- Email: [email protected]
Real State of the Terminal Care of Lung Cancer in the Integrated Community Care System after Medical Fees Revision 2018
abstracts
Annals of Oncology P3 199
The Association of Social Support and Coping Mechanisms in Breast Cancer Patients
Background: Breast cancer is the most prevalent type of cancer in Indonesian women. To overcome psychosocial concerns due to treatment, breast cancer patients rely on coping mechanisms and social support. Thus, the aim of this study is to assess the association of social support and coping strategies in breast cancer patients receiving chemotherapy. Methods: A cross-sectional study is conducted at our general Hospital in Tangerang from October 2018-February 2019. The data sample is breast cancer patients who underwent mastectomy and adjuvant chemotherapy. Data were collected using the Multidimensional Scale of Perceived Social Support questionnaire which assessed social support. Cancer Coping Questionnaire (CCQ-21) is used to classify coping mechanisms. The data were presented using descriptive statistics and analyzed with Chi-square test using SPSS version 24.0 Result: This study enrolled 36 breast cancer patients with a mean age of 49.93 (29-73) 611.473 years old. Among them, 41.4% received moderate support while 58.6% received high social support from family members. Meanwhile, 68.9% received moderate support and 31.1% received high support from friends. From other forms of social support, 44.8% received moderate support while 55.1% received high support. The total social Result makes of 62.1% moderate social support and 37.9% high social support. For coping mechanisms, 65.5% had adaptive coping mechanisms and 34.5% had maladaptive coping mechanisms. 9 of the patients received moderate support but maladaptive, while 11 others had adaptive coping mechanism. The rest received high social support with 2 maladaptive and 14 adaptive coping. (p-value¼0.039) Conclusion: Social support in breast cancer patients in Indonesia is moderate and most of it comes from family members. With most patients used adaptive coping paired with high social support. A deeper study is required to confirm the Results.
P3 200
Correlation between Social Support Given and its Psychological Effects in Breast Cancer Patients: A Preliminary Study 1
1
1
1
1
Maria Claudia , Natasya Reina , Michelle Octavia , Felix Wijovi , Helenia Putri , Cindy Cindy1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia Background Breast cancer is the most common cancer diagnosed in women. The diagnosis and treatments can cause distress among patients. Social support plays an important role in helping patients. However, the study between this correlation is still limited. Thus, the aim of this study is to know the correlation between social support given and its psychological effects on breast cancer patients. Methods A cross-sectional study was done in our general hospital from October 2018February 2019. The patients included in this study are breast cancer patients and have undergone mastectomy and adjuvant therapy. Multidimensional Scale of Perceived Social Support questionnaire has 4 parts, social support from other people, family, friends, and total scores. The score range is low(1-2.9); moderate(3-5); and high(5-7). The psychological aspect was assessed using the Hospital Anxiety Depression Scale with total score of 21, where 0-7 is normal, 8-10 is the borderline, and 11-21 means anxiety or depression is present. The correlation between variables was analysed with Spearman correlation. Results 36 breast cancer patients with a mean age of 49.93611.473, the Results for social support show family supports median is 3(2-3), friends supports median is 2(23), other people supports median is 3(2-3), and the total median is 2(2-3). Results for anxiety are 55.1% normal, 27.5% in borderline, and 17.24% with anxiety. Results for depression are 65.5% normal, 31% in the borderline, and 3.4% with depression. The correlation between total support and anxiety is r¼0.151 (p-value¼0.379). While its correlation with depression is shown with r¼0.173 (p-value¼0.312). Conclusion There is no correlation between social support given with its psychological effects. There are many factors that may affect breast cancer patients psychologically. Further study needs to be done with more variables and samples to get more reliable Results.
P3 201
Real State of the Terminal Care of Lung Cancer in the Integrated Community Care System after Medical Fees Revision 2018
Kan Kato1,2,3, Chikage Koganemaru1, Tokuken Oh2, Kageaki Watanabe3, Yuusuke Ookuma3, Yukio Hosomi3 1 Department of Internal Medicine, Tokyo Kensei Hospital, 2Department of Internal Medicine, Ooizumi Health Cooperative Hospital, 3Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Background: After Medical Fees Revision FY2018, movements from Integrated Community Care Ward(IW) to Long-term Treatment Ward(LW) are not regarded as
Volume 30 | Supplement 6 | October 2019
P3 202
Best supportive care for advanced lung cancer patients aged 85 and older
Taisuke Kazuyori1, Yoshitaka Seki1, Akihito Satou1, Syouta Fujimoto1, Masami Yamada1, Yumie Yamanaka1, Ikumi Fujisaki1, Kyuuto Odashima1, Aya Seki1, Takeo Ishikawa1, Kazuyoshi Kuwano2 1 The Jikei University School of Medicine Daisan Hospital, Division of Respiratory Medicine, Tokyo, Japan, 2The Jikei University School of Medicine, Division of Respiratory Medicine, Tokyo, Japan Background: In Japan, the rate of the elderly population is rising, and elderly lung cancer patients are also increasing. Because of their genetic and environmental factors, they often received only best supportive care (BSC). Methods: We performed retrospective analysis of 25 patients with advanced lung cancer patients aged 85 and older since 2014 to 2017 and assessed Background and prognosis. Results: The age was 85-94 years, and 17 patients were male. Thirteen patients had malignant pleural effusion. In these cases, 10 were adenocarcinoma (3 harboring EGFR mutation), 6 squamous cell carcinoma, 4 NSCLC-NOS, 2 SCLC, and 3 unknown. Nine patients were assigned an ECOG good PS of 0,1,2, and 16 patients a poor PS of 3,4. The common reasons of patients who received BSC with PS (13 patients) and cognitivefunction disorder (6 patients). Median overall survival were 2.7 months. According to univariate analysis (Cox proportional analysis),PS¼3 or 4 [hazard ratio: 5.94, 95% confidence interval (C.I): 1.77-19.93] and hypoalbuminemia (serum albumin < 3.5 g/dl) [hazard ratio: 6.84, 95% C.I: 1.48-31.6] were associated with significantly shorter OS but there was no statistically significant difference in Cognitive-function disorder [hazard ratio: 2.17, 95% C.I: 0.75-6.23]. Only 2 patients were alive over one year, and 11patients were in Nursing and Healthcare units. Conclusion: In elderly patients, BSC had often been selected for reasons other than aggressive disease. Since the elderly population is expected to rise further in the future, it is important to construct a palliative treatment strategy that takes into consideration the characteristics of the elderly.
P3 222
Cancer-oriented comprehensive nursing-caregiving service in Korea: 1 year report
Hyojin Kim1, Boram No1, Ara Ko1, Miso Choi1, Seol Lee1, So Young Park1, Yongchel Ahn2, Moon-Ho Kim2 1 Department of Nursing, Gangneung Asan Hospital, Republic of Korea, Korea, 2 Department of Hematology and Oncology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Republic of Korea Background: Korean comprehensive nursing-caregiving service, which is covered by national insurance, has been officially initiated in 2016. Following interim analysis presented at JSMO 2018, we report our 1-year experience of cancer-oriented comprehensive nursing-caregiving units outcomes and issues. Methods: and Results Our institution is a general hospital (827 beds) with 246 doctors and 703 RNs. We are running cancer-oriented comprehensive nursing-caregiving service (46 beds with 25 RNs and 12 nurse´s aides) since December 2017. This special ward is caring only medical oncology patients. For 12 months, 11,946 inpatients (average 32.4 patients/day, bed turnover rate 85.7%) and 5,682 patients received chemotherapy in our unit. We evaluated our Results in three categories: structure, process, and outcome. First, structural (environmental) improvements were found in more interval between
doi:10.1093/annonc/mdz343 | vi147
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz343.137/5582966 by MCP Hahnemann University user on 10 November 2019
Friecelie N Sutarna1, Elizabeth Celine1, Angeline Tancherla1, Regina Nathania1, Helenia Putri1, Fernando Dharmaraja1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
going home, but we foresaw in the last annual meeting that the Integrated Community Care System(IS) might still function well in the terminal care of lung cancer if home care system and LW were effective. So we verify the predict by examining our additional practice over the last year. Methods: We investigated medical records of 164 dead lung cancer patients treated in Tokyo Kensei Hospital(THp) (35 IW beds, 64 LW beds) and Ooizumi Health Cooperative Hospital(OHp) (47 IW beds, and 47 acute ward beds) in the last 6 years, and checked the state of cooperation between hospitals and clinics, the places of death. Results: 41 of 66 THp patients passed away in LW, and 12 in IW. Such cases are still increasing due to introduction for BSC from acute hospitals. In FY2018 we saw a lung cancer patient who enjoyed the terminal care under the cooperation among acute hospital, IW, home care system, and LW (case presentation). In OHp no patients move to hospice or LW in FY2018, 32 (with 3 additional) cases of 98 patients passed away at home, and 8 (with 5 additional at one year) cases died in IW. Since FY2015 when IWs were opened in both hospitals, 1632 patients of all diseases stayed 28.4 days on average at IW in THp, and 1995 patients 29.4 days in OHp, significantly longer (P < 0.001) in OHp without LW. But in FY2018, 401 patients stayed 28.0 days at IW, which is significantly shorter (P < 0.05) like in THp than 29.7 days of the former 1594 cases. 22 lung cancer patients in terminal stage in THp stayed 28.2 days at IW, and 13 patients in OHp stayed 21.9 days at IW, fewer (but rapid increased number of) patients and shorter period than in THp. Conclusion: After revision 2018, definition of going home has been more strict, but we recognize that IS where IW centers actually functions well under the close cooperation with home care or LW.
Annals of Oncology P3 199
The Association of Social Support and Coping Mechanisms in Breast Cancer Patients
Background: Breast cancer is the most prevalent type of cancer in Indonesian women. To overcome psychosocial concerns due to treatment, breast cancer patients rely on coping mechanisms and social support. Thus, the aim of this study is to assess the association of social support and coping strategies in breast cancer patients receiving chemotherapy. Methods: A cross-sectional study is conducted at our general Hospital in Tangerang from October 2018-February 2019. The data sample is breast cancer patients who underwent mastectomy and adjuvant chemotherapy. Data were collected using the Multidimensional Scale of Perceived Social Support questionnaire which assessed social support. Cancer Coping Questionnaire (CCQ-21) is used to classify coping mechanisms. The data were presented using descriptive statistics and analyzed with Chi-square test using SPSS version 24.0 Result: This study enrolled 36 breast cancer patients with a mean age of 49.93 (29-73) 611.473 years old. Among them, 41.4% received moderate support while 58.6% received high social support from family members. Meanwhile, 68.9% received moderate support and 31.1% received high support from friends. From other forms of social support, 44.8% received moderate support while 55.1% received high support. The total social Result makes of 62.1% moderate social support and 37.9% high social support. For coping mechanisms, 65.5% had adaptive coping mechanisms and 34.5% had maladaptive coping mechanisms. 9 of the patients received moderate support but maladaptive, while 11 others had adaptive coping mechanism. The rest received high social support with 2 maladaptive and 14 adaptive coping. (p-value¼0.039) Conclusion: Social support in breast cancer patients in Indonesia is moderate and most of it comes from family members. With most patients used adaptive coping paired with high social support. A deeper study is required to confirm the Results.
P3 200
Correlation between Social Support Given and its Psychological Effects in Breast Cancer Patients: A Preliminary Study 1
1
1
1
1
Maria Claudia , Natasya Reina , Michelle Octavia , Felix Wijovi , Helenia Putri , Cindy Cindy1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia Background Breast cancer is the most common cancer diagnosed in women. The diagnosis and treatments can cause distress among patients. Social support plays an important role in helping patients. However, the study between this correlation is still limited. Thus, the aim of this study is to know the correlation between social support given and its psychological effects on breast cancer patients. Methods A cross-sectional study was done in our general hospital from October 2018February 2019. The patients included in this study are breast cancer patients and have undergone mastectomy and adjuvant therapy. Multidimensional Scale of Perceived Social Support questionnaire has 4 parts, social support from other people, family, friends, and total scores. The score range is low(1-2.9); moderate(3-5); and high(5-7). The psychological aspect was assessed using the Hospital Anxiety Depression Scale with total score of 21, where 0-7 is normal, 8-10 is the borderline, and 11-21 means anxiety or depression is present. The correlation between variables was analysed with Spearman correlation. Results 36 breast cancer patients with a mean age of 49.93611.473, the Results for social support show family supports median is 3(2-3), friends supports median is 2(23), other people supports median is 3(2-3), and the total median is 2(2-3). Results for anxiety are 55.1% normal, 27.5% in borderline, and 17.24% with anxiety. Results for depression are 65.5% normal, 31% in the borderline, and 3.4% with depression. The correlation between total support and anxiety is r¼0.151 (p-value¼0.379). While its correlation with depression is shown with r¼0.173 (p-value¼0.312). Conclusion There is no correlation between social support given with its psychological effects. There are many factors that may affect breast cancer patients psychologically. Further study needs to be done with more variables and samples to get more reliable Results.
P3 201
Real State of the Terminal Care of Lung Cancer in the Integrated Community Care System after Medical Fees Revision 2018
Kan Kato1,2,3, Chikage Koganemaru1, Tokuken Oh2, Kageaki Watanabe3, Yuusuke Ookuma3, Yukio Hosomi3 1 Department of Internal Medicine, Tokyo Kensei Hospital, 2Department of Internal Medicine, Ooizumi Health Cooperative Hospital, 3Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Background: After Medical Fees Revision FY2018, movements from Integrated Community Care Ward(IW) to Long-term Treatment Ward(LW) are not regarded as
Volume 30 | Supplement 6 | October 2019
P3 202
Best supportive care for advanced lung cancer patients aged 85 and older
Taisuke Kazuyori1, Yoshitaka Seki1, Akihito Satou1, Syouta Fujimoto1, Masami Yamada1, Yumie Yamanaka1, Ikumi Fujisaki1, Kyuuto Odashima1, Aya Seki1, Takeo Ishikawa1, Kazuyoshi Kuwano2 1 The Jikei University School of Medicine Daisan Hospital, Division of Respiratory Medicine, Tokyo, Japan, 2The Jikei University School of Medicine, Division of Respiratory Medicine, Tokyo, Japan Background: In Japan, the rate of the elderly population is rising, and elderly lung cancer patients are also increasing. Because of their genetic and environmental factors, they often received only best supportive care (BSC). Methods: We performed retrospective analysis of 25 patients with advanced lung cancer patients aged 85 and older since 2014 to 2017 and assessed Background and prognosis. Results: The age was 85-94 years, and 17 patients were male. Thirteen patients had malignant pleural effusion. In these cases, 10 were adenocarcinoma (3 harboring EGFR mutation), 6 squamous cell carcinoma, 4 NSCLC-NOS, 2 SCLC, and 3 unknown. Nine patients were assigned an ECOG good PS of 0,1,2, and 16 patients a poor PS of 3,4. The common reasons of patients who received BSC with PS (13 patients) and cognitivefunction disorder (6 patients). Median overall survival were 2.7 months. According to univariate analysis (Cox proportional analysis),PS¼3 or 4 [hazard ratio: 5.94, 95% confidence interval (C.I): 1.77-19.93] and hypoalbuminemia (serum albumin < 3.5 g/dl) [hazard ratio: 6.84, 95% C.I: 1.48-31.6] were associated with significantly shorter OS but there was no statistically significant difference in Cognitive-function disorder [hazard ratio: 2.17, 95% C.I: 0.75-6.23]. Only 2 patients were alive over one year, and 11patients were in Nursing and Healthcare units. Conclusion: In elderly patients, BSC had often been selected for reasons other than aggressive disease. Since the elderly population is expected to rise further in the future, it is important to construct a palliative treatment strategy that takes into consideration the characteristics of the elderly.
P3 222
Cancer-oriented comprehensive nursing-caregiving service in Korea: 1 year report
Hyojin Kim1, Boram No1, Ara Ko1, Miso Choi1, Seol Lee1, So Young Park1, Yongchel Ahn2, Moon-Ho Kim2 1 Department of Nursing, Gangneung Asan Hospital, Republic of Korea, Korea, 2 Department of Hematology and Oncology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Republic of Korea Background: Korean comprehensive nursing-caregiving service, which is covered by national insurance, has been officially initiated in 2016. Following interim analysis presented at JSMO 2018, we report our 1-year experience of cancer-oriented comprehensive nursing-caregiving units outcomes and issues. Methods: and Results Our institution is a general hospital (827 beds) with 246 doctors and 703 RNs. We are running cancer-oriented comprehensive nursing-caregiving service (46 beds with 25 RNs and 12 nurse´s aides) since December 2017. This special ward is caring only medical oncology patients. For 12 months, 11,946 inpatients (average 32.4 patients/day, bed turnover rate 85.7%) and 5,682 patients received chemotherapy in our unit. We evaluated our Results in three categories: structure, process, and outcome. First, structural (environmental) improvements were found in more interval between
doi:10.1093/annonc/mdz343 | vi147
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz343.137/5582966 by MCP Hahnemann University user on 10 November 2019
Friecelie N Sutarna1, Elizabeth Celine1, Angeline Tancherla1, Regina Nathania1, Helenia Putri1, Fernando Dharmaraja1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
going home, but we foresaw in the last annual meeting that the Integrated Community Care System(IS) might still function well in the terminal care of lung cancer if home care system and LW were effective. So we verify the predict by examining our additional practice over the last year. Methods: We investigated medical records of 164 dead lung cancer patients treated in Tokyo Kensei Hospital(THp) (35 IW beds, 64 LW beds) and Ooizumi Health Cooperative Hospital(OHp) (47 IW beds, and 47 acute ward beds) in the last 6 years, and checked the state of cooperation between hospitals and clinics, the places of death. Results: 41 of 66 THp patients passed away in LW, and 12 in IW. Such cases are still increasing due to introduction for BSC from acute hospitals. In FY2018 we saw a lung cancer patient who enjoyed the terminal care under the cooperation among acute hospital, IW, home care system, and LW (case presentation). In OHp no patients move to hospice or LW in FY2018, 32 (with 3 additional) cases of 98 patients passed away at home, and 8 (with 5 additional at one year) cases died in IW. Since FY2015 when IWs were opened in both hospitals, 1632 patients of all diseases stayed 28.4 days on average at IW in THp, and 1995 patients 29.4 days in OHp, significantly longer (P < 0.001) in OHp without LW. But in FY2018, 401 patients stayed 28.0 days at IW, which is significantly shorter (P < 0.05) like in THp than 29.7 days of the former 1594 cases. 22 lung cancer patients in terminal stage in THp stayed 28.2 days at IW, and 13 patients in OHp stayed 21.9 days at IW, fewer (but rapid increased number of) patients and shorter period than in THp. Conclusion: After revision 2018, definition of going home has been more strict, but we recognize that IS where IW centers actually functions well under the close cooperation with home care or LW.