Information needs across time after a hematological cancer diagnosis: A qualitative study of patient and clinician perspectives.

OBJECTIVE: The aim of this study was to characterize the information needs experienced by adult patients across the continuum of their hematological cancer. METHODS: Individual semi-structured telephone interviews were conducted with 28 adults with hematological cancer and 18 clinicians recruited from across Canada and analyzed using interpretive description. RESULTS: Distinct information needs were organized across seven points of the cancer continuum: prior to diagnosis, at diagnosis, prior to treatment, during treatment, after treatment, relapse/non-response, and end of life. Patients' information needs reflected a desire to better understand their current physical and psychosocial circumstances, as well as how to make decisions about their treatment, self-management, and health care. The need to receive information in a preparatory way was relevant across all phases of the cancer continuum. CONCLUSION: Our work contributes an initial approach for providing patient education and counselling for people with hematological cancers, which can be tailored based on individuals' unique characteristics and treatment pathways. PRACTICE IMPLICATIONS: Adults with hematological cancers require information to support decision making over the course of their diagnosis, treatment, and survivorship, but can experience information overwhelm. These findings provide an approach for organizing the delivery of information based on different points of need across the cancer continuum.

Exploring the needs of children and caregivers to inform design of an artificial intelligence-enhanced social robot in the pediatric emergency department.

Background & Objective: Socially assistive robots (SARs) are a promising tool to manage children's pain and distress related to medical procedures, but current options lack autonomous adaptability. The aim of this study was to understand children's and caregivers' perceptions surrounding the use of an artificial intelligence (AI)-enhanced SAR to provide personalized procedural support to children during intravenous insertion (IVI) to inform the design of such a system following a user-centric approach. Methods: This study presents a descriptive qualitative needs assessment of children and caregivers. Data were collected via semi-structured individual interviews and focus groups. Participants were recruited from two Canadian pediatric emergency departments (EDs) between April 2021 and January 2022. Results: Eleven caregivers and 19 children completed 27 individual interviews and one focus group. Three main themes were identified: A. Experience in the clinical setting, B. Acceptance of and concerns surrounding SARs, and C. Features that support child engagement with SARs. Most participants expressed comfort with robot technology, however, concerns were raised about sharing personal information, photographing/videotaping, and the possibility of technical failure. Suggestions for feature enhancements included increasing movement to engage a child's attention and tailoring language to developmental age. To enhance the overall ED experience, participants also identified a role for the SAR in the waiting room. Conclusion: Artificial intelligence-enhanced SARs were perceived by children and caregivers as a promising tool for distraction during IVIs and to enhance the overall ED experience. Insights collected will be used to inform the design of an AI-enhanced SAR.

Do ASD and ADHD Have Distinct Executive Function Deficits? A Systematic Review and Meta-Analysis of Direct Comparison Studies.

OBJECTIVE: To evaluate if children and adolescents with a diagnosis of ASD or ADHD have distinct executive function (EF) profiles. METHODS: Peer-reviewed articles comparing ASD, ADHD, and typically developing individuals under 19 years of age were identified. The domains evaluated were: working memory, response inhibition, planning, cognitive flexibility, attention, processing speed, and visuospatial abilities. RESULTS: Fifty-eight articles met inclusion criteria. Analyses were performed on 45 performance metrics from 24 individual tasks. No differences in EF were found between individuals diagnosed with ASD and ADHD. Individuals diagnosed with ASD and ADHD exhibited worse performance in attention, flexibility, visuospatial abilities, working memory, processing speed, and response inhibition than typically developing individuals. Groups did not differ in planning abilities. CONCLUSION: Children and adolescents with ASD and ADHD have similar EF profiles. Further research is needed to determine if comorbidity accounts for the commonality in executive dysfunction between each disorder.

The effect of mind-body exercise on cognitive function in cancer survivors: A systematic review.

Objective: Cancer-related cognitive impairments experienced by cancer survivors cause many to seek non-pharmacological intereventions to manage these symptoms. The aim of this systematic review was to evaluate the effects of one such intervention, mindbody exercise (MBE), on cognitive function in cancer survivors. Design: Searches for relevant studies were conducted in four electronic databases, including PubMed, Embase, Scopus, and Web of Science. The Joanna Briggs Institute and Jadad scales were utilized to evaluate the quality of the selected studies. Results: Eleven studies including 1,032 participants, published between 2006 and 2019, were selected for review based on specific inclusion criteria. Our results indicated that interventions including, yoga, tai chi, and qigong may improve objective and subjective cognitive function in cancer survivors. Conclusion: Cancer survivors experiencing cognitive symptoms may benefit from participation in MBE. Adequately powered randomized controlled trials are required to establish the short- and long-term effects of MBE on cognitive functioning.

Patterns of Concerns Among Hematological Cancer Survivors.

BACKGROUND: Advances in treatment for hematological cancers warrant greater attention on survivorship concerns. OBJECTIVE: The aims of this study were to describe survivorship concerns among hematological cancer survivors, identify subgroups of survivors with distinct classes of concerns, and examine sociodemographic and clinical differences across subgroups. METHODS: We conducted a cross-sectional analysis of data from 1160 hematological cancer survivors, who rated their degree of concern regarding 20 physical, emotional, and practical changes. Clusters of concerns were identified using latent class analysis. Associations between respondent characteristics and cluster membership were calculated using multinomial logistic regression. RESULTS: Survivors had a mean of 7.5 concerns (SD, 4.6; range, 0-19), the most frequent being fatigue/tiredness (85.4%); anxiety, stress, and worry about cancer returning (70.2%); and changes to concentration/memory (55.4%). Three distinct classes of concerns were identified: class 1 (low, 47.0%), characterized by low endorsement of most concerns, apart from fatigue; class 2 (moderate, 32.3%), characterized by high endorsement of a combination of concerns across domains; and class 3 (high, 20.7%), characterized by the highest number of concerns out of the 3 identified classes, including greater endorsement of concerns relating to sexual well-being. Class membership was differentiated by survivor age, sex, marital status, and diagnosis. CONCLUSIONS: Three distinct patterns of concerns were detected in a large sample of hematological cancer survivors. Patterns of concerns could be differentiated by survivor characteristics. IMPLICATIONS FOR PRACTICE: Our study highlights the concerns experienced by hematological cancer survivors and provides support for a tailored biopsychosocial approach to survivorship care in this context.