Search

For the treatment choice of localized prostate cancer, effective patient decision aids have been developed. The implementation of decision aids in routine care, however, lags behind. Main known barriers are lack of confidence in the tool, lack of training on its use, lack of resources and lack of time. A new implementation strategy addresses these barriers. Using this implementation strategy, the implementation rate of a decision aid was measured in eight hospitals and questionnaires were filled out by 24 care providers and 255 patients. The average implementation rate was 60 per cent (range 31%–100%). Hardly any barriers remained for care providers. Patients who did not use the decision aid appeared to be more unwilling than unable to use the decision aid. By addressing known barriers, that is, informing care providers on the effectiveness of the decision aid, providing instructions on its use, embedding it in the existing workflow and making it available free of charge, a successful implementation of a prostate cancer decision aid was reached. [ABSTRACT FROM AUTHOR]

Implementation of patient's decision aids in routine clinical care is generally low. This study evaluated uptake and usage of a novel Dutch web-based prostate cancer treatment decision aid within the Prostate Cancer Patient Centered Care trial. From an estimated total patient sample of 1006 patients, 351 received a decision aid (35% implementation rate; hospital ranges 16%–84%). After receipt of the decision aid, most patients accessed the decision aid, utilized most functions, although not completely, and discussed the decision aid summary in a subsequent consultation with their care provider. Including nurses for dissemination of decision aids seemed to positively affect decision aid uptake. Once received, patients seemed able to use the decision aid and engage in shared decision-making as intended; however, decision aid uptake and complete usage of all decision aid components should be further improved. Prior to the diagnosis consultation, handing out of the decision aid should be prepared. [ABSTRACT FROM AUTHOR]

Introduction: The EORTC QLQ-CR29 is a patient-reported outcome measure to evaluate health-related quality of life among colorectal cancer patients in research and clinical practice. The aim of this systematic review was to investigate whether the initial positive results regarding the measurement properties of the QLQ-CR29 are confirmed in subsequent studies.Methods: A systematic search of Embase, Medline, PsycINFO, and Web of Science was conducted to identify studies investigating the measurement properties of the QLQ-CR29 published up to January 2019. For the 11 included studies, data were extracted, methodological quality was assessed, results were synthesized, and evidence was graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology on the measurement properties: structural validity, internal consistency, reliability, measurement error, construct validity (hypothesis testing, including known-group comparison, convergent and divergent validity), cross-cultural validity, and responsiveness.Results: Internal consistency was rated as "sufficient," with low evidence. Reliability was rated as "insufficient," with moderate evidence. Construct validity (hypothesis testing; known-group comparison, convergent and divergent validity) was rated as "inconsistent," with moderate evidence. Structural validity, measurement error, and responsiveness were rated as "indeterminate" and could therefore not be graded.Conclusion: This review indicates that current evidence supporting the measurement properties of the QLQ-CR29 is limited. Additionally, better quality research is needed, taking into account the COSMIN methodology. [ABSTRACT FROM AUTHOR]

Introduction: Body image is acknowledged as an important aspect of health-related quality of life in cancer patients. The Body Image Scale (BIS) is a patient-reported outcome measure (PROM) to evaluate body image in cancer patients. The aim of this study was to systematically review measurement properties of the BIS among cancer patients.Methods: A search in Embase, MEDLINE, PsycINFO, and Web of Science was performed to identify studies that investigated measurement properties of the BIS (Prospero ID 42017057237). Study quality was assessed (excellent, good, fair, poor), and data were extracted and analyzed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology on structural validity, internal consistency, reliability, measurement error, hypothesis testing for construct validity, and responsiveness. Evidence was categorized into sufficient, insufficient, inconsistent, or indeterminate.Results: Nine studies were included. Evidence was sufficient for structural validity (one factor solution), internal consistency (α = 0.86-0.96), and reliability (r > 0.70); indeterminate for measurement error (information on minimal important change lacked) and responsiveness (increasing body image disturbance in only one study); and inconsistent for hypothesis testing (conflicting results). Quality of the evidence was moderate to low. No studies reported on cross-cultural validity.Conclusion: The BIS is a PROM with good structural validity, internal consistency, and test-retest reliability, but good quality studies on the other measurement properties are needed to optimize evidence. It is recommended to include a wider variety of cancer diagnoses and treatment modalities in these future studies. [ABSTRACT FROM AUTHOR]

Background: Evidence-based, easily accessible, supportive interventions for partners of cancer patients are limited, despite the fact that they often suffer from diminished emotional, social, physical, and relational functioning. To develop a new intervention that will fit their demands, it is important to consult potential users. Objective: To examine partners' interest in a Web-based psychological intervention and to identify their needs and wishes regarding such an intervention. Methods: Semistructured interviews were conducted with 16 partners of cancer patients, who varied in terms of age, gender, education, employment, type, and stage of disease. Partners were asked (1) whether they would use a psychological Web-based intervention and which preconditions (maximum time, structure, participate alone or with their partner) it should meet; (2) which functionalities (information, peer support, online psychological counseling) the intervention should contain; and (3) which topics (eg, taking care of oneself) should be addressed. Data were coded by 2 coders independently. Results: The need for a Web-based intervention varied. Arguments for being interested in a Web-based intervention included the need for acknowledgement; the need for someone they could talk to; and the need for information, tips, and support. Based on their experiences as a partner of a cancer patient, participants would prefer an intervention that is not too time-consuming (about 1-2 hours a week) and which is based on a "step-by-step" approach, meaning that the content of the intervention should match the stage of their partner's disease. Also, they would prefer a positive approach, which means that the intervention should be a source of hope and energy. Most participants stated that they would prefer to participate without their ill spouse, because they do not want to burden their partners with their own problems. An intervention should contain information and optional peer support. Participants' opinions about online psychological counseling in the intervention were divided. Arguments for online psychological counseling were that a professional could check on them and they were able to ask questions. Arguments against online counseling were that partners were not in need for guidance or they had enough support from usual care. Topics with the highest priority were "coping with feelings and emotions," "should I or shouldn't I spare my partner?," "communicating with each other," "asking for help and refusing help," and "moving on with life after cancer treatment." Furthermore, participants suggested additional topics of "dare to enjoy" and "acceptance of the patient's disease." Conclusions: A Web-based intervention can be a valuable addition to existing support initiatives for partners of cancer patients. This study provides important information about the content and form of such an intervention. Flexibility and a positive approach seem to be the most important features. [ABSTRACT FROM AUTHOR]

To gain insight into healthcare professionals' (HCPs') perspectives on the use of outcome data in consultations and to understand which aggregated outcomes patients find important. This study had a mixed-methods design and consisted of two steps: 1. HCPs (n = 11) were interviewed about the use of outcome data in consultations. Thematic analysis was used for data analysis. 2. Patients with prostate cancer, lung cancer, and inflammatory bowel disease (IBD) completed questionnaires (n = 283) to identify important outcomes. Descriptive statistics were used for data analysis. HCPs indicated that aggregated outcome data are not routinely used in consultations. They pointed out various barriers to using outcome data, e.g., low response rates of PROMs, and suggested actions to address these barriers, including training of HCPs in outcome data usage. Patients rated the majority of aggregated outcomes as important, although preferences differed between the studied health conditions. Both HCPs and patients underscored the importance of discussing outcome data in consultations. Nevertheless, HCPs encountered several barriers to using outcome data. Furthermore, patients with different health conditions have somewhat different information needs. The study identified several actionable steps to enhance the collection and application of outcome data in consultations. • Aggregated outcome data are not routinely used in consultations • Patients rate the majority of aggregated outcomes as important information • Patients with different health conditions have somewhat different information needs • Healthcare professionals experience barriers to use outcome data in consultations • Multiple actions to increase use of outcome data in consultations were identified [ABSTRACT FROM AUTHOR]

OBJECTIVES: To gain an understanding of the perceptions of patients with incurable cancer regarding a new nurse-led self-management support intervention with an integrated eHealth application (Oncokompas) and its potential effectiveness. SAMPLE & SETTING: 36 patients receiving support in the home setting. METHODS & VARIABLES: A pre- and post-test mixed-methods design was used with a period of 12 weeks between the tests and qualitative interviews. Outcome measures were the perceived application of the intervention, patient satisfaction, patient activation, and quality of life. RESULTS: 85% of patients were satisfied with the assessment of their needs and the advice received. They valued nurses' expertise and the assistance provided in their homes. Twenty-five percent of the patients used Oncokompas. However, no statistically significant changes in patient activation and quality of life were found. IMPLICATIONS FOR NURSING: This intervention can be used for encouraging self-management by patients with incurable cancer. Additional refinement and tailoring is desirable. Offering the intervention as early in the palliative phase as possible is recommended. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To explore how nurses perceive their self-efficacy and performance in supporting self-management among patients with incurable cancer, and whether these perceptions differ between community and hospital nurses. SAMPLE & SETTING: 222 hospital nurses (n = 94) and community nurses (n = 128) working with adult patients with incurable cancer. METHODS & VARIABLES: An online survey included the Self-Efficacy and Performance Into Self-Management Support instrument. Possible differences in age, gender, work setting, and additional training in oncology between groups were explored. RESULTS: Nurses felt confident about their selfefficacy, particularly in assessing patients' knowledge and beliefs and in advising about their disease and health status. Nurses felt less confident in their performance, particularly in the use of technology (arranging follow-up care), but also in agreeing on collaborative goals and assisting patients in achieving these goals. Compared to hospital nurses, community nurses reported significantly higher scores on self-efficacy and performance. IMPLICATIONS FOR NURSING: More effort is needed to increase nurses' confidence in providing self-management support, with a focus on arranging follow-up care with the use of technology and on collaborating with patients in setting and achieving goals. [ABSTRACT FROM AUTHOR]

Background: eHealth can be defined as information provision about illness or health care and/or support for patients and/or informal caregivers, using the computer or related technologies. eHealth interventions are increasingly being used in cancer care, e.g. to support patients and informal caregivers in managing symptoms and problems in daily life.Objectives: To synthesize evidence from systematic reviews on the effects of eHealth for cancer patients or their informal caregivers.Materials and Methods: A systematic meta-review, in the sense of a systematic review of reviews, was conducted. Searches were performed in PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library. All steps in the review process were either performed by two reviewers independently or checked by a second reviewer. Disagreements were resolved by consensus.Results: Ten systematic reviews were included. All reviews focused on the effects of eHealth for patients and none on effects for informal caregivers. Except for one review of high methodological quality, all reviews were of moderate methodological quality. Evidence was found for effects on perceived support, knowledge levels, and information competence of cancer patients. Indications of evidence were found for health status and healthcare participation. Findings were inconsistent for outcomes related to decision-making, psychological wellbeing, depression and anxiety, and quality of life. No evidence was found for effects on physical and functional wellbeing.Conclusion: There is evidence for positive effects of eHealth on perceived support, knowledge, and information competence of cancer patients. For effects on other outcomes in cancer patients, findings are mainly inconsistent or lacking. This meta-review did not find relevant reviews focusing on or including the effects of eHealth on informal caregivers, which seems a rather unexplored area. [ABSTRACT FROM AUTHOR]