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ABSTRACT Introduction: Acute myeloid leukemia (AML) is most commonly presented in older adults; however, it appears 10 years earlier in Latin American countries. Clinical evolution in older adults from this populations has not been characterized. We analyzed outcomes and survival predictors. Methods: Patients ≥ 55 years old diagnosed with AML at a hematology referral center from 2005 to 2020 receiving intensive chemotherapy (IC), low-dose cytarabine (LDAC) and best supportive care (BSC) were included. Survival analysis included the Kaplan-Meier and Cox models and the cumulative incidence of relapse (CIR). Results: Seventy-five adults were included and the overall survival (OS) was 4.87, 1.67 and 1.16 months, using IC, LDAC and BSC, respectively. The IC led to a higher OS (p < 0.001) and was a protective factor for early death, at a cost of more days spent hospitalized and more non-fatal treatment complications; non-significant differences were found between the LDAC and BSC. Eight (10.7%) patients underwent hematopoietic cell transplantation, with a higher OS (p = 0.013). Twenty (26.7%) patients achieved complete remission; 12 (60%) relapsed with a 6-month CIR of 57.9% in those < 70 years old vs. 86.5% in those ≥ 70 years old, p = 0.034. Multivariate analysis showed the white blood cell count (WBC) and IC had a significant impact on the patient survival, whereas chronological age and the Charlson comorbidity index (CCI) did not. Conclusion: AML in low-middle income countries demands a different approach; the IC improves survival, even with a high incidence of relapse, and should be offered as first-line treatment. Eligibility criteria should include WBC and a multidimensional evaluation. The age per se and the CCI should not be exclusion criteria to consider IC.
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Humans , Middle Aged , Aged , Leukemia, Myeloid, Acute , Hematopoietic Stem Cell Transplantation , Cytarabine , Drug TherapyABSTRACT
Polyembolokoilamania is a rare but serious medical condition that involves the presence of multiple foreign bodies in the patient's body. This condition can be challenging to diagnose and manage in the emergency department. In this chapter, we will discuss the presentation, diagnosis, and management of polyembolokoilamania in the emergency department.
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Objective:To explore the potential categories of post-operative supportive care demand trajectory for patients with non-small cell lung cancer (NSCLC), analyze the influencing factors, and propose targeted interventions.Methods:This was a prospective observational study. A convenient sampling method was used to select 177 NSCLC patients who received surgical treatment in Shanghai Lung Hospital Affiliated to Tongji University from January 2021 to February 2022. The Supportive Care Demand Scale for cancer patients was used to investigate the level of patients′supportive care demand 1 day before operation, 3 days after operation, 1 day before discharge, 1 week after discharge, 1 month after discharge, and 3 months after discharge, and the potential growth model was used to identify the trajectory category and multi category Logistic regression analysis was used to explore the influencing factors.Results:Three supportive care demand trajectories were fitted out in this study, which were the continuous high demand group (46.33%), the slowly decreasing demand group (30.51%), and the low decreasing demand group (23.16%). With the potential category group 3, low demand reduction group as the reference category, Logistic regression analysis showed that high psychological distress, low social support, high disease stage, high comorbidities were more likely to enter the continuous high demand group ( OR = 0.826 to 18.526, all P<0.05), and high education level (college education and above and high school) were more likely to enter the slowly decreasing demand group ( OR = 6.076, 4.199, both P<0.05). Conclusions:The demand track of NSCLC patients for supportive care after surgery has population heterogeneity. Clinical medical staff should provide personalized social support and emotional support for patients with high disease stage, more complications and low education level in the early postoperative period.
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Objective:To deeply explore the supportive care needs of patients with inflammatory bowel disease, in order to provide reference for the development of supportive care strategies.Methods:A qualitative description was conducted based on the supportive care needs framework. Objective sampling method was used to select 17 patients with inflammatory bowel disease from the First Affiliated Hospital with Nanjing Medical University from August to November 2021 for semi-structured in-depth interview and directed content analysis was used to analyze the interview data.Results:The final analysis yielded a total of 5 categories. These were physiological need, information need, practical (daily life) need, emotional and social support need, psychological and spiritual needs. They were all within the framework of supporting care needs.Conclusions:In the future, targeted education and diversified social support should be implemented based on the needs of patients with inflammatory bowel disease and from the perspectives of hospital, family members and peers.
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Abstract Objective To explore the main sexuality complaints of gynecologic cancer survivors after treatment and to identify the care strategies provided. Data Source Searches were conducted in six electronic databases: Scopus, Web of Science, LILACS, MEDLINE, PsychINFO, and EMBASE. Study Selection Articles published between 2010 and 2020 were selected and the following descriptors were used in the English language: female genital neoplasms and gynaecological cancer. The methodological quality of the studies used the Mixed Methods Appraisal Tool (MMAT). Data Collection The primary data extracted were: names of the authors, year of publication, country of origin, objective and type of study, data collection instrument, sample size and age range, types of cancer, and symptoms affected with the strategies adopted. Data Summary A total of 34 out of 2,536 screened articles were included. The main strategies found for patient care were patient-clinician communication, practices for sexuality care, individualized care plan, multiprofessional team support, and development of rehabilitation programs. For sexuality care, the most common practices are pelvic physiotherapy sessions and the use of vaginal gels and moisturizers. Conclusion The main complaints identified in the scientific literature were low libido and lack of interest in sexual activity, vaginal dryness, pain during sexual intercourse, and stenosis. Different care strategies may be adopted, such as follow-up with a multidisciplinary health team and sexual health rehabilitation programs, which could minimize these symptoms and ensure the quality of life of patients.
Resumo Objetivo Explorar as principais queixas da sexualidade com sobreviventes de câncer ginecológico após o tratamento e identificar as estratégias de cuidados prestados. Fonte dos Dados As buscas foram realizadas em seis bases eletrônicas: Scopus, Web of Science, LILACS, MEDLINE, PsychINFO e EMBASE. Seleção dos Estudos Foram selecionados artigos publicados entre 2010 e 2020 e os descritores utilizados (em inglês) foram female genital neoplasms e gynaecological cancer. A qualidade metodológica dos estudos utilizou a ferramenta Mixed Methods Appraisal Tool (MMAT). Coleta de Dados Os principais dados extraídos foram: nomes dos autores, ano de publicação, país de origem, objetivo e tipo de estudo, instrumento para coleta de dados, tamanho da amostra e faixa etária, tipos de câncer, os sintomas acometidos e as estratégias adotadas. Síntese dos Dados Dos 2,536 artigos identificados, 34 foram incluídos. As principais estratégias encontradas para os cuidados aos pacientes foram a comunicação paciente-médico, práticas para os cuidados sexuais, plano de cuidados individualizado, apoio a equipes multiprofissionais e desenvolvimento de programas de reabilitação. Para os cuidados de sexualidade, as práticas mais comuns são sessões de fisioterapia pélvica e o uso de géis vaginais e hidratantes. Conclusão As principais queixas identificadas na literatura científica foram baixa libido e falta de interesse na atividade sexual, secura vaginal, dor durante a relação sexual e estenose. Diferentes estratégias de cuidados podem ser adotadas, como o acompanhamento com uma equipe de saúde multidisciplinar e programas de reabilitação da saúde sexual, as quais poderiam minimizar estes sintomas e garantir a qualidade de vida dos pacientes.
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Humans , Female , Sexuality , Needs Assessment , Cancer Survivors , Genital Neoplasms, FemaleABSTRACT
Objective:To develop the supportive care information platform based on full cycle needs of patients and explore the application effect of platform in hemiplegia patients with ischemic stroke.Methods:Based on the supportive care scheme for patients with ischemic stroke in the previous study of the research group, combined with literature review and expert group discussion, the supportive care information platform version 1.0 was developed. After 5 patients with ischemic stroke hemiplegia tried for 3 weeks, it was optimized and upgraded to version 2.0 according to the use experience. From June to December 2020, 64 patients with acute ischemic stroke hemiplegia in the Department of Neurology of the First Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Soochow University hospital were randomly divided into intervention group and control group, 32 cases in each group. Barthel Index and balance ability were compared between the two groups. The control group received supportive care plan, and the intervention group received supportive care information platform.Results:After the intervention, the scores of Barthel index in the intervention group were 85 (75,90), 95 (95,100) at 1 and 3 months of illness, which were significantly higher than 65 (55,75), 75 (70,85) in the control group ( P<0.05). After intervention, the scores of balance ability in intervention group were 37 (28,43), 48 (45,51) at 1 and 3 months after illness, which were significantly higher than 28 (16,36), 31(20,37) in control group ( P<0.05). After the intervention, the scores of stroke related knowledge in the intervention group one day before discharge, one month after illness and three months after illness were 14.97 ± 2.98, 19.00 ± 2.14, 22.81 ± 1.60, which were significantly higher than those in the control group (8.69 ± 1.64), (8.88 ± 1.52), (9.09 ± 1.61) ( t values were 109.37-1 169.84, P<0.05). Conclusions:The application of supportive care information platform can provide targeted nrusing measures for patients at different stages of disease development. The platform has good feasibility, and can significantly improve patients′ Barthel index, balance ability and stroke related knowledge, which shows that the platform has good feasihility and clinical application value.
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Music therapy is an integrative oncology practice that has been rapidly emerging, over the past two decades, as a field of its own, clinically and academically. The randomized controlled trials that evaluate the clinical impact of music therapy are growing in number, and at the same time, there has been progress in understanding the neurobiological mechanisms that underly the beneficial effects of music therapy. Cultural background and autobiographical memories may uniquely influence music perception and cognition. It is vital to personalize music therapy because music preferences are unique; one size does not fit all. Cognitive music science studies and clinical music therapy trials that study individualized music choices will serve as a vital step forward in providing patient-directed personalized integrative cancer care. The field of music therapy is advancing, and its ability to improve a patient's quality of life can be understood only through robust, personalized, evidence-based initiatives that focus on research, advocacy, education, and delivery of care.
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Humans , Integrative Oncology , Music/psychology , Music Therapy , Neoplasms/therapy , Quality of LifeABSTRACT
Five cases of various diseases associated with breast cancer treatment including arthralgia, menopausal symptoms, chemotherapy-associated symptoms (nausea, vomiting, numbness, pain, general fatigue), and anxiety neuroses during follow-up were treated with Kampo medicine and a favorable course was obtained. Combined use of Kampo treatment can reduce the suffering caused by the side effects of breast cancer treatment, alleviate mental symptoms, prevent recurrence, and improve the patients' health. Kampo medicine plays a role in cancer supportive care for breast cancer.
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Objective:To investigate the levels of supportive care needs of patients with psoriasis, and to master the unmet care needs of psoriasis patients, so as to provide reference for the development of personalized care plan for patients with psoriasis.Methods:The convenience sampling method was used to investigate the inpatients with psoriasis from April to May in 2020 by using the Support Care Needs Scale-Short Form 34 (SCNS-SF34). The patients came from 15 dermatology hospitals and tertiary general hospitals with dermatology inpatients of 14 provinces and municipalities.Results:The total scores of each item of SCNS-SF34 were as followed: health information needs was 35.72 ± 14.14, the psychological needs was 28.07 ± 11.37, the physical and daily life needs of was 13.03 ± 5.85, the care and support needs was 14.34 ± 6.07, the sexual needs was 6.75 ± 3.47.Conclusions:Psoriasis patients in many ways are not satisfied with the need for care. Patients should receive personalized professional psychological guidance. In order to meet the patients' nursing and support needs, including sexual needs, physiological needs and daily needs, attention should be paid to and innovative access to health information and disease guidance knowledge.
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Inspite of so many available health facilities, humans are unable to prevent preterm deliveries may be because of evolution process for increasing intelligence in Human species. Now a days most of the preterm babies are surviving due to antenatal steroid coverage, with advancement of health care facilities. As authors are unable to replace the nature and create in utero environment, Kangaroo mother care is a simple but most effective way of developmental supportive care. Here baby is exposed to some known and similar environment like in utero. Preterm survival without morbidity and com-promised quality is an important than survival alone. As preterm organs are still in a developing stage particularly central nervous system where organization, synapse formation still occurring hence enriched environment is necessary for optimal development. In kangaroo care baby usually meet enriched environment, here authors are giving a brief review of Kangaroo Care because of more evidence was there but still not practicing fully in many centers where needed particularly in developing countries. That's why authors are adding from their side.
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This study summarizes the clinical achievement in key technologies of cancer supportive care. 1) Conceptual change. Medical teams now recognize supportive care as the core of comprehensive treatments for cancer. Supportive care is widely implemented clinically. 2) Team composition and operation mode. The program shapes an ideal supportive care team. The ideal team shall operate as one of the three models: solo practice model, congress practice model, or integrated care model according to the actual situation. 3) Scope of work. Supportive care team provides patients with spiritual care, pharmacologic assist, exercise guidance, nutritional support, effective communication, emotional support, and rehabilitation consultation. Efforts have been made to set up demonstrative wards that are free of pain, bleeding, thrombosis, hunger, and depression nationwide. 4) Standardized pain management for cancer patients. To optimize pain management, a multidisciplinary team is formed, an outpatient follow-up system is set up, and the focus is put on cancer pain education and policy advocacy. 5) A system of nutritional diagnosis and treatment. It urges the bi-diagnosis of cancer and malnutrition for inpatients and leads the proposal of the three-level diagnosis and five-ladder therapy for malnutrition. 6) Extension and expansion of supportive care out of the hospital. The program proposes the hospital-community-home management model, an integrated model for comprehensive nutritional therapy. 7) Emphasis on the quality of life. A new quality of life assessment method for cancer patients and a survival prediction model for end-stage cancer patients are established. 8) Comprehensive nursing care. It integrates spiritual care into the care of cancer patients. A management platform for continuous care service is developed with the help of internet technology and virtual reality.
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Objective To evaluate the reliability and validity of the Chinese version of the Supportive Care Needs Survey (SCNS-SF34) in patients with prostate cancer. Methods The Chinese version of SCNS-SF34 was translated and revised . The exploratory factor analysis was used to assess the structural validity of the tool, and the Cronbach α coefficient was used to evaluate the reliability of the scale. Results Two items of the Chinese version of SCNS-SF34 were deleted. Five factors were extracted by principal component analysis, including psychological, health systems and information, patient care and support, physical and daily living and sexuality needs. It was consistent with the structure of original scale. The cumulative variance contribution rate reached 70.500% . Except for item 17, the maximum load value was<0.4, and the other item load values were>0.4. The total Cronbach α coefficient of the questionnaire was 0.929, and the Cronbach α coefficient was 0.780-0.940. Conclusions The Chinese version of SCNS-SF34 has good psychometric properties and it can be used to assess the supportive care needs for patients with prostate cancer in China.
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OBJECTIVES: Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients' quality of life, disease progress, and survival. METHODS: The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design. RESULTS: The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I² =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity. CONCLUSIONS: Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.
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Female , Humans , Breast Neoplasms , Breast , Cohort Studies , Comorbidity , Depression , Iran , Population Characteristics , Prevalence , Publications , Quality of Life , Sample Size , SurvivorsABSTRACT
Objective@#To evaluate the reliability and validity of the Chinese version of the Supportive Care Needs Survey (SCNS-SF34) in patients with prostate cancer.@*Methods@#The Chinese version of SCNS-SF34 was translated and revised. The exploratory factor analysis was used to assess the structural validity of the tool, and the Cronbach α coefficient was used to evaluate the reliability of the scale.@*Results@#Two items of the Chinese version of SCNS-SF34 were deleted. Five factors were extracted by principal component analysis, including psychological, health systems and information, patient care and support, physical and daily living and sexuality needs. It was consistent with the structure of original scale. The cumulative variance contribution rate reached 70.500%. Except for item 17, the maximum load value was <0.4, and the other item load values were >0.4. The total Cronbach α coefficient of the questionnaire was 0.929, and the Cronbach α coefficient was 0.780-0.940.@*Conclusions@#The Chinese version of SCNS-SF34 has good psychometric properties and it can be used to assess the supportive care needs for patients with prostate cancer in China.
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OBJECTIVES: Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients' quality of life, disease progress, and survival.METHODS: The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design.RESULTS: The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I² =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity.CONCLUSIONS: Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.
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Female , Humans , Breast Neoplasms , Breast , Cohort Studies , Comorbidity , Depression , Iran , Population Characteristics , Prevalence , Publications , Quality of Life , Sample Size , SurvivorsABSTRACT
Purpose: Cancer survivors often lack the knowledge and skills to return to positive health behaviors following a cancer diagnosis. The use of retreats may be an ideal environment for cancer survivors to learn about health behaviours while receiving social support from other survivors. Methods: Knights Cabin Cancer Retreats was created as a charitable organization in 2014 and is at no cost to participants or their supporters. Elements of the retreat include guided hikes, yoga, classes on nutrition, stress, mindfulness and sleep management techniques, all with a focus on the evidence based theories of behavioral change. Results: Ten retreats have been hosted across Canada to date with 137 cancer survivors and their supporters. Survivors reported that their top learning outcomes from the retreat were physical activity/nutrition and behavioral change/habit development. Conclusion: Knight's Cabin Cancer retreats are unique in their programming with a format of health education that allows for emotional support and engagement with other cancer survivors in a therapeutically natural environment.
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Patient Education as Topic , Cancer Survivors , Quality of Life , Self-Help Groups , Canada , Exercise/psychology , Community ParticipationABSTRACT
Objective To investigate the supportive care needs of liver cancer patients after interventional therapy and its influencing factors. Methods A total of 228 patients with primary liver cancer treated by interventional therapy were included. General demographic characteristics and clinical data were collected, and a questionnaire survey was conducted using 34 items of cancer patients' supportive care needs, a brief questionnaire(SCNS-SF34), Self-rating an Anxiety S cale(SAS)and a Self-rating Depression Scale(SDS). Multiple regression models were used to analyze the impact factors of demand domain score. Results The score of psychological needs, health systems and information needs, physiological and daily life needs, patient care and support needs, sexual needs of patients with liver cancer intervention were 3.15±1.31, 3.08±1.16, 2.96± 1.44, 2.60 ±1.09, and 2.60 ±1.09, rescpectively. Anxiety and depression were found in 37.19% and 46.31% of patients, respectively. The average scores of SAS and SDS were 46.79 and 51.49. Multiple linear regression analysis showed that the psychological needs of patients with scores of age and education were negatively correlated. SAS score of patients with mental health score system and demand, information demand and demand areas were positively correlated. Women patients with high SDS scores, has high score of physical and daily life needs . The score of patient care and support were positively correlated to clinical requirements in the field of TNM stage. Conclusion The medical staff should support the intervention for the different demands and the bad mental state of the patients after liver cancer interventional surgery, and effectively improve the patient's compliance and improve their quality of life.
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Objective To observe the level of supportive care need and quality of life in patients postoperation for breast cancer and ac-cepting chemotherapy, and the relationship between them. Methods From September, 2015 to June, 2016, 235 patients with breast cancer af-ter surgery were conveniently sampled, and investigated with the general situation questionnaire, Supportive Care Need Survey Short-form (SCNS-SF34) and Functional Assessment of Cancer Therapy-Breast (FACT-B). Results A total of 230 patients were analyzed. Patients self-reported to need supportive care in all dimensions of SCNS-SF34, and the most frequency was in the health information (31.30％). The score of FACT-B was (93.25±23.53), that needed further improvement. The needs of supportive care in each dimension negatively correlat-ed with the scores of FACT-B in the dimensions (|r|>0.168, P<0.05) except society/family and function. Conclusion The patients with breast cancer need variety of supportive care, which may impact their quality of life.
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Breast cancer is the most common cancer among females. During the time of treatment and rehabilitation, the patients and their relatives need to help them to prevent, control or relieve all sorts of complications and adverse events that beyond their medical, surgi-cal or radiation interventions, called Supportive Care Need. There are many tools to evaluate these needs, such as Supportive Care Need Sur-vey, Cancer Patients Needs Questionnaire, etc., and mainly involved the needs of health system, information, patient support, psychology, physical and daily living, and sexuality, varied with the factors of social demography, disease and treatment, and psychology;and the inter-ventions contain cognitive behavior and psychology.
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@#This case involved periodontal supportive care after non-surgical management of localized, severe chronic periodontitis (possibly with a history of aggressive periodontitis) and periodontal abscess. This included maintaining the current periodontal health, and rehabilitation of patient’s oral function and aesthetic concern using simple, economical and reversible direct restorations without further damaging the patient’s dentition for example composite resin as splint. Besides that, to address the patient’s complaint of unsightly gaps in between the teeth, an acrylic gingival prosthesis with denture tooth incorporated was constructed.