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Emphasis on making psychosocial care part of routine cancer carepays off for patients by dedwf wefweg





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Emphasis on making psychosocial care part of routine cancer carepays off for patients by
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Emphasis on making psychosocial care part of routine cancer carepays off for patients


 
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Researchers at Moffitt Cancer Center have placed new emphasis ongathering data on cancer patient quality of life during both treatment and survivorship.Their focus is on gathering and using that data to developinterventions to improve the quality of life for patients intreatment and for cancer survivors. Much of the quality of life and survivorship research is carriedout by researchers in Moffitt's Department of Health Outcomes &Behavior. "Among the several research goals of the Department of HealthOutcomes & Behaviors is the evaluation and improvement of qualityof life and quality of care," said department chair Thomas H.Brandon, Ph.D. "We aim to understand and improve a patient'squality of life throughout the disease course by identifyingclinical practices and health outcomes that can inform our effortsto improve the quality of cancer care." Quality of life should be considered "The question of how well people are surviving cancer is asimportant as how long they survive cancer," said lead author Paul.B. Jacobsen, Ph.D., associate center director for PopulationScience, and Heather S.L.

Jim, Ph.D., of Health Outcomes &Behaviors. Their study on patient quality of life was published ina recent issue of Cancer Epidemiology, Biomarkers & Prevention (2011; 20). Assessment of quality of life factors is important, said theauthors, but many of the measurements for assessing quality oflife, particularly for cancer survivors, need development. "Quality of life is a multidimensional construct about dailyfunctioning - from physical to social - which is most oftenassessed by patient self-report," Jim said.

"It is important thatclinical trials include quality of life as an endpoint because iftwo treatments are found to work equally well, the treatment thatoffers the best quality of life for cancer survivors should beprescribed." Prolonged fatigue after treatment In a recent study published in CANCER, researchers from Moffitt found that when patients treated withchemotherapy or chemotherapy and radiation for breast cancer were compared to a control group who had not had cancer, thepatients who had experienced chemotherapy and/or radiotherapy hadmore fatigue . These patients also had fatigue that lasted years after theirtherapy. "This finding was contrary to our expectations," Jacobsen said."Conventional thinking is that patients receiving chemotherapywould, over time, experience less fatigue and would eventually seetheir fatigue diminish to the levels of controls who had not hadcancer, or to the level of fatigue they had prior to theirchemotherapy." One variable that could have affected the group with prolongedfatigue, noted the researchers, was a lack of supportive care, suchas exercise and cognitive behavioral therapy. Interventions such asthese could have an impact on patient fatigue and thus help improvequality of life, they noted.

Pain helped by psychosocial care In a study published recently in the Journal of Clinical Oncology , Moffitt researchers who teamed with colleagues at fiveuniversities across the United States concluded that psychosocialinterventions could have an effect on patient's pain severityduring cancer treatment. "Our study looked at randomized, controlled studies of psychosocialinterventions for pain published between 1966 and 2010 in whichpain was measured as an outcome for adults with cancer or thoseundergoing procedures to diagnose cancer," Jacobsen said. When they analyzed 37 past studies, the researchers found that themost successful psychosocial, nonpharmacological interventions wereskill-based or educational. "Skill-based interventions focused on changing a patient'sdysfunctional beliefs about pain and promoted the use of skills -such as distraction and relaxation - to manage it," explainedJacobsen. "We found that psychosocial interventions could improvepain severity and interference with daily activities." Stigma affects quality of life of lung cancer patients When Moffitt researchers Jacobsen and Brian D.

Gonzalez, M.A., ofHealth Outcomes & Behavior, studied depression among patients with lung cancer , they found that perceived stigma related to their diseasecorresponded to greater levels of depression, and that patientswith depression had more "dysfunctional attitudes." "Given its strong association with tobacco use, lung cancer may beviewed as a preventable disease, so patients might blame themselvesand feel stigmatized," explained Jacobsen. The aim of the study, according to Gonzalez, was to examine ratesof social rejection, financial insecurity, internalized shame andsocial isolation, and develop psychosocial interventions fordepression. "Therapy that focuses on altering the patient's thoughts andfeelings associated with their perceptions of stigma could proveeffective in reducing symptoms of depression and improve patientquality of life," Gonzalez said. Additional References Citations.

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