Search

GPs were not informed about the incentive trial until a thank-you letter was posted at the conclusion of the survey; all participating GPs then received $20 gift vouchers. Keywords: Randomized controlled trial as topic; General practice; Research design EN Randomized controlled trial as topic General practice Research design 585 586 2 06/21/22 20220615 NES 220615 General practitioners view health and medical research positively, but their participation in postal surveys is typically low.1 Poor response rates reduce the sample size and consequently the generalisability of survey results. [Extracted from the article]

Objective: Our aim is to examine whether provider screening for physical and emotional symptoms, as reported by medical oncology outpatients, varies across medical oncology treatment centres.Methods: A cross-sectional sample of 716 patients attending the outpatient medical oncology department of six public cancer treatment centres across five Australian states participated. Four patient-report survey items explored how often patients were specifically asked by clinical staff at the treatment centre about their (i) emotional distress (anxiety, distress and depression), (ii) pain, (iii) fatigue and (iv) other physical symptoms (e.g. nausea and constipation). Asking at less than half of all appointments was classified as infrequent screening.Results: No significant associations were found between treatment centre and symptom screening for emotional distress (p = 0.65), pain (p = 0.21), fatigue (p = 0.95) and other physical symptoms (p = 0.40). The proportion of patients who were regularly screened versus infrequently screened was significantly higher for physical symptoms than emotional symptoms (p < 0.001): 36% infrequently screened for emotional distress (range: 33-45%), 15% infrequently screened for pain (range: 9-21%), 16% infrequently screened for fatigue (range: 15-19%) and 11% infrequently screened for other physical symptoms (range: 5-17%).Conclusions: No significant variation in symptom screening was found across treatment centres. While the majority of patients received recommended care, treatment centres must continue to improve symptom screening rates, particularly for emotional distress. However, screening is only the first step and must be accompanied by the offer of help and provision of help to relieve patient suffering. [ABSTRACT FROM AUTHOR]

Skin cancers including melanoma and non-melanoma skin cancers are a high-cost and largely preventable form of cancer. While limiting exposure to solar ultraviolet ( UV) light via outdoor activities is a focus of public health efforts, indoor UV exposure via solaria or 'tanning booths' has also become a cause for concern. In recent decades the availability of less harmful non- UV self-tanning products such as sprays and lotions has increased. This review explores (i) the available data regarding the prevalence and behavioural factors associated with use of solaria and self-tanning products and (ii) data that may shed light on the likelihood of solaria users substituting self-tanning products as a less harmful alternative to solaria exposure. While there are insufficient data on which to draw a firm conclusion about the potential for substitution, it appears unlikely that most solaria users would readily substitute self-tanning products in place of solaria exposure. Public health advocates may need to consider whether a robust research study of the cost-effectiveness of encouraging substitutional use of self-tanners is desirable, or whether efforts to severely restrict access to solaria may be a better approach. [ABSTRACT FROM AUTHOR]

Objective: To describe travel burden and travel-related financial burden experienced by cancer patients over the first year after diagnosis. Design, setting, participants: Population-based longitudinal cohort of recent adult cancer patients diagnosed with the eight most incident cancers recruited from New South Wales and Victorian Cancer Registries. Self-report survey data were collected at 6 and 12 months after diagnosis from 1410 participants (city: n = 890; regional/remote: n = 520). Main outcome measures: Travel time to cancer treatment, living away from home for treatment, travel-related treatment decisions, extent of financial issues, unmet need for financial help. Results: During the first 12 months after diagnosis, outer regional/remote residents had the greatest travel burden; 61% (n = 79) travelled at least 2 hours one way to receive treatment, and 49% (n = 66) lived away from home to receive treatment. Strongest associates of travel burden were living in regional/remote areas (odds ratio (OR) = 18.9-135.7), having received surgery (OR = 6.7) or radiotherapy (OR = 3.6). Between 6 and 12 months after diagnosis, 2% (n = 24) of patients declined cancer treatment because of the time it would take to get to treatment. Patients who travelled more than 2 hours or lived away for treatment reported significantly greater financial difficulties (38%; 40%) than those who did not (12%; 14%), even after adjusting for covariates. Conclusions: Travel burden is greatest for rural patients, and is associated with greater financial burden. Appropriate and adequate provision of travel and accommodation assistance schemes remains paramount to achieving equitable delivery of cancer services. [ABSTRACT FROM AUTHOR]

Objective: Coping strategies mediate the relationship between challenging situations and their impact on psychosocial outcomes. Many long-term cancer survivors continue to face a range of challenges in their daily lives, yet little is known about how this population copes. The study explored the prevalence and predictors of cancer-specific coping strategies among a heterogeneous sample of long-term cancer survivors. Methods: A population-based cross-sectional sample of 863 adult cancer survivors 5-6 years post-diagnosis completed a pen-and-paper survey. Cancer-specific coping was assessed via the Mini-Mental Adjustment to Cancer (mini-MAC) Scale. Potential predictor variables included patient, disease and treatment characteristics and social support. Results: The most commonly used coping strategies were fatalism and fighting spirit. Of those survivors that used any of the coping strategies assessed, 53% used at least two strategies. Maladaptive coping was commonly predicted by low social support (OR=1.77 to 2.49) and being a disability pensioner, whereas having ever received chemotherapy widely predicted greater use of all types of coping. A weekly household income of over $1000 a week uniquely predicted not using any mini-MAC coping strategies. Conclusions: Survivors continue to engage in cancer-specific coping strategies many years after diagnosis, albeit to a lesser extent than recent survivor populations. A number of predictors were identified that can alert health workers to long-term survivors at increased risk of maladaptive coping. Given that low social support consistently predicted maladaptive coping responses, interventions aimed at promoting positive coping responses should include strategies to increase access to social support. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article presents a large-scale, population-based study in Australia which assessed the prevalence and predictors of anxiety and depression among a heterogenous sample of long-term adult cancer survivors. It outlines the instruments utilized in the study, including Hospital Anxiety and Depression Scale (HADS) and the Mini-Mental Adjustment to Cancer (mini-MAC). It has found that levels of anxiety and depression were low. It has revealed that most survivors had adjusted well to their cancer treatment.

A letter to the editor is presented in response to the article "Anxiety and depression among long-term survivors of cancer in Australia: results of a population-based survey," by A. W. Boyes et al, published in a 2009 supplementary issue.

Objectives: The study examined: 1) the proportion of patients who received their preferred level of information about life expectancy; and 2) sociodemographic, clinical and psychological factors associated with patients' perceptions of whether they received too little, too much, or the right amount of information about life expectancy.Design: Cross-sectional survey.Setting: Eleven large Australian medical oncology treatment centres.Participants: A total of 1431 medical oncology outpatients participated (81% consent rate). Eligible patients were approached between September 2012 and May 2014.Main Outcome Measures: Patients indicated whether the information about life expectancy they received aligned with their preferences.Results: Almost one in four patients (24%) received too little information, 4% received too much, and 50% received all the information they wanted; 22% of patients neither wanted nor received information about life expectancy. Patients were more likely to receive too little information if they were not in remission (odds ratio [OR], 1.77), did not know their cancer stage at diagnosis (OR, 3.64), or were anxious (OR, 1.48) or depressed (OR, 1.48). Patients had greater odds of receiving too much information if they were younger (OR, 1.45), had more advanced cancer (OR, 2.01) or did not know their cancer stage at diagnosis (OR, 4.42).Conclusions: That fact that 28% of cancer patients did not receive their desired level of information about life expectancy highlights the difficulties associated with discussing this sensitive topic. To ensure that life expectancy discussions correspond with patient preferences, clinicians should routinely ask patients whether they want to know this information, in what format, and at which level of detail. [ABSTRACT FROM AUTHOR]