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Most patients with chronic myeloid leukemia (CML) experience fatigue and pain related to the disease or its treatment, which often co-occur with other psychoneurological symptoms (PNS). Literature found PNS burden can be aggravated by stress but alleviated by social support in cancer patients. Although financial toxicity (FT) is a leading cause of stress during cancer treatment, little is known about how FT affects PNS and whether social support alleviates the negative consequences of FT on PNS among CML patients treated with tyrosine kinase inhibitors (TKIs). This study examined the association between FT and PNS burden and the moderating effect of social support among CML patients taking TKIs. A secondary analysis was conducted for 81 CML patients taking TKIs. PNS burden was assessed using the average of the Patient-Reported Outcome Common Terminology Criteria for Adverse Events (PRO-CTCAE) composite grades of eight symptoms (the higher, the worse): pain, fatigue, insomnia, concentration problems, memory problems, anxiety, discouragement, and sadness. FT and social support were assessed by Comprehensive Score for Financial Toxicity (COST) (the higher, the better) and Interpersonal Support Evaluation List-12 (ISEL-12) (the higher, the better). To determine the associations among FT, PNS burden, and social support, we performed Spearman correlation analysis and regression-based moderation analysis with mean-centered COST and ISEL-12 total scores. About half were male (55.6%), White (55.6%), married (49.4%), and currently employed (56.8%). The median year since CML diagnosis was 5.5. Overall, patients reported low FT (mean = 26.9, standard deviation [SD] = 10.9), low PNS burden (mean = 0.7, SD = 0.6), and moderate social support ( mean = 28.2, SD = 7.3). Increased FT was associated with increased PNS burden (p = -.49, p <.001) and increased social support (p = .47, p <.001). We found no moderating effect of social support between FT and PNS burden. Only when patients' ISEL-12 total score was greater than 18.7, FT had a significant association with PNS burden. The association between FT and PNS burden suggests a need for assessing and addressing FT as a part of symptom management among CML patients taking TKIs. Social support may not buffer the association between FT and PNS burden in CML patients taking TKIs, but it may play a role in alleviating FT. [ABSTRACT FROM AUTHOR]

The article presents a report focused on improving symptom management for patients with acute and chronic conditions, including cancer, and developing interventions to improve patient outcomes. It mentions about the need to implement practice models that address barriers to cancer care and facilitate enhanced access.

This study investigated factors associated with cognitive performance among Black caregivers of persons living with two chronic conditions: dementia or cancer. Fifty-six Black caregivers of people living with dementia or cancer were recruited from clinic and community sources. Variables measured included: depression, anxiety, stress, sleep, fatigue, and caregiver burden. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Descriptive statistics and non-parametric analyses were conducted to identify factors related to MoCA scores. Caregivers were 58.3 years of age and predominantly female. The average MoCA score was 25.23. Gender and education, along with positive appraisal of caregiving were significantly associated with cognitive performance. Several other factors approached significance including cohabitation with the care recipient, fatigue, and stress due to perceived individual and institutional racism. Our findings suggest several factors that warrant further investigation for understanding the relationship between caregiving and cognitive performance in Black caregivers of people living with cancer or dementia., Competing Interests: Declaration of competing interest None, (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life., Objective: The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do., Methods: A purposive sample of 27 individuals participated in semistructured interviews conducted by 2 research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management., Results: Participants described 2 approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience., Conclusions: This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms., Implications for Practice: As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.

People with epilepsy must adopt many self-management behaviors, especially regarding medication adherence, stress management, and sleep quality. In response to the need for theory-based self-management programs that people with epilepsy can easily access, the WebEase Web site was created and tested for feasibility, acceptability, and usability. This article discusses the theoretical background and developmental phases of WebEase and lessons learned throughout the development process. The WebEase research team developed content for the Web site on the basis of social cognitive theory, the transtheoretical model of behavior change, and motivational interviewing. Formative research and development of the WebEase program included a literature search, computer use survey, a focus group, and review by content experts and consumers. The program has 2 main components: 1) the modules, which provide a tailored opportunity for learning, reflection, and goal setting, and 2) MyLog, a place to enter daily information.