bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fostering hope and enhancing end of life experiences: two Phase II RCTs of dignity therapy
Authors: Hall S , Goddard C , Speck P , Opio D , Chochinov H M , Higginson I J 
Published: May 2011

AbstractIntroduction and aimsMaintaining dignity and having hope are important at the end of life. The aim of these studies is to assess the acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in people (i) with advanced cancer, and (ii) living in care homes for older people.MethodsWe randomly allocated 45 cancer patients and 60 care home residents to an intervention (Dignity Therapy) or control group. We collected outcomes in face-to-face interviews at two post intervention follow-ups: 1 and 4 weeks for cancer patients; and 1 and 8 weeks for care home residents (equivalent in the control group). The primary outcome was dignity related distress. Secondary outcomes were: hopefulness; anxiety/depression; quality of life; and acceptability (views on the intervention/taking part in the study).ResultsCancer patients in the intervention group were more hopeful at both follow-ups. Effect sizes were large (partial η20.195 and 0.150 respectively). Baseline levels of distress were low in both studies and the two groups did not differ on measures of distress or quality of life. Residents in both groups showed a decrease in dignity-related distress at 8 weeks. Participants in the intervention groups outperformed the control groups on all acceptability items at both follow-ups. Effect sizes (Cohen's d) ranged from 0.25 to 1.09).ConclusionDignity Therapy increases hopefulness for people with advanced cancer and enhances their end of life experiences and those of residents of care homes. The impact of Dignity Therapy on more distressed patients needs to be determined.
Predictors of non-remission of depression in a palliative care population
Authors: Goodwin L , Lee W , Price A , Rayner L , Monroe B , Sykes N , Hansford P , Higginson I J , Hotopf M 
Published: May 2011

AbstractIntroduction and aimsProspective studies of depression in palliative care are rare. Two studies which examine depression prospectively in patients with advanced disease have not looked at predictors of remission. This study aims to explore prospective predictors of non-remission of depression in palliative care.MethodsThe study design comprised two data collections: with initial assessment on referral to a palliative care service in South London, UK and a 4-week follow-up. 76 participants met the criteria for ‘any depressive syndrome’ at the time 1 assessment using the PRIME-MD, who also participated at time 2. The outcome measure was remission (N=39) or non-remission (N=37) of depression by time 2.ResultsThe findings showed that reporting low social support at time of referral was the most powerful risk factor for non-remission. There was also a strong association between improved physical symptoms, from time 1 to 2, and remission of depression.ConclusionThis study in palliative care is the first of which we are aware to explore factors associated with non-remission of depression. Depressed patients identified with low social support on referral to palliative care might particularly benefit from additional psychosocial care in the treatment of their depression. This study provides evidence that effective physical symptom management in palliative care may be a valuable intervention for depressive symptoms.
Psychological distress in cancer outpatients: a prospective cohort study
Authors: Kleiboer A M , Hansen C Holm , Walker J , Sharpe M 
Published: May 2011

AbstractIntroduction and aimsPsychological distress is common in cancer patients. It can be viewed as a continuum from no symptoms at one end to psychiatric diagnoses such as major depression at the other. While major depression is likely to persist and to require treatment, there is much we need to know about patients with milder symptoms of distress. This study aimed to: (1) Describe the course of distress over 7 months in patients with clinically significant distress (HADS ≤15) at routine symptom monitoring but who did not meet criteria for major depression, (2) Determine whether demographic and clinical characteristics and severity and short-term persistence of initial distress predict significant distress at 7 months.Methods326 patients with a relatively good prognosis (>12 months) were recruited from two specialist NHS Cancer Centres in Scotland, UK. Patients completed the HADS at routine symptom monitoring on touch screen computers and at 1, 2, 4 and 7 months by telephone.ResultsPreliminary results showed that more than a third of patients (36%) had clinically significant distress at 7 months. The data is currently being analysed to look at the characteristics of patients with persistent distress at 7 months. These results will be presented at the conference.ConclusionA substantial group of patients with significant distress at routine symptom monitoring, but who do not meet criteria for major depression, have distress that persists over 7 months. These patients might benefit from treatment for their symptoms and services should be developed for these patients.
2020 Vision: improving supportive and palliative care in the age of social media and global telecommunications
Authors: Jadad A R 
Published: May 2011

AbstractIn the second decade of the twenty-first century, social media are ushering a second wave in the evolution of the Web. Very rapidly, applications such as Google, Wikipedia, Facebook, YouTube and Twitter have risen to be among the most used sites on the Web, re-shaping how humans communicate, learn and live. Mobile communication devices are converging with Internet-based services, penetrating every region of the planet at a speed that dwarfs the growth in the adoption of personal computers or any other preceding technological innovation. These devices can now access hundreds of thousands of applications directly through the Internet, promising to satisfy almost any human need for information and communication.The exponential pace of evolution of information and communication technology, however, is outpacing the ability of clinicians, researchers, managers and policy makers to keep up. As a generation with the rare privilege to witness the emergence of a new set of powerful technologies that could have a profound and widespread effect on society, we must look beyond the hype, and try our best to understand what works, what does not work and what could be harmful.This session will give participants an opportunity to learn about emerging innovations in social media that could enable us to reduce unnecessary suffering. It will also underscore key methodological, political, cultural, technological and financial challenges that must be addressed urgently if we are to harness their power to improve the way in which we design, develop, provide, receive and evaluate supportive and palliative care services.
Pain and depression in cancer patients: a longitudinal study
Authors: Jack L , Scott A , Colvin L , Laird B , Fallon M 
Published: May 2011

AbstractIntroductionAlthough pain and depression co-exist in 36.5% of cancer patients, the precise nature of the relationship between these symptoms requires elucidation. This study aimed to further understanding of the relationship by determining whether improved pain is associated with a significant reduction in depression and increased quality of life in cancer patients.MethodsA secondary data analysis of patients enrolled in pain intervention studies (n=123) was undertaken. Pain, depression and quality of life were measured at baseline and endpoint using the Brief Pain Index (BPI), Hospital and Anxiety and Depression Score (HADS) and EuroQol Thermometer assessment tools respectively. The Mann-Whitney U-test and Fisher's Exact Test were used to statistically analyse score differences between pain response groups.ResultsBaseline BPI, HADS and EuroQol scores were well matched between the groups. Patients responding to pain interventions had an average 2.95 point decrease in endpoint HADS scores, contrasting with a 0.89 increase in non-responding patients (score range 0–42). There was a statically significant difference in the endpoint total HADS scores between the two groups (p=0.0015). Similar mean changes in EuroQol scores revealed increased quality of life scores occurring in patients with (10.64) and without (12.41) improved pain.ConclusionsImproving pain results in reduced depression scores. This supports a unidirectional relationship between pain and depression. Further study is required to establish the presence of a bidirectional relationship. Understanding the relationship between pain and depression allows prioritisation of targeted management of co-existent pain and depression, which may improve the clinical care of cancer patients.
Identifying patients psychological needs in oncology consultations: an exploration of rates of discussion and patterns of referral
Authors: Warrington L , Velikova G 
Published: May 2011

AbstractBackgroundHigh levels of emotional distress are common in cancer patients but oncologists often report feeling ill-equipped to discuss these issues. Little information exists on the discussion of depression and anxiety within consultations and how further support is offered.AimsThe current study aims to determine the frequency of discussion of depression and anxiety within consultations and how often referrals and prescriptions are offered and made.Method28 oncologists and 286 cancer patients were recruited to a randomized controlled trial examining the effects of the regular collection and use of health-related quality-of-life data in oncology practice on process of care and patient well-being. Each patient was recorded at four consecutive consultations, which were then analysed using content analysis. Descriptive data relating to the discussion of depression and anxiety and the offer and uptake of referrals and prescriptions was then extracted using SPSS version 16.0.ResultsDepression and anxiety was discussed with 17.5% of patients in at least one of the four consultations. Referrals were offered to 6.6% and made for 1.4% of patients.1.7% mentioned ongoing psychosocial care. Prescriptions were offered to 3.5% and made for 1.4% of patients. 4.9% mentioned ongoing psychotropic medications. 42% of patients who discussed depression or anxiety with their doctors were not offered any further support.ConclusionDepression and anxiety are not routinely discussed in oncology consultations and if discussed; patients are not always offered further support. Oncologists could benefit from a clear pathway of how to manage distress and make patients aware of support available.
Lung cancer survivorship: patients' and carers' views of after care
Authors: Calman L , Beaver K , Roberts C 
Published: May 2011

AbstractIntroduction and aimsEvidence for the management of patients after treatment is limited and particularly so for patients with advanced cancer. There is little empirical evidence to establish best practice in the after care of lung cancer patients. The aim of this study was to develop an understanding of patients' and carers' views of their aftercare and to integrate these into a new intervention.MethodsA qualitative approach was taken using the principles of grounded theory. 35 interviews were conducted with patients and carers, participants had a range of histological diagnoses and stage of cancer and all treatment options were included in the sampling strategy.ResultsThe period after treatment was highlighted as a difficult time for participants with anxiety and uncertainty after the ‘treadmill’ of treatment. Follow-up appointments provided significant reassurance about the patients' condition, which participants felt was best assessed by x-ray. Despite often poor prognosis the focus was to ‘get back to normal’ and live life to the full. Participants highlighted a lack of appropriate information after treatment, specific information about long term effects of treatment, symptoms and disease progression/recurrence. Transitions between teams were important concerns which led to worries about rapid access back to treatment/specialists.ConclusionPatient and carer preferences should be incorporated into the development of interventions; they have revealed important issues that impact on the day-to-day lives of people living with lung cancer, specifically, targeted information focusing on aftercare issues, care planning and identification of key contacts to manage care and transitions.
Widening participation in West Hertfordshire Hospices: enhancing access and diversity
Authors: Williams H , Papadopoulos I , Kelly D 
Published: May 2011

AbstractIntroductionHospices have an established goal to meet the needs of local communities. These communities are increasingly diverse and provide important sources of goodwill and financial support. However, previous research has indicated that negative perceptions may also be associated with hospices; with Christian values being promoted and death being the primary focus.AimsThe aims of this research were to help understand access issues to hospice services in West Hertfordshire and to identify barriers that may prevent marginal community groups, including the Gypsy Traveller community, from using these services. Actions were identified to help reduce access barriers in the future.MethodsA mixed method design, including a literature review, was implemented and 44 individuals shared their views about hospice care. Data collection tools included semi structured interviews, focus groups and email surveys.FindingsKey findings confirmed existing negative attitudes towards hospice services. There was a perception that some professionals would not refer those who did not fit the ‘typical’ patient profile (ie, limited prognosis and no cultural mismatch). Practical concerns included lack of appropriate food, caring practices and environment. This presentation will concentrate on the Gypsy Traveller community as exemplar case.
A systematic review of complementary and Alternative medicine interventions in the management of cancer-related fatigue
Authors: Finnegan-John J , Molassiotis A , Richardson A , Ream E 
Published: May 2011

AbstractIntroduction and aimsFatigue, experienced by patients during and following cancer treatment, is a significant clinical problem. It is a prevalent and distressing symptom yet pharmacological interventions are used little1 and confer limited benefit for patients.2 However, many cancer patients use some form of Complementary and Complementary medicine (CAM) and some evidence suggests it may relieve fatigue.3 A systematic review was conducted to appraise the effectiveness of CAM interventions in ameliorating cancer-related fatigue (CRF).MethodsSystematic searches of biomedical, nursing and specialist CAM databases were conducted, including Medline, Embase and AMED (August 2010). Included papers described interventions classified as CAM by the National Centre of Complementary and Alternative Medicine, and evaluated through randomised controlled trial (RCT) or quasi experimental design.Results15 studies were eligible for the review, of which 12 were RCTs. Forms of CAM interventions examined included acupuncture, massage, yoga and relaxation training. Findings suggested acupuncture, medical qigong and restorative yoga are somewhat effective for reducing CRF, whereas vitamins, massage and hypnosis are not.ConclusionAcupuncture appeared to confer most benefit to patients. However, trials incorporated within the review varied greatly in quality; most were methodologically weak and at high risk of bias. Consequently, there is currently insufficient evidence to conclude with certainty the effectiveness or otherwise of CAM in reducing CRF. The design and methods employed in future trials of CAM should be more rigorous; increasing the strength of evidence should be a priority.
Developing the clinical assessment of female sexual difficulties after pelvic radiotherapy
Authors: White I D , Allan H , Faithfull S 
Published: May 2011

AbstractIntroduction and aimsPelvic radiotherapy creates physical and psychological effects that impact negatively on the sexual well-being of women and their partners. The aim of this ethnographic study was to develop an assessment methodology to improve the clinical assessment of sexual morbidity following radiotherapy in women with pelvic malignancy.MethodsObservation of follow-up clinics (50 gynaecological, 19 colorectal consultations) plus interviews with women (n=24), partners (n=5) and health professionals (n=20) explored sexual morbidity assessment after treatment completion. Women with pelvic malignancy who had completed radical radiotherapy 3, 6, 12 and 24 months previously were included. Doctors, nurses and therapy radiographers were interviewed to establish professional perspectives on assessment. Observation and interview data were analysed using both SPSS v.14 and NVivo v.2 software.ResultsConsultations focused on disease surveillance, specific aspects of toxicity monitoring and managing active symptoms. Sexual concerns were not routinely assessed in gynaecological (11/50) or colorectal (6/19) clinics. Health professionals felt inhibited discussing sexual concerns with older women and when partners were present. Patient and partner interviews revealed inconsistency in the management of treatment induced menopause, inadequate knowledge of sexual health resources and unidentified difficulties including loss of desire, dyspareunia and reduced sexual satisfaction.ConclusionsTraditional models of medical follow-up may not offer an appropriate clinical context for the optimal assessment and management of sexual concerns associated with pelvic radiotherapy. These findings are important for the development of survivorship services and can inform the training of health professionals engaged in post-treatment toxicity assessment, patient information and support.
Perceptions of prostate cancer in black African and Caribbean men: a systematic review
Authors: Pedersen V H , Armes J , Ream E 
Published: May 2011

AbstractIntroduction and aimsProstate cancer (PC) is common and affects black African and Caribbean men disproportionally. Awareness of PC is low in these groups, but knowledge is lacking about other factors that may deter information seeking or getting tested for PC. The aim of the review was to appraise and synthesise research on knowledge and perceptions of PC among black men.MethodsFour medical and social science databases were systematically searched and reference lists of relevant papers hand searched. Non-English publications were excluded. Qualitative findings were synthesised using comparative thematic analysis, to which quantitative findings were incorporated.Results13 qualitative studies and 20 cross-sectional surveys were included. All except one were conducted in North-America. The analysis identified individual, cultural and social factors likely to impact on black men's awareness of, and willingness to be tested for, PC. Black men's awareness of personal risk of PC varied greatly between studies. Misunderstandings regarding methods of diagnosis and treatment were widespread. PC testing and treatment were perceived as threatening to men's sense of masculinity. Mistrust of the healthcare system, limited access to healthcare and lack of consistent, trusting relationships with health professionals were also prominent.ConclusionThese factors could contribute to late PC diagnosis and should be taken into account when planning PC services and communicating with black men who seek prostate care. Further, the review demonstrated a need for high quality studies in Europe to determine the relevance of the review findings for black European men.
Formulations of living with cancer: a discursive analysis of nurse talk
Authors: Hubbard G , Forbat E 
Published: May 2011

AbstractAimThis presentation is regarding a study of the ways in which living with cancer is being formulated by acute sector nurses.IntroductionMore complete definitions of cancer survivorship are emerging as evidence accumulates regarding the subject. Yet, what living with cancer is and how it is being formulated by nurses has not been published.MethodsThe Discursive Action Model1 provided the theoretical and methodological guide to examine the constructive and functional dimensions of verbal accounts of 20 health professionals, mainly acute sector nurses, gathered during three focus groups conducted in 2008/2009.ResultsTo the best of our knowledge, this is the first study to report health professional formulations of living with cancer in the UK. It illustrates the key discursive manoeuvres used by acute sector nurses to construct cancer as a long-term illness, which include the description of on-going physical and psychosocial effects, particularly fear and risk, of recurrence. Importantly, the rationale for locating on-going support in the acute versus community sector is constructed as derived from patient feedback, not from the acute-based staff themselves.ConclusionImplications for cancer survivors: Cancer is being constructed as a significant and powerful disease as opposed to a trivial and time-limited one; this lends legitimacy to calls for on-going surveillance and support for cancer survivors. The profession that positions itself as being the experts and specialists in cancer is likely to be able to make the claim to provide on-going support with the most authority.
Celebrating user involvement in research
Authors: Rainey P , Morris C , Kendall M , Murray S A , Cameron D 
Published: May 2011

AbstractBackgroundThis year the scientific committee has examined abstract submissions for evidence of User Involvement that is,▶Present from the early stages of the research cycle (eg, generating ideas, prioritising, study design).▶Collaborative – working as co-researchers – not simply commenting on completed work.▶Innovative – (eg, presenting to funding/ethics boards undertaking interviews, leading dissemination in some areas).▶And has created a tangible output which has contributed to the conduct of the study (eg, protocol writing, higher recruitment, richer data).AimsTo highlight and acknowledge those researchers who have demonstrated a high level of commitment to User Involvement in their work.To emphasise the importance of collaborating with service users in research and to offer some insight into the future of User Involvement in SUPAC research.MethodsProfessor David Cameron, Clinical Director at the Edinburgh Cancer Research Centre and former Director of NCRN, will reflect on the significance of User Involvement during his time at NCRN and offer some personal insight into how best SUPAC research might flourish. Following this talk, three shortlisted candidates for this year's User Involvement Award will take part in a short discussion about their work, following which a presentation will be made to the winner.