care professionals need to routinely initiate conversations, effectively engage with patients, and assess needs in order to provide essential support. One proposed method that could support health care professionals to do this involves the use of prompts or structured frameworks to guide conversations. OBJECTIVE This study aimed to assess feasibility, acceptability, and satisfaction with the tablet-based Engagement, Assessment, Support, and Sign-posting (EASSi) tool designed to facilitate and structure sexual well-being discussions in routine prostate cancer care. METHODS Health care professionals (n=8) used the EASSi tool during 89 posttreatment appointments. Quantitative data were recorded based on program usage and surveys completed by health care professionals and patients. Qualitative data exploring perceptions on use of the tool were gathered using semistructured interviews with all health care professionals (n=8) and a sample of patients (n=10). RESULTS Surveys were completed by health care professionals immediately following each appointment (n=89, 100%). Postal surveys were returned by 59 patients (66%). Health care professionals and patients reported that the tool helped facilitate discussions (81/89, 91% and 50/59, 85%, respectively) and that information provided was relevant (82/89, 92% and 50/59, 85%, respectively). The mean conversation duration was 6.01 minutes (SD 2.91). Qualitative synthesis identified the tool’s ability to initiate and structure discussions, improve the “depth” of conversations, and normalize sexual concerns. CONCLUSIONS The EASSi tool was appropriate and acceptable for use in practice and provided a flexible approach to facilitate routine brief conversations and deliver essential sexual well-being support. Further work will be conducted to evaluate the effectiveness of using the tablet-based tool in prostate cancer care settings.

CheckMate 459: Health-related quality of life (HRQoL) in a randomized, multicenter phase III study of nivolumab (NIVO) versus sorafenib (SOR) as first-line (1L) treatment in patients (pts) with advanced hepatocellular carcinoma (aHCC).

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 483-483
Author(s):  
Julien Edeline ◽  
Thomas Yau ◽  
Joong-Won Park ◽  
Masatoshi Kudo ◽  
Kwang-Hyub Han ◽  
...  
Keyword(s):  
Side Effects ◽  
Repeated Measures ◽  
Proportional Hazards ◽  
Unmet Need ◽  
Well Being ◽  
Cox Proportional Hazards ◽  
Phase Iii ◽  
Advanced Hepatocellular Carcinoma ◽  
Treatment Benefit ◽  
Patient Reported

483 Background: SOR is approved as 1L therapy for pts with aHCC, but there is still an unmet need to help improve or maintain HRQoL. This phase 3 study compared HRQoL of NIVO vs SOR as 1L therapy in pts with aHCC as an exploratory endpoint. Methods: FACT-Hep was administered cycle 1, day 1 and every other cycle. The effect of NIVO vs SOR on HRQoL using FACT-Hep was assessed via repeated measures mixed models (MMRM). Kaplan–Meier curves and Cox proportional-hazards models determined between-treatment differences in time to first and time until definitive deterioration (TTD/TUDD) based on prespecified thresholds for minimally important differences. The GP5 item from FACT-Hep was used to assess the burden associated with treatment side effects. Results: 743 pts with aHCC were randomized to NIVO (n = 371) or SOR (n = 372). Median OS was 16.4 mo for NIVO, 14.7 mo for SOR (HR 0.85 [95% CI 0.72–1.02]; P = 0.0752). ORR was 15% for NIVO, 7% for SOR (OR 2.41 [95% CI 1.48–3.92]). HRQoL scores were completed at baseline by 94.6% and 92.5% of participants, respectively, and were similar (FACT-Hep total: NIVO 140.7 [SD 21.5] and SOR 140. 6 [SD 19.1]. Questionnaire compliance rates exceeded 70% at most visits. MMRM analyses yielded clinically meaningful and statistically significant least squares means differences favoring NIVO on FACT-Hep total (10.1 [95% CI 7.3–13.0]), physical well-being (PWB; 2.0 [95% CI 1.4–2.6]), and functional well-being (FWB; 2.5 [95% CI 1.7–3.2]) scores. No sub-scales favored sorafenib. TTD was significantly delayed in NIVO for FACT-Hep total (HR 0.62 [95% CI 0.51–0.74]), PWB (HR 0.62 [95% CI 0.52–0.74]), FWB (HR 0.73 [95% CI 0.61–0.88]), and hepatobiliary cancer subscale (HR 0.57 [95% CI 0.48–0.69]). TUDD results were consistent with TTD. A greater proportion of NIVO pts did not experience increased burden of side effects (50%–67.7%) compared with SOR (26.8%–45%) based on the GP5 item. Conclusions: These patient-reported findings demonstrate that pts taking NIVO had superior HRQoL and reduced side effect burden, further supporting clinical data showing a treatment benefit for 1L NIVO in aHCC. Clinical trial information: NCT02576509.

Brain cancer and sexual health: A case report

2004 ◽  
Vol 2 (3) ◽  
pp. 315-318 ◽  
Author(s):  
MICHAEL L. KRYCHMAN ◽  
ALISON AMSTERDAM ◽  
JEANNE CARTER ◽  
MERCEDES CASTIEL ◽  
LISA DeANGELIS
Keyword(s):  
Case Report ◽  
Sexual Health ◽  
Cancer Patients ◽  
Brain Cancer ◽  
Terminal Illness ◽  
Clinical Signs ◽  
Recovery Phase ◽  
Laboratory Evaluation ◽  
Cancer Center ◽  
Sexual Concerns

Objective: Cancer patients often encounter sexual concerns during the diagnosing, treatment, and recovery phase of their illness. However, the sexual concerns of these patients are often overlooked. Brain cancer patients are no exception to this oversight.Methods: A case report of a 39-year-old patient with a history of high-grade anaplastic astrocytoma presented to the Sexual Health Program at the Memorial Sloan-Kettering Cancer Center complaining of vaginal discharge and several months of amenorrhea. Although the patient was administered extensive aggressive antineoplastic treatments, her disease rapidly progressed.Results: Despite the patient's terminal illness she continued to have normal sexual thoughts, feelings, and desires; however, she had difficulty discussing these issues with her partner and caregiver, who was her mother. An examination by the sexual medicine gynecologist noted no clinical signs of genital infections; however, there was minimal vaginal atrophy. Her sexual health laboratory evaluation was extensively abnormal. Her treatment consisted of intravaginal non-hormonal moisturizers and vaginal lubricants, counseling, and sexual education. The patient successfully engaged in sexual contact with her partner by the third counseling session.Significance of Results: Almost all oncology patients have sexual concerns during or following cancer treatment. These patients should be referred to comprehensive sexual health programs for treatment, if available.

scholarly journals Effects of Center-Based Delivery of Tai Chi and Qi Gong Group Classes on Self-Reported Symptoms in Cancer Patients and Caregivers

2020 ◽  
Vol 19 ◽  
pp. 153473542094160
Author(s):  
Gabriel Lopez ◽  
Santhosshi Narayanan ◽  
Aimee Christie ◽  
Catherine Powers-James ◽  
Wenli Liu ◽  
...  
Keyword(s):  
Tai Chi ◽  
Well Being ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Qi Gong ◽  
Cancer Symptoms ◽  
Significant Difference ◽  
Edmonton Symptom Assessment Scale ◽  
Clinically Significant ◽  
Global Distress

Background: There is increasing interest in complementary approaches such as Tai Chi (TC) and Qi Gong (QG) in oncology settings. We explored the effects of TC/QG delivered in group classes at a comprehensive cancer center. Methods: Patients and caregivers who participated in TC or QG completed assessments before and after an in-person group class. Assessments included questions about expectancy/satisfaction and common cancer symptoms (Edmonton Symptom Assessment Scale [ESAS]). ESAS distress subscales analyzed included global (GDS), physical (PHS), and psychosocial (PSS). Results: Three hundred four participants (184 patients, 120 caregivers) were included in the analysis. At baseline, caregivers had a greater expectancy for change in energy level as a result of class participation compared with patients (22.9% vs 9.9%). No significant difference was observed between baseline patient and caregiver PSS. Clinically significant improvement in well-being was observed among patients in TC classes (1.0) and caregivers in QG classes (1.2). For fatigue, patients (1.4) and caregivers (1.0) participating in QG experienced clinically significant improvement. Both TC and QG classes were associated with clinically significant improvements (ESAS GDS decrease ≥3) in global distress for patients (TC = 4.52, SD= 7.6; QG = 6.05, SD = 7.9) and caregivers (TC = 3.73, SD = 6.3; QG = 4.02, SD = 7.8). Eighty-nine percent of participants responded that their expectations were met. Conclusions: Patients and caregivers participating in TC or QG group classes were satisfied overall and experienced significant improvement in global distress. Additional research is warranted to explore the integration of TC and QG in the delivery of supportive cancer care.

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