Cancer Diagnosis Disclosure and Quality of Life in Elderly Cancer Patients

Ying, Zheng; Lei, Fang; Liu, Bao

doi:10.3390/healthcare7040163

“…Rehabilitation based on the HBM can enhance the psychological resilience and rehabilitation compliance of patients, leading patients to actively participate in postoperative rehabilitation treatment and achieve a more ideal rehabilitation effect. Previous studies [ 26 , 27 ] have also shown that psychological interventions can improve survival in cancer patients. This evidence further proves the value of HBM psychological intervention in elderly gynaecological cancer patients in improving survival.…”

Section: Discussionmentioning

confidence: 99%

Effect of Health Belief Model Education on Increasing Cognition and Self-Care Behaviour among Elderly Women with Malignant Gynaecological Tumours in Fujian, China

Liu

¹

,

Chen

²

,

Huang

³

et al. 2021

Journal of Healthcare Engineering

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Objective. This study evaluated the effect of a health belief model (HBM) educational intervention on the self-perception of and complications related to disease in elderly gynaecological malignancy patients. Methods. This randomized controlled trial was conducted at the Fujian Maternal and Child Health Hospital, China. A total of 301 women aged 60 years and older who were diagnosed with gynaecological malignancies from January 2019 to August 2020 were recruited. Participants were randomly divided into the HBM education and basic nursing groups. The participants in the HBM education group received perioperative rehabilitation education based on the HBM, and the participants in the basic nursing group received routine basic nursing. Rehabilitation training compliance, psychological resilience, psychological flexibility, self-efficacy, self-care ability, and lower extremity deep venous thrombosis (LEDVT) incidence were assessed before and after the intervention. Results. Thirty-three women were excluded based on the exclusion criteria, and 268 participants were eventually included and randomly divided into two groups: 134 participants in the HBM education group and 134 participants in the basic nursing group. Before HBM education, there were no significant differences in the mean scores of psychological resilience (50.43 ± 3.29 vs. 50.55 ± 2.29, P = 0.738), psychological flexibility (48.98 ± 3.45 vs. 49.29 ± 3.59, P = 0.465), self-efficacy (26.49 ± 5.26 vs. 26.29 ± 6.41, P = 0.781), or rehabilitation training compliance (28.4% vs. 27.8%, P = 0.922) between the two groups. After HBM education, the scores of training compliance (80.6% vs. 30.1%, P < 0.001), psychological resilience (55.47 ± 5.01 vs. 50.46 ± 2.62, P < 0.001), psychological flexibility (56.53 ± 4.51 vs. 49.13 ± 3.62, P < 0.001), self-efficacy (30.79 ± 4.56 vs. 26.41 ± 6.37, P < 0.001), self-care knowledge (43.36 ± 7.60 vs. 34.05 ± 6.99, P < 0.001), self-concept (29.57 ± 5.67 vs. 20.11 ± 3.86, P < 0.001), self-care responsibility (27.54 ± 5.09 vs. 20.86 ± 4.53, P < 0.001), and self-care skills (34.51 ± 5.62 vs. 21.62 ± 5.64, P < 0.001) were higher in the HBM education group than those in the basic nursing group. Additionally, the incidence of LEDVT was lower in the HBM group than that in the basic nursing group (2.2% vs. 8.3%, P = 0.027). Conclusion. This study indicated that perioperative HBM education can improve the cognition and self-care ability of elderly gynaecological malignancy patients and reduce postoperative complications.

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“…The disruption that DR-TB causes in an individual’s ability to fulfil social and familial responsibilities were particularly worrisome and frightening for patients which needs timely intervention at the time of disclosing the diagnosis [ 5 , 22 ]. The disclosure process of DR-TB diagnosis could be made in a more sensitive and guided way as similar to other disease conditions, such as HIV and cancer, which could prepare the patients and caregivers mentally and socially [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

A Dual Perspective of Psycho-Social Barriers and Challenges Experienced by Drug-Resistant TB Patients and Their Caregivers through the Course of Diagnosis and Treatment: Findings from a Qualitative Study in Bengaluru and Hyderabad Districts of South India

Nagarajan

¹

,

Kumarsamy

²

,

Begum

³

et al. 2022

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Qualitative insights regarding psycho-social barriers and challenges experienced by drug-resistant tuberculosis (DR-TB) patients and their caregivers are understudied in India. We conducted a qualitative study using semi-structured qualitative interviews among treatment-completed DR-TB patients (n = 20) and caregivers (n = 20) in Bengaluru and Hyderabad districts, which represented two different socio-cultural settings in South India. Criterion sampling was used for recruiting the eligible participants who completed treatment with adherence. “Emotional issues and social barriers” were identified to represent a major challenge for patients and caregivers, which occurred acutely after disease diagnosis, characterized by fear and emotional distress due to their perceived loss of life prospects, severity of symptoms, discomfort, and disease denial. Medication intolerance, chronic symptoms, lack of visible signs of treatment progress, loss of weight, and physical concerns caused subsequent fear and distress during the treatment phases for patients along with experiences of stigma. External triggers generated “decisive moments” of hopelessness and life-ending thoughts for patients at the diagnosis and early treatment phase. Medication related challenges included the perceived burden and power of pills which caused emotional distress for patients and intolerance towards caregivers. Pill burden was found as consequential as the side effects of injections. Challenges related to lack of support were another major theme, in which caregivers lacked resources for treatment support and nutrition. Throughout treatment, caregivers and patients expressed concern about a lack of supportive care from family members, sympathy, and intangible social support. Challenges during hospital admission in terms of lack of privacy, quality of services, individual attention, and empathy from health care workers were reported by patients and caregivers. Despite better adherence, DR-TB patients and caregivers experienced considerable emotional and social consequences. Differentiating DR-TB patients and caregivers’ issues at different stages of diagnosis and treatment could help improve patient-centered outcomes in India and other high-burden nations.

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“…In contrast, another study among elderly patients mentioned that not knowing their cancer condition results in an incomplete understanding of their diagnosis, which would hurt the trust relationship between these patients and physicians [ 21 ]. Based on a study of a total of 127 cancer patients and their caregivers, no significant difference was found before and after disclosing the cancer diagnosis to patients, while the quality of life could be improved with psychological care intervention [ 22 ]. We found that in patients with lung cancer, those who knew their cancer status had a better survival rate, while there are few studies about this issue in breast cancer patients [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Knowledge of a cancer diagnosis is a protective factor for the survival of patients with breast cancer: a retrospective cohort study

He¹,

Zhu

²

,

Tang³

et al. 2021

BMC Cancer

2

0

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Background The health burden of breast cancer is rising in China. The effect of informed diagnosis on long-term survival is not fully understood. This retrospective cohort study aims to explore the association between early informed diagnosis and survival time in breast cancer patients. Methods A total of 12,327 breast cancer patients were enrolled between October 2002 and December 2016. Potential factors, including knowing the cancer diagnosis status, sex, age, clinical stage, surgery history, grade of reporting hospital and diagnostic year were, analyzed. We followed up all participants every 6 months until June 2017. Propensity score matching (PSM) was used to balance the clinicopathologic characteristics between patients who knew their diagnosis and those who did not. Results By June 2017, 18.04% of the participants died of breast cancer. Before PSM, both the 3-year and 5-year survival rates of patients who knew their cancer diagnosis were longer (P < 0.001). After PSM, the above conclusion was still established. By stratified analysis, except for the subgroups of male patients and stage III patients, patients who knew their diagnosis showed a better prognosis in all the other subgroups (P < 0.05). Cox regression analysis showed that knowing a cancer diagnosis was an independent risk factor for survival in breast cancer patients (P < 0.001). Conclusions Being aware of their cancer diagnosis plays a protective role in extending the survival time of breast cancer patients, which suggests that medical staff and patients’ families should disclose the cancer diagnosis to patients in a timely manner. Further prospective studies need to be made to validate our findings.

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Cancer Diagnosis Disclosure and Quality of Life in Elderly Cancer Patients

Cited by 12 publications

References 31 publications

Effect of Health Belief Model Education on Increasing Cognition and Self-Care Behaviour among Elderly Women with Malignant Gynaecological Tumours in Fujian, China

Effect of Health Belief Model Education on Increasing Cognition and Self-Care Behaviour among Elderly Women with Malignant Gynaecological Tumours in Fujian, China

A Dual Perspective of Psycho-Social Barriers and Challenges Experienced by Drug-Resistant TB Patients and Their Caregivers through the Course of Diagnosis and Treatment: Findings from a Qualitative Study in Bengaluru and Hyderabad Districts of South India

Knowledge of a cancer diagnosis is a protective factor for the survival of patients with breast cancer: a retrospective cohort study

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