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Experiences of endocrine therapy after breast cancer surgery
abstracts CN83
Symptom cluster of fatigue, sleep disturbance and depression and its impact on quality of life among Chinese breast cancer patients undergoing adjuvant chemotherapy: A cross-sectional study
Annals of Oncology Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
X. He1, W.K.W. So1, K.C. Choi1, L. Li2, W. Zhao2, M. Zhang2 The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China, 2School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, China
1
CN84
Health-related quality of life in Greek haematological malignancies patients undergoing chemotherapy
M. Lavdaniti1, S. Kosmaoglou2, A. Chatzinikolaou1, E. Zioga3, K. Marmara1, E. Stalika4, S. Zyga5, G. Tzavelas6 1 Nursing Department, Alexander Technological Educational Institute, Thessaloniki, Greece, 2Statistics and Insurance Science, University of Piraeus, Pireaus, Greece, 3 Cardiologic Clinic, General Hospital of Veroia, Veroia, Greece, 4Lab of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece, 5Nursing Department, University of Peloponessus, Thessaloniki, Greece, 6Statistics and Insurance Science, University of Piraeus, Piraeus, Greece Background: Recent studies indicate that quality of life plays crucial role in cancer patients’ outcome. In order to obtain a more comprehensive view into this option, we applied three different questionnaires, the European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30), the Functional Assessment of Cancer Therapy-general (FACT-G) and the generic Short –Form 36 (SF36) for registering the haematological malignancies patients’ point of view. Methods: A cross- sectional study was established involving 67 patients, treated in a large hospital in a major Northern Greek city, with haematological malignancies undergoing chemotherapy in cycle 3. Data was collected using the three aforementioned scales in addition with a questionnaire with demographic and clinical characteristics. Results: The vast majority of patients were men (n ¼ 42, 62.7%) and married ( 65.7 %, n ¼ 44). Ten out of sixty-seven were multiple myeloma patients (n ¼ 10, 14.9%). The mean scores of overall scales were: SF-36: 47.93618.84, FACT-G: 73.68618.25, EORTC-QLQ: 70,70617.93. Cronbach’s a was >0.70 for all of the subscales of the questionnaires. There is an exception in emotional well being subscale of FACT-G and in physical functional subscale of EORTC QLQ-C30. Also, there was a strong correlation (>0.50) between physical functional subscale and emotional function subscale of the FACT-G, EORTC QLQ-C30 and SF-36 instruments (p < 0.001) and generally between the overall scores of three questionnaires (r ¼ 0.771, p < 0.001 between FACTG, EORTC QLQ-C30; r ¼ 0.771, p < 0.001 between SF-36 and FACT-G; r ¼ 0.842 p < 0.001 between SF-36 and EORTC QLQ-C30). Conclusions: The Greek versions of FACT-G, EORTC QLQ-C30 and SF-36 questionnaires are valuable tools that could be easily applied in a daily practical routine for assessing quality of life in patients with hematological malignancies. Additionally, the above procedure provides valid information to the nursing staff in order to help their patients to improve their quality of life having possible influence in the disease outcome.
v840 | Cancer Nursing: Symptom Management
Experiences of endocrine therapy after breast cancer surgery
S. Ahlstedt Karlsson1, R. Olofsson Bagge2, I. Henoch1, C. Wallengren1 Health Care Sciences, University of Gothenburg - The Sahlgrenska Academy, Gothenburg, Sweden, 2Clinical Sciences, University of Gothenburg - The Sahlgrenska Academy, Gothenburg, Sweden
1
Background: For patients diagnosed with hormone-receptor-positive breast cancer, endocrine therapy (ET) is prescribed, which reduces recurrence and mortality rates (Early Breast Cancer Trialists’ Collaborative Group, 2011). Despite the prognostic benefits of ET, the adherence to treatment varies, and 30%–70% of the patients discontinue their treatment within five years (Daly et al., 2017; Tinari et al., 2015; Ursem et al., 2015), often during their first year of treatment (He et al., 2015), due to the fact that ET is associated with adverse side-effects (Regan et al., 2011). Methods: The study was conducted in a surgical out-patient care unit at a hospital in Sweden. Inclusion criteria were women diagnosed with breast cancer and treated with ET after surgery. Forty-eight patients were invited to participate, of which 23 declined, thus 25 women were included. Seven focus group interviews, with two to five participants in each group, were conducted using an interview guide according to Krueger’s (2014) strategy. The interview guide contained six open-ended questions aiming to explore the women’s experiences of ET after breast cancer surgery. Inductive qualitative content analysis was used (Graneheim & Lundman, 2004). Results: The analysis resulted in three categories that described the women’s experiences: the treatment “creates discomfort”; “promotes levels of management”; and “causes feelings of abandonment”. Women’s experiences of treatment could at first glance be seen as positive, as perceived protection, but after further analysis, a deeper meaning was identified: protection with reservation. When experiencing discomfort, the women were urged to manage the situation, although the mode of management sometimes varied. The women reported that they needed support, but when the support did not appear, they felt as though they had been abandoned. Moreover, knowledge about sideeffects became an obstacle. The participants described feeling abandoned, but they also described their disease as “cancer light”. Conclusions: Professionals need to explore the pre-knowledge and preconceptions that patients might have. This could be achieved by listening to the patient before providing them with information. The information needs to be customized specifically to each person. Legal entity responsible for the study: The authors. Funding: Assar Gabrielsson’s Foundation, Herbert and Karin Jacobsson’s Foundation, and the Swedish Society of Nursing. Disclosure: All authors have declared no conflicts of interest.
CN86
The effects of progressive muscle relaxation and mindfulness meditation on fatigue, coping styles, and quality of life in breast cancer patients receiving adjuvant paclitaxel regimen: An assessor blinded, three-arm randomized controlled trial
Z. Gok Metin1, N. Izgu2, C. Karadas2, L. Ozdemir2, U. Demirci3 Internal Medicine Nursing, Hacettepe University - Faculty of Nursing, Ankara, Turkey, 2 Faculty of Nursing, Hacettepe University, Ankara, Turkey, 3Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Training Hospital, Health Sciences University, Ankara, Turkey
1
Background: This study aimed to examine the effects of progressive muscle relaxation (PMR) and mindfulness-based stress reduction (MBSR) on fatigue, coping styles and quality of life (QOL) in breast cancer patients receiving adjuvant paclitaxel regimen. Methods: Participants (stages 1-3) were randomly assigned to either a 12-week (PMR) (n ¼ 31), MBSR (n ¼ 32) interventions or control group (CG) (n ¼ 29). Participants in the intervention groups were instructed on PMR and MBSR, the steps of interventions were recorded a voice recorder, and were asked to listen the recorded audio files during exercises. Participants in the intervention groups continued PMR or MBSR 20 min. each day, totally 12 weeks at their home. The CG received only a single time attention placebo education (15 min.) on breast cancer before paclitaxel regimen. No intervention was applied to neither the interventions nor the control group until the follow-up assessment (week 14). Data collection tools included Patient Information Form, Brief Fatigue Inventory (BFI), Brief COPE, and the Functional Living Index-Cancer (FLIC). The data were collected at three time points including at baseline, week 12, and week 14. To analyze data repeated measures ANOVA and Kruskal Wallis tests were used. Results: The BFI scores were significantly decreased in the MBSR, PMR groups when compared with the CG at week 12 and week 14 (p<.05). The use of emotional support, use of instrumental support, venting, positive reframing, and planning sub-dimension scores of Brief COPE were significantly higher in the MBSR, and PMR groups than the CG at week 12 and week 14 (p<.05). Besides, the humor and acceptance sub-dimension
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz276.017/5576485 by guest on 26 October 2019
Background: Breast cancer (BC) itself and curative treatments can cause various concurrent distressing symptoms. These symptoms may “cluster” together and create a synergistic impact compared to a single symptom on patients’ quality of life (QoL). Among various symptom clusters identified in BC population, the cluster of fatigue, sleep disturbance and depression (F-S-D) is frequently reported during active adjuvant chemotherapy. A cross-sectional study was conducted to evaluate this symptom cluster in Chinese BC patients and explore its impact on QoL. Methods: Female adults currently receiving adjuvant chemotherapy for BC in two tertiary public hospitals in Xi’an, China were recruited in this study. Four validated measurements were used: Chinese version of Brief Fatigue Inventory, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-Depression, and Functional Assessment of Cancer Therapy-Breast. Patient-rated outcomes were measured on day-8 of recently received chemotherapy via face-to-face or telephone call. Descriptive statistics, Spearman correlation and One way ANOVA were used in data analysis. Results: A total of 372 consented subjects with a mean age of 50.169.2 years completed the survey. Most of them were married, diagnosed with I-II stage BC, and undergone mastectomy. 99.2% of subjects experienced with fatigue, 87.4% were poor sleepers, while 93.3% had depressive symptom. The proportions of subjects who experiencing 0, 1, 2 and 3 symptoms were 0.8%, 3.0%, 11.8% and 84.4%, respectively. Spearman correlation analysis showed that fatigue, sleep disturbance and depression were significantly correlated with each other (RFS¼.45, RFD¼.57, RSD¼.50, all P<0.001), and each of the single symptoms was negatively related to QoL (RFQ¼-.57, RSQ¼-.35, RDQ¼-.60, all P<0.001). When using One way ANOVA to explore the influence of symptom cluster on QoL, we found that there was a significant (F ¼ 34.76, P<0.001) decreasing trend in QoL across BC patients experiencing an increased number of symptoms (F-S-D). Conclusions: The symptom cluster of F-S-D exists in most BC patients and it adversely affects their QoL. Legal entity responsible for the study: Xiaole He. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN85
Symptom cluster of fatigue, sleep disturbance and depression and its impact on quality of life among Chinese breast cancer patients undergoing adjuvant chemotherapy: A cross-sectional study
Annals of Oncology Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
X. He1, W.K.W. So1, K.C. Choi1, L. Li2, W. Zhao2, M. Zhang2 The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China, 2School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, China
1
CN84
Health-related quality of life in Greek haematological malignancies patients undergoing chemotherapy
M. Lavdaniti1, S. Kosmaoglou2, A. Chatzinikolaou1, E. Zioga3, K. Marmara1, E. Stalika4, S. Zyga5, G. Tzavelas6 1 Nursing Department, Alexander Technological Educational Institute, Thessaloniki, Greece, 2Statistics and Insurance Science, University of Piraeus, Pireaus, Greece, 3 Cardiologic Clinic, General Hospital of Veroia, Veroia, Greece, 4Lab of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece, 5Nursing Department, University of Peloponessus, Thessaloniki, Greece, 6Statistics and Insurance Science, University of Piraeus, Piraeus, Greece Background: Recent studies indicate that quality of life plays crucial role in cancer patients’ outcome. In order to obtain a more comprehensive view into this option, we applied three different questionnaires, the European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30), the Functional Assessment of Cancer Therapy-general (FACT-G) and the generic Short –Form 36 (SF36) for registering the haematological malignancies patients’ point of view. Methods: A cross- sectional study was established involving 67 patients, treated in a large hospital in a major Northern Greek city, with haematological malignancies undergoing chemotherapy in cycle 3. Data was collected using the three aforementioned scales in addition with a questionnaire with demographic and clinical characteristics. Results: The vast majority of patients were men (n ¼ 42, 62.7%) and married ( 65.7 %, n ¼ 44). Ten out of sixty-seven were multiple myeloma patients (n ¼ 10, 14.9%). The mean scores of overall scales were: SF-36: 47.93618.84, FACT-G: 73.68618.25, EORTC-QLQ: 70,70617.93. Cronbach’s a was >0.70 for all of the subscales of the questionnaires. There is an exception in emotional well being subscale of FACT-G and in physical functional subscale of EORTC QLQ-C30. Also, there was a strong correlation (>0.50) between physical functional subscale and emotional function subscale of the FACT-G, EORTC QLQ-C30 and SF-36 instruments (p < 0.001) and generally between the overall scores of three questionnaires (r ¼ 0.771, p < 0.001 between FACTG, EORTC QLQ-C30; r ¼ 0.771, p < 0.001 between SF-36 and FACT-G; r ¼ 0.842 p < 0.001 between SF-36 and EORTC QLQ-C30). Conclusions: The Greek versions of FACT-G, EORTC QLQ-C30 and SF-36 questionnaires are valuable tools that could be easily applied in a daily practical routine for assessing quality of life in patients with hematological malignancies. Additionally, the above procedure provides valid information to the nursing staff in order to help their patients to improve their quality of life having possible influence in the disease outcome.
v840 | Cancer Nursing: Symptom Management
Experiences of endocrine therapy after breast cancer surgery
S. Ahlstedt Karlsson1, R. Olofsson Bagge2, I. Henoch1, C. Wallengren1 Health Care Sciences, University of Gothenburg - The Sahlgrenska Academy, Gothenburg, Sweden, 2Clinical Sciences, University of Gothenburg - The Sahlgrenska Academy, Gothenburg, Sweden
1
Background: For patients diagnosed with hormone-receptor-positive breast cancer, endocrine therapy (ET) is prescribed, which reduces recurrence and mortality rates (Early Breast Cancer Trialists’ Collaborative Group, 2011). Despite the prognostic benefits of ET, the adherence to treatment varies, and 30%–70% of the patients discontinue their treatment within five years (Daly et al., 2017; Tinari et al., 2015; Ursem et al., 2015), often during their first year of treatment (He et al., 2015), due to the fact that ET is associated with adverse side-effects (Regan et al., 2011). Methods: The study was conducted in a surgical out-patient care unit at a hospital in Sweden. Inclusion criteria were women diagnosed with breast cancer and treated with ET after surgery. Forty-eight patients were invited to participate, of which 23 declined, thus 25 women were included. Seven focus group interviews, with two to five participants in each group, were conducted using an interview guide according to Krueger’s (2014) strategy. The interview guide contained six open-ended questions aiming to explore the women’s experiences of ET after breast cancer surgery. Inductive qualitative content analysis was used (Graneheim & Lundman, 2004). Results: The analysis resulted in three categories that described the women’s experiences: the treatment “creates discomfort”; “promotes levels of management”; and “causes feelings of abandonment”. Women’s experiences of treatment could at first glance be seen as positive, as perceived protection, but after further analysis, a deeper meaning was identified: protection with reservation. When experiencing discomfort, the women were urged to manage the situation, although the mode of management sometimes varied. The women reported that they needed support, but when the support did not appear, they felt as though they had been abandoned. Moreover, knowledge about sideeffects became an obstacle. The participants described feeling abandoned, but they also described their disease as “cancer light”. Conclusions: Professionals need to explore the pre-knowledge and preconceptions that patients might have. This could be achieved by listening to the patient before providing them with information. The information needs to be customized specifically to each person. Legal entity responsible for the study: The authors. Funding: Assar Gabrielsson’s Foundation, Herbert and Karin Jacobsson’s Foundation, and the Swedish Society of Nursing. Disclosure: All authors have declared no conflicts of interest.
CN86
The effects of progressive muscle relaxation and mindfulness meditation on fatigue, coping styles, and quality of life in breast cancer patients receiving adjuvant paclitaxel regimen: An assessor blinded, three-arm randomized controlled trial
Z. Gok Metin1, N. Izgu2, C. Karadas2, L. Ozdemir2, U. Demirci3 Internal Medicine Nursing, Hacettepe University - Faculty of Nursing, Ankara, Turkey, 2 Faculty of Nursing, Hacettepe University, Ankara, Turkey, 3Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Training Hospital, Health Sciences University, Ankara, Turkey
1
Background: This study aimed to examine the effects of progressive muscle relaxation (PMR) and mindfulness-based stress reduction (MBSR) on fatigue, coping styles and quality of life (QOL) in breast cancer patients receiving adjuvant paclitaxel regimen. Methods: Participants (stages 1-3) were randomly assigned to either a 12-week (PMR) (n ¼ 31), MBSR (n ¼ 32) interventions or control group (CG) (n ¼ 29). Participants in the intervention groups were instructed on PMR and MBSR, the steps of interventions were recorded a voice recorder, and were asked to listen the recorded audio files during exercises. Participants in the intervention groups continued PMR or MBSR 20 min. each day, totally 12 weeks at their home. The CG received only a single time attention placebo education (15 min.) on breast cancer before paclitaxel regimen. No intervention was applied to neither the interventions nor the control group until the follow-up assessment (week 14). Data collection tools included Patient Information Form, Brief Fatigue Inventory (BFI), Brief COPE, and the Functional Living Index-Cancer (FLIC). The data were collected at three time points including at baseline, week 12, and week 14. To analyze data repeated measures ANOVA and Kruskal Wallis tests were used. Results: The BFI scores were significantly decreased in the MBSR, PMR groups when compared with the CG at week 12 and week 14 (p<.05). The use of emotional support, use of instrumental support, venting, positive reframing, and planning sub-dimension scores of Brief COPE were significantly higher in the MBSR, and PMR groups than the CG at week 12 and week 14 (p<.05). Besides, the humor and acceptance sub-dimension
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz276.017/5576485 by guest on 26 October 2019
Background: Breast cancer (BC) itself and curative treatments can cause various concurrent distressing symptoms. These symptoms may “cluster” together and create a synergistic impact compared to a single symptom on patients’ quality of life (QoL). Among various symptom clusters identified in BC population, the cluster of fatigue, sleep disturbance and depression (F-S-D) is frequently reported during active adjuvant chemotherapy. A cross-sectional study was conducted to evaluate this symptom cluster in Chinese BC patients and explore its impact on QoL. Methods: Female adults currently receiving adjuvant chemotherapy for BC in two tertiary public hospitals in Xi’an, China were recruited in this study. Four validated measurements were used: Chinese version of Brief Fatigue Inventory, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-Depression, and Functional Assessment of Cancer Therapy-Breast. Patient-rated outcomes were measured on day-8 of recently received chemotherapy via face-to-face or telephone call. Descriptive statistics, Spearman correlation and One way ANOVA were used in data analysis. Results: A total of 372 consented subjects with a mean age of 50.169.2 years completed the survey. Most of them were married, diagnosed with I-II stage BC, and undergone mastectomy. 99.2% of subjects experienced with fatigue, 87.4% were poor sleepers, while 93.3% had depressive symptom. The proportions of subjects who experiencing 0, 1, 2 and 3 symptoms were 0.8%, 3.0%, 11.8% and 84.4%, respectively. Spearman correlation analysis showed that fatigue, sleep disturbance and depression were significantly correlated with each other (RFS¼.45, RFD¼.57, RSD¼.50, all P<0.001), and each of the single symptoms was negatively related to QoL (RFQ¼-.57, RSQ¼-.35, RDQ¼-.60, all P<0.001). When using One way ANOVA to explore the influence of symptom cluster on QoL, we found that there was a significant (F ¼ 34.76, P<0.001) decreasing trend in QoL across BC patients experiencing an increased number of symptoms (F-S-D). Conclusions: The symptom cluster of F-S-D exists in most BC patients and it adversely affects their QoL. Legal entity responsible for the study: Xiaole He. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN85