bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of the palliative care preferences scale (PCPS).
Authors: Perry Laura M , Kazan Adina S , Rogers James Louis , Hoerger Michael 
Published: November 2018

151 Background: Research has not thoroughly examined patient-level factors such as perceptions that could contribute to underutilization of palliative care, which may be due in part to a lack of existing measures for this purpose. Therefore, this investigation aimed to develop and validate a 9-item measure called the Palliative Care Preferences Scale (PCPS-9), which was comprised of three subscales: emotional, cognitive, and behavioral. Methods: Data were collected in three separate online studies of individuals with cancer (study 1: N = 633; study 2: N = 462) or one of the following non-cancer serious illnesses: COPD, heart failure, or kidney failure (study 3: N = 248). Analyses assessed various psychometric properties of the scale in cancer and non-cancer patients, including internal consistency reliability, confirmatory factor analyses (CFAs), multigroup CFAs, and convergent validity associations with related constructs. Results: Across all three studies, results supported the internal consistency reliability for the total scale (αs from 0.76 to 0.83) and subscales: emotional (αs from 0.83 to 0.84), cognitive (αs from 0.60 to 0.77), behavioral (αs from 0.87 to 0.91). CFAs supported the three-factor model of the PCPS-9 (CFI ≥ 0.97, NNFI ≥ 0.96, RMSEA ≤ 0.07, SRMR ≤ 0.04), and a multigroup CFA supported the generalizability of its factor structure across cancer and non-cancer serious illness subgroups (ΔCFIs ≤ 0.006, ΔRMSEA ≤ 0.003). Finally, convergent validity analyses in studies 2 and 3 found that the PCPS-9 was significantly associated with related constructs, including a separate measure of palliative care preferences ( ps < 0.001) and a measure of palliative care knowledge ( ps < 0.001). Conclusions: Findings support the overall reliability and validity of the PCPS-9 in cancer and non-cancer serious illness samples and have implications for increasing palliative care utilization via clinical care and future research efforts.
Nurses and health care assistants: Evaluation of attitude towards the care of patients who are terminally ill with cancer.
Authors: Lopane Diego , Pavesi Carlotta , Arcanà Concetta , Morazzoni Gaia , Lopane Diego , Ferrari Stefano , Giuffrè Santina , Poggio Chiara , Banfi Daria , Lamiani Giulia , Saetta Annalisa , Rimassa Lorenza , Santoro Armando 
Published: November 2018

158 Background: Terminally ill cancer patients (pts) are often hospitalized in the last 3 months of life, and a large number of them die in hospital. They require specific care provided by a team of health professionals with expertise in palliative (PC) and end-of-life care (EoLC). The aim of this analysis is to investigate the attitudes of nurses (Ns) and health care assistants (HCAs) towards terminally ill patients in a Cancer Center (CC). Methods: From July to November 2017 we applied the Frommelt Attitudes Toward Care of the Dying FORM-B Scale (FATCOD) to Ns and HCAs working in a CC, situated in a metropolitan area in Italy. FATCOD is a validated tool in its Italian version, composed of 30 questions investigating 6 specific areas: Fear (Fe), Communication (Co), Relationship (Rs), Care of the family (CoF), Family as Caring (FaC), Active Care (Ac). Each question has 5 answer options: strongly disagree, disagree, don’t know, agree, strongly agree, with scores from 1, negative, to 5, positive attitude. The total score ranges from 30 to 150. Results: We administered 116 questionnaires, 102 (87.9%) were completed. 81 Ns were involved (79.4%, 31/50 males/females) and 21 HCAs (20.6%, 4/17 males/females). The median age of Ns was 39 years (range 20-50) and 43 for the HCAs (range 30-50). The median duration of employment was 10 years for both groups (range 0-20). The median score achieved by both groups was 110.3 (range 78-140). Ns obtained a score of 112.1 (range 98.7-125.5), HCAs of 103.4 (range 89.4-117.7). Our analysis shows a positive attitude in both groups across 3 areas ( FaC, CoF, AC) and a negative one in others (Fe, Co, Rs), with a statistically significant concordance between the 2 groups (p=0.0037). Conclusions: Data shows NS and HCAs negative attitude in 3 important areas, with scores below the average results reported in literature. Based on our results, we proposed some intervention strategies. We organized periodic meetings with our psychologists. Our Institution introduced the PERCS ( Program to Enhance Relational and Communication Skills) and specific programs in medical and nursing schools of our university, favoring the earliest approach to PC and EoLC. We also provided seminars in PC to Ns and HCAs working in the CC.
The efficacy of psycho-oncological intervention on anxiety and depression in gastrointestinal tumor patients.
Authors: Mangelsen Sophie , Kadur Nancy , Stuebs Patrick 
Published: November 2018

160 Background: We aimed to investigate the degree of anxiety and depression associated with the physical consequences of gastrointestinal tumors in relation to the treatment situation. Methods: 104 patients undergoing chemotherapeutic treatment were included in the study. The efficacy of the interventions and the changes in the stress level were evaluated by using the Hospital Anxiety and Depression Scale. Additionally, three intervention groups in individual setting: Conversational, relaxation and psycho-educational. Results: We demonstrate that overall the gastrointestinal patients were psychologically strained by anxiety and depression before the start of psycho-oncological intervention (at the beginning of chemotherapy). MA_t1 = 6,61 ( mA_t1_curative = 6,55 ; mA_t1_palliative = 6,64); η 2 A_t1 = 0,667; MD_t1 = 6,68 ( mD_t1_curative = 6,28 ; mD_t1_palliative = 6,88). Palliative patients seemed to be more strained in descriptive terms than patients in curative treatment situation. We determined an increase in a clinically relevant cutoff of about 32 % (anxiety) to about 54 % (depressiveness) in both pre-post survey groups. Anxiety and depressiveness showed a declining trend towards the end of the intervention or chemotherapy, independent of the curative or palliative treatment situation. Differential effects in effectiveness on anxiety and depression levels were observed between the various interventions ( p > .05). A significant decrease in anxiety towards the end of chemotherapy was empirically evident only in patients in adjuvant treatment ( MA_t1 = 6.95; Mt2 = 4.97; p > .016), we did not observe any correlation with the interventions. In addition, a reduction in both anxiety and depressiveness was found in the relaxation group in patients in adjuvant treatment. Conclusions: Our data demonstrates the importance of relaxation and discussion intervention over a purely psycho-educative intervention. A particular strength of our study lies in its longitudinal design and in its focus on a group of patients with exclusively gastrointestinal tumors. Further studies are needed to optimize the therapeutic potential of relaxation and discussion intervention in gastrointestinal cancer.
Electronic distress screening for early symptom identification and management.
Authors: Meadors Patrick , Meadors Pamela , York Beth , Walsh Declan 
Published: November 2018

170 Background: Sustainable comprehensive screenings for cancer-related symptoms and distress is a challenge for large multisite cancer centers. Technological solutions are necessary to compile patient-reported outcomes at institutions with high volumes across broad geographic regions. Interdisciplinary collaboration and leadership engagement is required to effectively screen for and manage symptoms. Once integrated, electronic distress screening (EDS) produces large symptom databases for management of cancer related symptoms, strategic programmatic growth, and research. Methods: System-wide (n=44 clinic locations) implementation of EDS at consultation visits and simulations occurred in phases between November 2016-Dec 2016. EDS content, clinical sensitivity thresholds, and referral processes were developed with input from Supportive Oncology Department. Automatic alerts via email based on clinical thresholds developed and various symptoms profiles used to aid referrals to supportive oncology resources. Information and Analytic services ensured clinical integration into the EMR, delineation by clinic site, and troubleshooting. Ongoing completion rate tracked and sent to all practice managers. Results: The network-wide EDS completion rate for January 2017-June 2018 is 69% (26,564 completed out of 38,435 eligible patient encounters). Mean completion time per patient was 8 minutes. 84% of clinic sites (n=37) screened >50% of eligible patients and 46% of clinics (n=20) screened >75%. Triggered referral rates were established for all supportive oncology sections (e.g. 60% of patients reported clinically significant distress and 18% indicated being at risk for malnutrition). All screening data available for ongoing analysis. Conclusions: EDS can be integrated as a solution for distress and cancer related symptoms in multisite cancer centers. Interdisciplinary collaboration is needed to ensure clinical relevance. Phased rollouts, structured education, and completion rate dashboards help establish leader buy-in and consistent symptom screening. Such symptom databases allow large cancer hospital networks to strategically allocate limited resources based on highest volume/acuity/symptom profiles.
Predictors of quality of life, symptoms of anxiety, and depression in Latino patients with cervical cancer.
Authors: Galindo Vazquez Oscar , Menes Mayra CU , Ortiz David , Meneses-Garcia Abelardo , Aguilar Jose Luis , Montalvo-Esquivel Gonzalo , Gómez Ángel Herrera , Caballero-Tinoco Rosario 
Published: November 2018

171 Background: Cervical cancer is considered one of the most frequent cancers among women and with the greatest causes of death in the world. In Mexico it is considered the second cause of death. Objective: The identify predictors of quality-of-life, symptomatology of anxiety and depression in patients with cervical cancer. Methods: 192 patients with cervical cancer aged between 44 and 60 years were included, through interview and consultation of the clinical file, information on sociodemographic and clinical variables were obtained. Instrument: European Organization Scale for Cancer Research and Treatment and Quality of Life (EORTC QLC-C30) and Hospital Anxiety and Depression Scale (HADS). Statistical analysis: Chi square or Fisher´s exact test. The association of the variables was evaluated by logistic regression analysis. Results: 48% had poor quality of life, 24% with depression, and 29% with anxiety.The predictors of a low quality of life are: presenting one or more comorbidities, family history with cancer, presenting anxious, and depressive symptoms Conclusions: Psychological assumptions are predictors of variables such as quality of life, in a population with cervical cancer, in Mexico this group of patients have low educational and economic levels. Psychosocial care programs are required in this group of Latina women.
Addressing health disparities in survivors of breast cancer through lifestyle modifications and group support.
Authors: McDunn Susan H. , Olorunfemi Olatokunbo , Rogowski Wendy , Tahsin Bettina , James Venita , Giese Karen , Miranda- Ocasio Harry , Fogelfeld Leon 
Published: November 2018

177 Background: Obesity and inactivity have been shown to adversely affect outcomes in survivors of breast cancer. These factors may contribute to poorer outcomes in women of black and Hispanic populations, and those from lower socioeconomic backgrounds. We sought to improve overall well-being and limit weight gain in patients from these underserved populations through a group lifestyle intervention in a public hospital setting. Methods: 46 women were recruited and gave informed consent after completion of adjuvant chemotherapy for stage I-III breast cancer to participate in this feasibility pilot program. Blood work, body measurements, diet, two-minute walk tests, and PHQ9 depression scores were collected at the first and last of six monthly sessions. The group classes were led by a registered dietician and included diet and light exercise instruction at each visit. Results: Patient demographics and results are in the table below. Trends for non-completers included younger age, ethnicity, no hormonal therapy, lower baseline weight, lower HOMA IR, and dropout after two sessions. Among the 40% who completed all six sessions, there was a trend toward greater well-being (lower PHQ) with slight weight gain and increased insulin resistance. Completers tended to start in the same cohort and were more likely to complete if they attended more than two visits. Conclusions: Greater well-being may be an important outcome for group lifestyle improvement programs in populations with disparities. Motivations for better attendance may include group bonding. Participants will continue to be followed to obtain information on long-term weight change and cancer recurrence.[Table: see text]
A systematic review of symptom experiences in survivors of colorectal cancer.
Authors: Han Claire J , Yang Gee-Su , Reding Kerryn , Syrjala Karen L 
Published: November 2018

186 Background: Colorectal cancer (CRC) is the third most common cancer diagnosis in the US. With expanding survival rates, increasing numbers of CRC survivors live with long-term disease and treatment-side effects. There is limited research about symptom experiences from which to provide evidence-based symptom management guidelines for CRC survivors. This study systematically reviews published studies on symptoms in CRC survivors, with an aim to understand symptom experiences and with a broad goal of developing effective symptom interventions and improving CRC survivorship. Methods: A systematic search for relevant studies between the years 2005-2018 was conducted with Scopus, CINAHL, Medline via PubMed, Web of Science, EMBASE, Cochrane Library (CENTRAL), and PsycINFO. A systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Results: Of an initial 588 unique studies, 33 were identified for inclusion in the systematic review. The majority of studies were conducted in the UK or had a cross-sectional design. The European Organization for Research and Treatment of Cancer Quality of Life-C30 was the most frequently used instrument to assess symptoms. When we converted symptom severity scores and symptom occurrences among CRC survivors on a 0-100 scale, the most severe and frequently reported symptom across the 33 studies was fecal incontinence (mean severity: 50 points; mean occurrence: 52%), followed by fatigue (mean severity: 49 points; mean occurrence: 44%). Patients who reported lack of symptom management information, poor family and social supports, and presence of a stoma also reported more frequent and more severe symptoms. Symptom experiences were correlated with poor quality of life, low physical activity, daily life interferences, problems with sexual relationships, financial concerns, and negative body image. Conclusions: CRC survivors experienced a unique set of symptoms. Research is needed on symptom trajectories across the cancer continuum, strategies to incorporate family and other social supports for managing symptoms, and to enhance communication between oncologists, patients and caregivers that will support improved symptom control.
Incidence of skeletal-related events in men with castration-resistant prostate cancer.
Authors: Kawai Alison Tse , Martinez David , Saltus Catherine W. , Vassilev Zdravko , Soriano-Gabarro Montse , Kaye James A. 
Published: November 2018

188 Background: Skeletal-related events (SREs) are common in men with bone metastases and have negative consequences for patients with castration-resistant prostate cancer (CRPC), including pain, reduced quality of life, and increased risk of death. Published data on background rates of SREs in men with CPRC in real-world practice are sparse. Methods: We included men aged ≥ 65 years in the SEER-Medicare database with a prostate cancer diagnosis in 2000-2011 if they had no prior malignancy, had surgical or medical castration, and met protocol-defined criteria for castration resistance. Castration resistance was inferred from subsequent treatment with any of these systemic therapies: abiraterone, cabazitaxel, docetaxel, enzalutamide, mitoxantrone, or sipuleucel-T. The first occurrence of an SRE was identified in Medicare claims using diagnosis or procedure codes for fracture, bone surgery, radiation therapy, or spinal cord compression. We estimated incidence rates (IRs) of SREs in all eligible person-time and stratified by person-time before and after any use of the following bone-targeted agents (BTAs): alendronate, denosumab, ibandronate, pamidronate, risedronate, or zoledronic acid. Results: Of 2,234 men with CRPC (84% white, mean age 76.6 years), 896 (40%) had an SRE during follow-up, with 74% occurring within a year after cohort entry. Overall, the IR of SREs was 3.78 (95% CI, 3.53-4.03) per 100 person-months. The IR of SREs before any BTA use was 4.16 (95% CI, 3.71-4.65) per 100 person-months, and after any use was 3.60 (95% CI, 3.32-3.91) per 100 person-months. Conclusions: In this large cohort of elderly men with CRPC in a real-world setting in the U.S., SREs were common, with most occurring within a year after cohort entry. Although a direct causal interpretation of the difference in rates before and after BTA use is not possible (since confounding by indication and other factors cannot be excluded), further analysis may address at least some potential confounders.
Symptom burden in hospitalized patients with curable and incurable cancers.
Authors: Waldman Lauren , Newcomb Richard , Nipp Ryan David , Hochberg Ephraim P. , Jackson Vicki , Greer Joseph , Ryan David P. , Temel Jennifer S. , El-Jawahri Areej 
Published: November 2018

190 Background: Inpatient supportive care interventions are targeted to patients with advanced solid tumors due to perceived higher symptom burden. Yet, few studies have characterized symptom prevalence in hospitalized patients with curable cancers. We aimed to describe and compare symptom burden and palliative care utilization in hospitalized patients with curable and incurable cancers to determine the allocation of such supportive care resources. Methods: We conducted a single center study of 1549 patients (238 curable hematologic, 239 curable solid, 123 incurable hematologic, 949 incurable solid cancers) who experienced an unplanned hospitalization between 9/14 - 4/17. On admission, we assessed patients’ physical symptoms (Edmonton Symptom Assessment System) and psychological distress (Patient Health Questionnaire - 4 and Primary Care PTSD Screen). Results: The median number of moderate to severe symptoms reported by patients with curable hematologic, curable solid, incurable hematologic, and incurable solid cancers were 5 [3-6], 5 [3-7], 5 [4-6], and 6 [4-7], respectively. Most patients reported moderate to severe fatigue (83.6%, 82.9%, 81.3%, 86.9%). Table 1 depicts rates of psychological distress. In adjusted analyses patients with incurable solid cancers reported higher symptom burden (β = 7.6, p < 0.01), depression (β = 0.4, p = 0.01), and anxiety (β = 0.3, p = 0.03) symptoms, but no difference in PTSD symptoms. Among patients in top quartile of symptom burden, palliative care was consulted in 16.2%, 7.9%, 23.8%, and 49.6% (p < 0.01) of patients with curable hematologic, curable solid, incurable hematologic, and incurable solid cancers, respectively. Conclusions: Hospitalized patients with solid and hematologic cancers experience substantial physical and psychological symptoms regardless of the curability of their illness. Palliative care is rarely consulted for highly symptomatic patients with curable cancers. Inpatient supportive care interventions should target the needs of all highly symptomatic patients with cancer. [Table: see text]
Efficacy of intravenous (IV) NEPA, a fixed NK1/5-HT3 receptor antagonist combination, for prevention of emesis following highly emetogenic chemotherapy (HEC).
Authors: Roeland Eric , Gralla Richard J. , Zhang Li , Hesketh Paul Joseph , Schwartzberg Lee Steven 
Published: November 2018

194 Background: An IV formulation of NEPA (fixed combination of fosnetupitant 235 mg and palonosetron 0.25 mg) was recently approved offering clinicians an additional antiemetic treatment option. Approval of IV NEPA was based on showing pharmacokinetic bioequivalence and comparable safety to oral NEPA. This post-hoc analysis presents the efficacy of IV NEPA relative to that of oral NEPA and other NK1 RAs in the HEC setting. Methods: Data is compiled from 3 pivotal NEPA registration studies in a total of 951 adult chemotherapy-naïve patients with solid tumors undergoing predominantly cisplatin-based HEC. All studies had similar inclusion/exclusion criteria. IV NEPA was administered as a single 30-min infusion and a single capsule of oral NEPA was given prior to HEC. All patients received dexamethasone (DEX) on Days 1-4. Data is also compiled from registration HEC trials on other NK1 RA (aprepitant, fosaprepitant, rolapitant) regimens. No emesis rates are summarized for the overall phase (0-120h) of the initial cycle of HEC for each study and also pooled for oral NEPA. No formal statistical comparisons were performed. Results: The overall no emesis rate was 84.2% for IV NEPA and 81.6% for oral NEPA for the pooled studies. The no emesis rates for aprepitant, fosaprepitant and rolapitant regimens ranged from 66.0% to 77.7%. Clinical trial information: NCT02517021. Conclusions: Both IV and oral formulations of NEPA represent effective and convenient single-dose prophylactic antiemetics targeting two distinct CINV pathways, offering comparable options for clinicians/patients in different settings.[Table: see text]