bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasigility study using tablet PC for assessment of quality of life and risk factors of breast cancer survivors.
Authors: Koh Su-Jin , Choi Yunsuk , Kim Chung Reen , Ju Hee Kim 
Published: March 2017

81 Background: The aim was to assess the feasibility of using tablet PC for assessment of risk of breast cancer recurrence and primary cancer, physical and psychological effect of breast cancer and treatment, health promotion at first visit among breast cancer survivors. Methods: The prospective study was carried out in the survivorship clinic, university teaching and tertiary referral hospital. After clearance from the Institutional Review Board, 40 breast cancer patients first visiting survival clinic received surgical treatment and adjuvant chemotherapy were included in the study after informed written consent, irrespective of the age and stage of disease. The patients were answered as per quality of life, physical function and activity, pain, fatigue, anxiety and depression, distress by using tablet PC. We evaluated the information of education, marriage, job, economic status and health, knowledge about management of cancer survivors, feasibility (difficulty, simplicity, necessity, comfort, satisfaction, recommendation) of using tablet PC and difficulty of the questionnaire in understanding, psychological, social and documenting aspect. Results: Most of patients using tablet PC agree with easy (85.7%), simplicity (75.4%), necessity (75.5%), comfort (72.1%), satisfaction (83.9%), recommendation to others (77.8%). Age over 60 years (83% vs 96%, p=0.037), general health status (r=0.491, p=0.001) affect to the difficulty of using tablet PC. And age, knowledge, education, general health status affect to the understanding of questionnaire. In multivariation analysis, educational status (elementary school (β=-0.312, p= 0.016), middle school (β=-0.452, p=0.001) and general health status (β=-0.344, p=0.010) affect to the understanding of questionnaire. Conclusions: We can use tablet PC in outpatient cancer surviors clinic effectively. But we need careful evaluation for who are not good in general health status.
Online social network use among parents of young childhood cancer survivors.
Authors: Wilford Justin Gregory , Osann Kathryn , Wenzel Lari B. 
Published: March 2017

82 Background: Online social networks (OSNs) have emerged in the past decade as potentially powerful tools for health information sharing and health behavior change. According to a recent study by the Pew Research Center, 75% of all parents are active on OSNs. Given the high level of need for childhood cancer survivorship health education and preventive health behavior change, OSNs represent key resources for parents to engage with experts and peers over survivorship health. Methods: A cross-sectional survey of 114 parents of young and adolescent ( < 13 years) childhood cancer survivors was used to examine parent OSN use in specific platforms. Recruitment was conducted through online social support groups of two childhood cancer non-profits that focus on parent support. The novel online survey investigated OSN frequency of use, history of making new friends in OSNs, and whether OSNs were “good for sharing and receiving reliable and high quality information on diet, physical activity, and other healthy behaviors.” Results: Parents reported high levels of OSN use with 80% reporting daily use. Facebook was the most commonly used OSN by a wide margin. Seventy-eight percent of parents reported using it every day. The next most used OSN was Instagram (15%). Parents reported making new friends on Facebook (86%), followed by Instagram (22%) and Twitter (10%). Among parents who have used the respective OSNs, several were endorsed as being “good” or “extremely good” for sharing survivorship-related preventive health information. Facebook was endorsed by 76% of its users, Twitter and Pinterest by 59%, Google+ by 52%, and Instagram by 40%. None of the demographic variables collected predicted parent OSN use or perception. There was a strong association between parents using OSNs daily and their reporting having made new friends on OSNs (p < .000). Conclusions: Parents of young childhood cancer survivors recruited from online support groups report high levels of OSN use and making new friends through OSNs, and find OSNs potentially good sources for sharing and receiving survivorship-related health information. OSNs in general, and Facebook in particular, represent promising avenues for childhood cancer survivorship health information dissemination.
The transition from treatment to follow-up care: A critical time for patient navigation.
Authors: Gaster Sam , Sanem Rita , Jones-Larson Diane , Fiegen Jordan , Arens Jamie 
Published: March 2017

83 Background: There are many points of transition in cancer care, and each presents a unique set of challenges for patients and providers (Nekhlyudov, Levit, Hurria, & Ganz, 2014). This includes the transition from treatment to follow-up care, or the transition to survivorship. For patients, challenges include the need for continued support, education, and communication with the cancer care team. For providers, challenges include the management of late- and long-term effects, modification of health behaviors, and coordination with other providers (IOM, 2005). These challenges can be overcome with patient navigation services. However, survivors’ access to these services is not universal. This evaluation describes the implementation and assessment of these services at six regional cancer centers in the Midwest. Methods: Key stakeholders designed a protocol for survivors to receive patient navigation after their transition to follow-up care. These navigation services are provided by nurse and social work navigators, and involve placing outbound calls to survivors. These contacts occur approximately two weeks after survivors receive a survivorship care plan (SCP) and a needs assessment. Results: From August through September 2016, 33 (91.67%) survivors were contacted by patient navigators. Three survivors could not be reached. Twenty-one percent (n = 7) of survivors contacted had not previously received navigation services. However, all survivors contacted received navigation services that would not otherwise been provided. Contacted survivors expressed high satisfaction with the services, and the most common needs addressed were anxiety and fatigue. Conclusions: Results support the value of patient navigation services for cancer survivors. This evaluation describes the successful implementation of a protocol for the continued navigation of survivors after their transition to follow-up care. Results encourage further development and evaluation of this protocol, including its impact on symptom management, health promotion, and care coordination via referrals and the provision of education and resources.
Information when patients participate in a phase I trial: A systematic review.
Authors: Gad Katrine Toubro , Lassen Ulrik Niels , Mau Sorensen Paul Morten , Høybye Mette Terp , Johansen Christoffer 
Published: March 2017

85 Background: While phase I trials are essential for the development of new anticancer drugs, there is a limited chance of benefitting for cancer patients participating in such trials. The information dialogue is therefore of substantial importance for providing a foundation to make a decision, and the support from relatives of potential value for the patient. This systematic review investigated patients’ prerequisites for deciding to participate in a phase I trial by summarizing the existing knowledge regarding patients’ decision-making when entering a phase I trial, and patients’ and their relatives’ perception of the information prior to enrollment. Methods: The review is based on the principles of Preferred Reporting Items for Systematic Reviews. A comprehensive systematic search was performed using the PubMed, Embase and PsycInfo databases and supplemented by a search for unpublished literature. Results: We identified 36 studies for inclusion in this review. When patients are offered participation in a phase I trial, information procedures as well as the patients’ individual approach influence the decision-making and the perception of the information provided. Across the studies exploring patients’ perception of information, there was a limited understanding of trial purpose and unrealistic expectations of benefit. The relatives’ perception of information remains unexplored. Evaluation of the included studies demonstrated a comprehensive risk of bias in the majority of studies. Conclusions: The information dialogue between physician and the patient concerning participation in a phase I trial seems to benefit from exact information taking account of the perspectives for each individual patient as well as the need for further discussion of trial. While relatives intuitively function as resources for patients entering a phase I trial, this topic is still not investigated.
Development of the medical appointment planner.
Authors: Clayton Margaret , Ellington Lee , Mooney Kathi 
Published: March 2017

86 Background: Breast cancer survivors experience multiple physical and emotional symptoms. Difficulties occur when women cannot effectively present questions and concerns during surveillance visits resulting in unmet needs and unanswered questions. Methods: The Medical Appointment Planner (MAP) is a structured visit preparation approach providing communication skills to facilitate presentation of a woman’s symptoms/concerns to medical providers. MAP was developed sequentially in 4 phases: Phase 1) Focus groups explored women’s issues during surveillance visits. Phase 2) Feasibility pilot, using paper-pencil delivery. Phase 3) IPad feasibility, usability / satisfaction pilot. Phase 4) National trial pilot with Susan Love’s Army of Women comparing electronic MAP delivery to a usual care group developing question lists. Results: Focus Groups. A major theme was “difficult interactions with medical providers” especially presenting concerns. Paper-Pencil Feasibility. Eight women (age 30-79) used MAP for medical visit preparation; the average number of symptoms endorsed was 17 out of a possible 21. All women successfully used MAP to prepare for their upcoming medical visit. MAP was determined to be feasible with women asking for electronic delivery for ease of use. IPad Prototype: 26 women (age 40-80); Outcomes of symptoms, mood, uncertainty, and well-being, improved pre to post-visit. National pilot: 49 women (age 50-77); 21 in the MAP intervention group, 28 in the usual care group preparing questions pre-visit. No differences between groups in age or breast cancer stage were observed. After first use, women report MAP is helpful, and providers have reacted favorably to visit preparation with feasible electronic national delivery. The question list group also reports ease of program use. Conclusions: Across MAP pilot studies women report that MAP helps organize thinking, condense thoughts, and stay “on track”. Improving current practice that recommends preparing question lists before medical appointments; the structured MAP visit preparation approach teaches communication skills to facilitate presentation of symptoms and concerns to providers, enabling women to break into the medical “script” and get their symptoms/concerns addressed.
Development of a statin risk communication tool for use in cancer survivors: A pilot.
Authors: Raghunathan Nirupa Jaya , Korenstein Deborah , Anderson Nassim , Adsuar Roberto , Tonorezos Emily S. , Oeffinger Kevin C. 
Published: March 2017

87 Background: There are currently over a million survivors of childhood, adolescent, and young adult (CAYA) cancer in the US, many of whom were treated with radiation therapy. Chest radiation with fields including the coronary arteries is a risk factor for cardiovascular disease (CVD). Of note, survivors are often unaware of this increased CVD risk or, if they are aware, do not know how to mitigate the risk. Visual aids and communicating risk in terms of absolute risk reductions are shown to improve patients’ understanding. The Institute of Medicine recommends use of decision aids to optimize patient discussions of benefits and harms of therapies. Our goal is to develop and pilot test a statin therapy risk communication tool for use in high-risk cancer survivors to improve shared decision making and patient knowledge of coronary artery disease risk. Methods: The Statin Risk Communication Tool, modeled after the validated Statin Choice decision aid, presents a pictorial representation of absolute risk of coronary heart disease risk in survivors of CAYA cancer treated with radiation to the chest. The intervention also presents data depicting absolute risk reduction of myocardial infarction with use of statins in similar risk populations (≥7.5% baseline risk). This pilot study compares the statin risk communication tool to usual care. The post-visit assessment uses Likert-like scales to explore patient perceptions of statin use, knowledge questions to assess patient understanding of the risks and benefits of using statins and the validated 16-item Decisional Conflict Scale to measure decisional satisfaction. We will also survey participants three months after introduction of the tool to ascertain statin use and attitudes towards the discussion of statins. Results: The timeline for data collection anticipates analyzable results by August 2017. Conclusions: This risk communication tool will be assessed for acceptability, knowledge enhancement, and decisional conflict. Additionally, we will gather qualitative data regarding usual care. With this information, a future randomized controlled trial across institutions could provide information on how CAYA survivors approach shared decision making with risk communication tools. Clinical trial information: NCT02895880.
Monitoring oral anti-cancer therapy adherence in cancer patients using web based application guided communication compared with nurse counseling in a community cancer center.
Authors: Dolezal Milana V. , Leong Vivian , Behl Rajesh 
Published: March 2017

88 Background: Smart phone web based applications (apps) can be effective communication tools for monitoring compliance and increasing adherence to oral anti-cancer therapy in the outpatient setting. Methods: Cancer patients age 18-90 treated with various oral anti-cancer therapies were recruited to this prospective, 3 month observational trial at our large community cancer center to determine feasibility of using an app for oral anti-cancer therapy compliance. Enrolled patients are randomized to either Arm 1 App arm and nurse counseling or Arm 2 nurse counseling only. The free apps MyMeds and Medisafe incorporate medication reminders and record doses. Patients complete the validated RAND 36- item quality of life (QOL) questionnaire and a free text feedback. Results: 91 patients were screened between 11/2015 to 9/2016 (45 declined enrollment due to various factors). 46 patients were randomized with 25 to Arm 1 and 21 to Arm 2. Demographics included 10 men (various tumor types but mostly multiple myeloma) and 36 women; 22 with breast cancer. MyMeds app lacked the necessary real-time communication so patients were switched to the MediSafe app which features email alerts. 15 patients have completed the study through Month 3. Four patients on Arm 1 missing their monthly visit or were non-compliant with the app. 23 patients remain active in the study. Differences are a higher QOL score in Arm 1 vs Arm 2 in measured domains of Energy/Fatigue (56% in Arm 1 compared to 44% for Arm 2) and Pain (72% in Arm 1 compared to 58% in Arm 2). Patients randomized to the app found the electronic alerts very helpful. Conclusions: Our limited pilot study demonstrated the potential of smart device apps as effective communication tools for improving patients’ adherence to oral anti-cancer therapy and QOL. Ultimately, convenient ways to monitor patients’ compliance with anti-cancer therapy will impact survival and facilitate provider-patient communication.
Patient-provider communication during post-treatment breast cancer care: Findings from a pilot project.
Authors: Chawla Neetu , Sanchez Michael , Harpster Jayson , Manace Brenman Leslie , Liu Raymond 
Published: March 2017

91 Background: Patient-provider communication is essential to delivering high quality cancer care, including post-treatment when survivors have many complex care needs. In this study, we used data collected for quality improvement from a small, feasibility sample to examine patient perceptions of provider communication and inform the development of a new Oncology Survivorship Clinic model. Methods: As part of a pilot project conducted at Kaiser Permanente Northern California (KPNC), we surveyed 51 breast cancer patients post-treatment. The survey included a communication measure from the 2011 Medical Expenditure Panel Survey (MEPS) Experiences with Cancer survey evaluating provider discussions of: surveillance for recurrence; late or long-term treatment effects; healthy lifestyle behaviors; and emotional or social needs. We also examined reports of the six core functions of patient-centered communication (i.e. managing uncertainty, responding to emotions, making decisions, fostering healing relationships, enabling self-management, and exchanging information) using a measure from the Health Information Trends Survey (HINTS) survey. Part of the purpose was to evaluate acceptability of a new Oncology Survivorship Clinic utilizing non-physician providers. Results: The sample included 51 breast cancer patients surveyed in 2016 within six months of treatment completion. Overall, sizable proportions received detailed communication about surveillance (65%), treatment side effects (46%), emotional needs (41%), and healthy lifestyles (71%) and the majority received patient-centered communication (range: 60-73% based on core function). Particular gaps were noted related to provider communication about treatment side effects (54%), emotional/social needs (59%), managing uncertainty (35%), and responding to emotions (40%). Conclusions: Our very preliminary findings suggest that the majority of women had positive communication experiences, including with non-physician providers. However, clear communications gaps existed underscoring future avenues for research and care delivery interventions to address the comprehensive needs of breast cancer patients.
Development of a preliminary model of connectedness with healthcare providers for adolescents and young adults with cancer.
Authors: Phillips Celeste , Haase Joan 
Published: March 2017

92 Background: Adolescents and young adults with cancer (AYA) have poorer outcomes than younger or older cancer patients. AYA survivorship outcomes are complicated by psychosocial late effects and engagement in risky lifestyle behaviors that may increase secondary cancers and other chronic illnesses. Earlier identification and enhancement of protective factors that foster healthy lifestyle behaviors is an NIH/NCI priority. Early connectedness with healthcare providers (HCPs) may diminish risk-taking behaviors and foster healthcare self-management in AYA survivors .The purpose of this presentation is to describe the processes of developing a preliminary model of connectedness with HCPs for AYA. Methods: A preliminary model of connectedness was initially derived from a concept analysis that systematically critiqued 28 peer-reviewed sources. The preliminary model of connectedness was then validated and expanded by results of a phenomenological study of AYA cancer survivors (n = 9) regarding their experience of connectedness with HCPs. Results: The concept analysis identified 7 critical attributes of connectedness: intimacy, belonging, empathy, caring, trust, respect, and reciprocity. Outcomes included: greater self-esteem, enhanced interpersonal skills, enhanced emotional adjustment, and greater identify exploration. Results of the phenomenological study uncovered two additional attributes of connectedness specific to AYA experiences of connecting with HCPs: a sense of gratitude and disconnectedness. The disconnectedness attribute indicated there are processes that can occur that either lead to an outcomes of sustained connectedness or disconnectedness. If AYA felt more connected (vs. disconnected) to their HCPs as a whole, then they continued to engage in long-term follow-up. On the other hand, if AYA felt more disconnected to their HCPs, it led to unwillingness to participate in long-term follow-up. Conclusions: A preliminary model of connectedness with HCPs for AYA was derived from two studies. This model can be used to help guide the development of interventions aimed at enhancing early connectedness and fostering long-term follow-up practices of AYA.
Comparative study of the perceptions of continuity of care of CRC survivors transitioned to primary care.
Authors: Sisler Jeffrey James , Nugent Zoann , Carpenter-Kellett Tara , Gingerich Joel Roger 
Published: March 2017

96 Background: Colorectal cancer (CRC) patients are increasingly being discharged to a primary care provider (PCP) for follow-up care. This study used a pre-post design to evaluate the impact of the Moving Forward After Cancer(MFAC) program at CancerCare Manitoba on patient perceptions of continuity of care. Methods: The MFAC program was introduced in 2010 to support transfer of care to primary care and includes transitional appointments (TAs) and survivorship care plans. The pre-implementation (PRE) group was a random sample of patients on the provincial cancer registry diagnosed in 2008/09 with Stage II / III CRC. The post-implementation (POST) group was recruited in oncology clinics after their TA over four years starting in 2010. Both groups completed the same mailed survey. Respondents were asked to identify the main provider(s) of their follow-up care. Those indicating a PCP completed the Patient Continuity of Care Questionnaire (PCCQ) which assesses continuity upon discharge with scoring between 5 and 25. Quality of life, disease, treatment, and demographic data were collected. Results: There were 246 responses in the PRE group (rate of 68.3%) and 83 (66%) in the POST. The POST group was significantly younger, more urban and further from diagnosis. It included more Stage III and rectal cancer patients who received more treatment. Comparing the subset of both groups (106 vs 65) who described a PCP as a main provider, the POST group demonstrated higher scores on the PCCQ (24.0 v 22.8, p=0.0065) and on two of its subscales. This finding persisted when tested for the impact of differences between the two groups in stage, site, age and treatment. The most common pattern of provider involvement in follow-up was the “FP alone,” which rose from 19% in the PRE group to 54% in the POST (p<0.0001). The proportion of participants who felt “adequately prepared” for their transfer of care was significantly increased (71 vs 91%, p=0.003). Conclusions: A formal information sharing process with CRC patients at time of transition to primary care follow-up improved their evaluation of continuity of care. Significant shifts were seen in the locus of care from oncology to primary care settings consistent with the intent of the MFAC program.