Clinical Considerations for Working with Patients with Advanced Cancer

Taylor-Ford, Megan

doi:10.1007/s10880-014-9398-z

Cited by 8 publications

(6 citation statements)

References 117 publications

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“…These individuals must choose whether to learn information about their future disease risks and potential shared familial risks while facing a poor prognosis and the psychosocial challenges of a terminal diagnosis. 7 Although patients with varying stages of cancer have reported interest in receiving such information from TGP in real 8 and hypothetical [9][10][11] settings, how patients decide whether to learn SGFs is unclear. Understanding the decision-making processes of patients with advanced cancers would allow clinicians to anticipate patient informational and decision support needs in this context.…”

Section: Conclusion These Results Provide Insight Into Sgf Decision-making Processes Of Patients With Advanced Cancers Which Can Allow CLmentioning

confidence: 99%

Decision-Making Preferences About Secondary Germline Findings That Arise From Tumor Genomic Profiling Among Patients With Advanced Cancers

Hamilton

Shuk

Garzon

et al. 2017

JCO Precision Oncology

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Purpose In patients with advanced cancers, tumor genomic profiling (TGP) can reveal secondary germline findings (SGFs) with regard to inherited disease risks. This study examined the process by which patients with advanced cancers would decide about whether to learn these SGFs and their preferences about specific challenging decision scenarios, including whether patients should be required to receive SGFs and whether SGFs should be returned to the family after a patient’s death. Patients and Methods We conducted qualitative semistructured interviews with 40 patients with advanced breast, bladder, colorectal, or lung cancer who had undergone TGP. Data were collected on participants’ perspectives about the hypothetical decision to learn their SGFs, including their anticipated approach to the decision-making process, and their preferences about challenging decision scenarios. Data were evaluated by thematic content analysis. Results We identified themes with regard to participants’ preferred degree of decisional autonomy, perceived vital role of doctors, information needs, and anticipated process of deliberation. Although participants reported that this decision was ultimately their own, many wanted input from family and trusted others. Oncologists were expected to provide decision guidance and key clarifying information. Most participants stated that patients should be able to make a choice about receiving actionable SGFs, and a majority stated that SGFs should be available to family after a patient’s death. Conclusion These results provide insight into SGF decision-making processes of patients with advanced cancers, which can allow clinicians to provide patients with optimal decision support in this context. Patients with advanced cancers have specific information needs and decision-making preferences that educational and communication interventions should address to ensure that patients make informed choices about learning SGFs.

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Section: Conclusion These Results Provide Insight Into Sgf Decision-making Processes Of Patients With Advanced Cancers Which Can Allow CLmentioning

confidence: 99%

Decision-Making Preferences About Secondary Germline Findings That Arise From Tumor Genomic Profiling Among Patients With Advanced Cancers

Hamilton

Shuk

Garzon

et al. 2017

JCO Precision Oncology

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“…From the moment of diagnosis, cancer patients face a new life situation and an uncertain future that is a source of apprehension and existential suffering [5]. In subsequent stages, the physical and psychological symptoms increasingly interfere with daily living, limiting the social roles within the family and community [6]. Therefore, patients must adjust to the stress of cancer and its treatment in an ongoing process that follows the course of the disease and proceeds with changes in HRQoL [7].…”

Section: Introductionmentioning

confidence: 99%

Biopsychosocial Correlates of Adjustment to Cancer during Chemotherapy: The Key Role of Health-Related Quality of Life

Lauriola

Tomai

2019

The Scientific World Journal

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Background. Patients adjust to cancer in a continuous process that follows the course of the disease. Previous research has considered several illness-related variables and demographics, quality of life, personality, and social factors as predictors of adjustment to cancer, which can be maladaptive (e.g., helplessness-hopelessness and anxious preoccupation) or adaptive (e.g., fighting spirit). Aims. Assuming a biopsychosocial view, we test an empirical model in which disease stage, patient’s age, and gender are viewed as the distal antecedents of positive and negative adjustment to cancer for chemotherapy patients. Health-related quality of life (HRQoL) has a key role, interposing between the distal antecedents and adaptational outcomes. Social support and positive thinking are also included in the model as related to adjustment. Methods. One-hundred-sixty-two consecutive cancer patients receiving adjuvant or standard chemotherapy participated in the study. Patients completed the Mini-Mental Adjustment to Cancer, the Brief-COPE, the Social Provision Scale, and the SF-12 Health Survey. Partial least squares structural equation modeling (PLS-SEM) was applied for model building and hypotheses testing. Results. We found a negative association between advanced stage and physical functioning, a strong positive link between physical functioning and mental health, and significant relations between mental health and helpless-hopelessness, anxious preoccupation, and cognitive avoidance. Social support and positive thinking were related to fighting spirit and fatalism. Cancer stage and female gender were indirectly associated with adaptational outcomes through HRQoL. The patient’s age had no significant relationships in the model. Discussion. HRQoL (both physical and mental) is a key factor for preventing maladjustment in chemotherapy patients. Social support and positive thinking coping style fosters fighting spirit and fatalism on health outcomes. Two potential lines of action seem promising: preventing maladaptive and promoting adaptive adjustments working on patient’s mental health individually and involving significant others in supportive care, respectively.

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“…Palliative day care offers psychosocial support alongside clinical services-patients in the UK are motivated to attend palliative day care because of potential gains in social support (Goodwin, Higginson, Myers, Douglas, & Normand, 2002;Kernohan, Hasson, Hutchinson, & Cochrane, 2006). Peer relationships developed in face-to-face group therapies or support groups are also highly valued by patients (Taylor-Ford, 2014). Thus, this review focuses on solely on interventions taking place outside of the home.…”

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confidence: 99%

Effectiveness of palliative care interventions offering social support to people with life-limiting illness-A systematic review

2018

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Individuals managing the challenges of life‐limiting illness require adequate social support to maintain quality of life. Qualitative research reports that patients value highly the social support obtained in palliative care interventions such as day care and group therapies. This systematic review aims to summarise existing quantitative evidence on palliative care interventions that facilitate social support. Research literature was systematically searched using electronic databases and key journals. Searches returned a total of 6,247 unique titles of which sixteen were eligible for inclusion. Interventions include group therapies, group practical interventions and palliative day care. Outcome measures and study designs were heterogeneous. Only one study used a validated outcome measure of social support. Benefits were influenced by participant characteristics such as baseline distress. Partial economic evaluation was attempted by two studies. Methodological challenges include attrition and use of outcome measures that were insensitive to change. Statistically significant results were reported in psychological and physical domains. Evidence is limited due to methodological issues and a scarcity of quantitative research, particularly regarding long‐term benefits and cost‐effectiveness. Interventions may be more beneficial to some groups than others.

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Clinical Considerations for Working with Patients with Advanced Cancer

Cited by 8 publications

References 117 publications

Decision-Making Preferences About Secondary Germline Findings That Arise From Tumor Genomic Profiling Among Patients With Advanced Cancers

Decision-Making Preferences About Secondary Germline Findings That Arise From Tumor Genomic Profiling Among Patients With Advanced Cancers

Biopsychosocial Correlates of Adjustment to Cancer during Chemotherapy: The Key Role of Health-Related Quality of Life

Effectiveness of palliative care interventions offering social support to people with life-limiting illness-A systematic review

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