Hospitalization For Cancer Treatment Research Articles

Economic burden of advanced lung cancer patients treated by gefitinib alone and combined with chemotherapy in two regions of China

AimTo assess the economic burden of different chemotherapies for lung cancer patients and influencing factors in China.Materials and methodsThe economic burden of lung cancer, including direct, indirect and intangible costs was measured within three months after diagnosis and treatment. Direct cost included the cost of hospitalization, outpatient visits, out-of-pocket drug purchases, costs of transportation, accommodation and meal expenses while seeking treatments in hospitals. Cost information was attained from questionnaire and patients’ medical record. Indirect cost was measured by the patients’ and their caregivers’ productive days lost due to outpatient visits and hospitalization for lung cancer treatment. Intangible cost was obtained through the willingness-to-pay method from a questionnaire completed by the patient.ResultsAmong the total cost of CNY71,401.92, direct cost, indirect cost and intangible cost constituted 89.02%, 4.29%, and 6.69% respectively. Educational level, occupation, family income, lung cancer classification, and the city of residence significantly influenced the total cost.LimitationsLimitations in our study included: First, our follow-up period of three months was relatively short compared to the whole survival period of lung cancer patients. Second, the sample size of the chemotherapy combined with targeted therapy group was not large enough, and the cost data obtained would need confirmation in future studies. Third, participants came from only two localities, which may somewhat limit the representativeness of the study results for the whole of China.ConclusionsThe economic burden of lung cancer treatment mainly came from the cost of the drugs. Patients taking chemotherapy had significantly higher cost compared to patients using targeted therapy. The cost was generally higher for those with higher educational level, those with higher family income, and those living in an economically more developed city. Patients with NSCLC had higher cost compared to patients with SCLC.

Molar‐incisor‐malformation in a paediatric cancer patient: Case report

AbstractAimTo report a case of molar‐incisor‐malformation (MIM) in a 7‐year‐old boy with a history of congenital infantile fibrosarcoma of the upper chest, which was surgically treated, without adjuvant radio/chemotherapy.Material and MethodsThe boy presented with mobility and pain on percussion of the permanent mandibular first molars. The radiographic features were suggestive of MIM. Both teeth were extracted and processed for conventional light microscopic examination and non‐decalcified ground sections.ResultsThe microscopic features confirmed the diagnosis of MIM. Regular follow‐up was recommended.ConclusionsMedical interventions during hospitalization for cancer treatment, other than chemo/radiotherapy, may cause MIM by adversely affecting the function of Hertwig's epithelial root sheath. Regular dental screening in paediatric cancer patients may reveal more MIM cases and help in elucidating its pathogenesis.

Family Care Coordination in the Children's Hospital: Phases and Cycles in the Pediatric Cancer Caregiving Journey

When a child is hospitalized with a serious illness, their family members must process emotional stress, quickly absorb complicated clinical information, and take on new caregiving tasks. They also have to coordinate with each other and with other family caregivers without abandoning existing work and home life responsibilities. Previous CSCW and HCI research has shown how the patient's experience changes across the illness journey, but less is known about the effect of this journey on family caregivers and their coordination work. CSCW technologies could support and augment family care coordination work across the journey, reducing stress levels and improving families' ability to stay connected and informed. In this paper, we report findings from an interview study we conducted with 14 parents of children undergoing extended hospitalization for cancer treatment. We propose the concept of caregiving coordination journeys and describe caregivers' current communication and coordination practices across different phases of the hospitalization journey, from diagnosis and early hospitalization to extended hospitalization and beyond. We characterize families' caregiving coordination routines across different time scales, and describe the current role of communication technologies in families' coordination practices. We then propose design opportunities for social computing technologies to support and augment families' communication and caregiving work during the hospitalization journey of their child.

Playful interventions to promote the subjective wellbeing of pediatric cancer inpatients during laboratory and imaging exams: A qualitative study.

We investigate the experience of pediatric oncology patients with objects and equipment involved in laboratory and image examinations during hospitalization for cancer treatment while generating guidelines for playful interventions to improve their subjective wellbeing. The study was carried out at a public tertiary referral teaching hospital in Southern Brazil. Data collection was based on participatory observations with six children aged 4-8 years. Their experiences with exams were observed through pretend play and recorded in field diaries, audio, and video. Data were analyzed using Thematic Analysis and discussed according to the PERMA-V model, a theoretical framework from positive psychology. Several objects and equipment that seem to affect the wellbeing of children during exams were identified. Four playful interventions were proposed as supportive care initiatives: use of technology to allow immersive experiences in learning about treatment and medical condition; design for personalization; gamifying experiences to allow positive reinforcement; and design for focus redirection. Guidelines for playful interventions to foster the subjective wellbeing of hospitalized children during image and laboratory exams were proposed. The PERMA-V model provided a solid base for the analysis of the interventions, which will be implemented and tested in future studies in clinical settings.

Volunteer medical students provide learning support to high school students who need long-term hospitalization for cancer treatment

Volunteer medical students provide learning support to high school students who need long-term hospitalization for cancer treatment

Effects of In-Hospital Physical Therapy on Activities of Daily Living in Patients with Hepatocellular Carcinoma.

Activities of daily living (ADL) are frequently impaired in patients with hepatocellular carcinoma (HCC). In this retrospective study, we aimed to investigate the effects of physical therapy on ADLs in patients with HCC during hospitalization for cancer treatment. Nineteen patients with HCC were enrolled. During hospitalization, patients performed a combination of resistance training, stretching, and aerobic exercise (20–60 min/day). ADLs were assessed using the functional independence measure (FIM). Changes in FIM were evaluated by before–after analysis. No significant difference was seen in Child–Pugh class before and after physical therapy. The bilateral knee extension strength and chair stand test were significantly increased after physical therapy compared with before physical therapy (p = 0.001 and p = 0.008, respectively). The total FIM score was significantly increased after physical therapy compared with that before physical therapy (p = 0.0156). Among the 18 indexes of FIM, the stairs index was significantly improved after physical therapy compared with that before physical therapy (5.9 vs. 6.4 points, p = 0.0241). We demonstrated that physical therapy improved muscle strength without worsening liver function. Furthermore, physical therapy improved FIM, especially in the stairs index, in patients with HCC. Thus, physical therapy may be beneficial in patients with HCC during cancer treatment.

Assessment of coronary artery disease during hospitalization for cancer treatment

BackgroundWith improvement of cancer-specific survival, comorbidities and treatment-related side effects, particularly cardiovascular toxicities, need close attention. The aim of the present study was to evaluate clinical characteristics and outcomes of cancer patients requiring coronary angiography during inpatient care.MethodsWe performed a retrospective analysis of patients hospitalized between 02/2011 and 02/2018 in our two university hospital cancer centers. From a cohort of 60,676 cancer patients, we identified 153 patients (65.7 ± 11.6 years, 73.2% male), who underwent coronary angiography and were eligible for analysis. These were compared to a control group of 153 non-cancer patients pair-matched with respect to age, sex, and indication for catheterization.ResultsCancer patients presented in 66% with an acute coronary syndrome (ACS). The most prevalent cancer entities were lymphoma (19%) and lung cancer (18.3%). The rate of primary percutaneous coronary interventions (PCI) was significantly lower in the cancer cohort (40.5% vs. 53.6%, p = 0.029), although manifestation of coronary artery disease (CAD) and PCI results were comparable (SYNergy between PCI with TAXus and cardiac surgery (SYNTAX)-score, delta pre- and post-PCI − 9.8 vs. − 8.0, p = 0.2). Mortality was remarkably high in cancer patients (1-year mortality 46% vs. 8% in non-cancer patients, p < 0.001), particularly with troponin-positive ACS (5-year mortality 71%).ConclusionStrategies to effectively control cardiovascular risks in cancer patients are needed. Additionally, suspected CAD in cancer patients should not prevent prompt diagnostic clarification and optimal revascularization as PCI results in cancer patients are comparable to non-cancer patients and occurrence of troponin-positive ACS leads to a significantly increased risk of mortality.Graphic

A Qualitative Study Exploring Coping Strategies in Chinese Families During Children's Hospitalization for Cancer Treatment

PurposeTo explore how Chinese families cope with children's hospitalization for cancer treatment. Design and methodsA descriptive qualitative inquiry was employed. Semi-structured interview was conducted in four pediatric oncology departments in four hospitals from November 2017 to June 2018. The interviews focused on how families cope with the challenges resulting from their children's hospitalization for cancer treatment. Twenty one parents participated into the study. ResultsFour categories related to family coping strategies emerged from the data, including increasing family strength, maintaining optimistic thoughts, seeking external support, and not disclosing the unfavorable information. ConclusionsFamilies had adopted multiple coping strategies to handle the challenges caused by children's hospitalization for cancer treatment. The influences of Chinese culture on family coping should be taken into consideration during family-centered interventions development. Further studies could analyze whether the spouse perspectives are independent from one another and whether the coping strategies change as the time of hospitalization. Practice implicationsThis study has reminded nurses' to become more concerned about the influences of culture on families' coping strategies during this challenging period. Other nurses in the world could understand how to enhance family coping strategies of Chinese clients.

O videogame ativo como estratégia do profissional de educação física no auxílio do tratamento de câncer infanto-juvenil

Buscou-se conhecer e analisar a percepção de crianças e adolescentes acerca da utilização do videogame ativocomo uma estratégia do profissional de educação física para auxiliar no enfrentamento do período de hospitalização de crianças e adolescentes para tratamento de câncer. Trata-se de uma pesquisa-ação que envolveu 14 pacientes com média de idade de 11,21 anos, internados no Centro Hospitalar de Oncohematologia Pediátrica do Hospital Universitário Oswaldo Cruz em Recife, Pernambuco. Utilizou-se da entrevista semiestruturada, da observação participante e do diário de campo para coleta de dados. Foram utilizados o X-Box 360 com Kineckte jogos de esporte e dança. Os resultados apontaram a aceitação do grupo de pacientes em relação aos jogos do videogame ativo, configurando-o em uma possível estratégia do profissional de educação física para auxiliar no de enfrentamento do período de hospitalização para tratamento oncológico. &#x0D;

Unmet Family Needs Concerning Healthcare Services in the Setting of Childhood Hospitalization for Cancer Treatment in Mainland China: A Qualitative Study

PurposeThe focus of this paper is to identify the unmet family needs during children's hospitalization for cancer treatment. Design and MethodsQualitative interviews were carried out with five fathers and fourteen mothers purposively sampled from four pediatric oncology departments in Mainland China from September 2013 to March 2014. Audiotaped interviews were transcribed verbatim, and data in transcripts were coded and analyzed by qualitative content analysis. ResultsThe identified unmet family needs pertaining to healthcare service during a child's hospitalization for cancer treatment were unmet need for warm and supportive attitudes; competent care; adequate information; a comfortable environment; and catering support. ConclusionsThe results showed that families with children hospitalized for cancer treatment have a variety of unmet needs related to healthcare service. These identified unmet family needs have already shed light on areas for healthcare service improvement. Practice ImplicationsThis study have reminded nurses' to become more concerned about unmet family needs instead of only focusing on the hospitalized child in clinical settings. Healthcare professionals can assist in promoting family adaptation to children's hospitalization by satisfying their unmet family needs.

No between-group difference but tendencies for patient support: A pilot study of a resilience-focused music therapy protocol for adults on a medical oncology/hematology unit

During hospitalization for cancer treatment, patients can experience adversities that negatively impact quality of life and hinder recovery. Thus, it is important for patients to develop resilience to help them adapt, cope, and potentially overcome stressors within hospital and home environments. The purpose of this study was to determine if and how a two-day resilience-focused music therapy (RFMT) support program would impact resilience of adults on a medical oncology/hematology unit. Participants (N=15) were randomly assigned to RFMT or a waitlist control condition. Participants in the RFMT condition received a two-day music therapy intervention: Resilience-themed patient-preferred live music (PPLM) on day one and RFMT through resilience-themed PPLM on day two. Experimental participants completed an individual semi-structured interview after the intervention. Quantitative results indicated no between-group difference at posttest. However, experimental participants tended to have slightly more favorable resilience and pain mean scores than control participants at posttest. Thematic analysis of patient feedback during interviews indicated that music therapy tended to (a) improve the therapeutic relationship, (b) highlight positive perceptions of music, (c) provide a positive distraction and improved mood, and (d) improve inner strength and hope. Although quantitative results were not significant, results from post-intervention interviews tended to provide initial support for the protocol. Limitations, implications for clinical practice, and suggestions for future research are provided.

Mastectomie en hospitalisation ambulatoire ou de 24 heures : faisabilité, satisfaction et préférences des patientes

The aim of this study is to analyze the feasibility of ambulatory hospitalization or 24hours hospitalization for breast cancer treatment by mastectomy, as well as the satisfaction and the preferences of patients with regard to these ways of hospitalization. MethodsThis observational retrospective study listed the patients operated for breast cancer who had required a mastectomy at the institute Paoli-Calmettes between the 1st of January 2013 and June 30th, 2015. A questionnaire of satisfaction was proposed to the patients regarding their mode of hospitalization. ResultsOne hundred and thirteen patients were included among which 29 were in the ambulatory group and 84 in the 24hours hospitalization group. The complications were represented by the rate of hematomas (3.5 %), which required a surgical resumption for two of the patients in the 24hours hospitalization group and for one patient in the ambulatory group (P=0.75). Patient's satisfaction rate was globally high: 72.7 % regardless of the mode of hospitalization (P=0.064). ConclusionThe realization of mastectomy in ambulatory hospitalization seems feasible when the organization in pre- and postoperative is anticipated with a high degree of satisfaction of the patients. The psychological impact of this radical surgery seems to be a factor to be taken into account and requires a meticulous selection of the patients.

A Qualitative Study on Unmet Family Needs Related to Healthcare Service during a Child's Hospitalization for Cancer Treatment

Background: Limited domestic study investigated the problem regarding unmet family needs pertaining to healthcare service during a cancer child's hospitalization for cancer treatment. The population of families with children hospitalized in pediatric oncology units is a considerable target group demanding special attention. Investigating unmet family needs related to healthcare service during a cancer child's hospitalization may provide insight into improving family care in pediatric oncology units. Objective: This study aimed to explore unmet family needs pertaining to healthcare service perceived by parents during a child's hospitalization for cancer treatment. Methods: Qualitative interviews were carried out with six fathers and fifteen mothers purposely sampled from pediatric oncology departments in Mainland China from September 2013 to March 2014. Audio-taped interviews were transcribed verbatim, and data in transcripts were coded and analyzed by qualitative content analysis. Results: Five categories depicts unmet family needs pertaining to healthcare service during a cancer child's hospitalization were identified: a warm and supportive attitude, professional support, adequate information, a comfortable environment and catering support. Conclusion: The findings from this study reinforce that more work need to be done in clinical settings to satisfy unmet family needs. It is the hope and expectation that healthcare professionals can act to enable the family to have a healthy adjustment by fulfilling unmet family needs.

Validation of Hospitalization Impact Scale among families with children hospitalized for cancer treatment.

To make further modifications to and validate the psychometric properties of the Hospitalization Impact Scale. A child's repeated and prolonged hospitalization for cancer treatment can result in great changes for the entire family. A hospitalization-specific screening tool is needed to help clinical nurses identify families who are experiencing major impacts during their child's hospitalization. A cross-sectional study was employed to examine the psychometric properties of the Hospitalization Impact Scale. The sample consisted of 253 families with children hospitalized for cancer treatment in four paediatric oncology departments in four hospitals in mainland China from September 2013 - March 2014. Parents completed the 36-item Hospitalization Impact Scale, demographic measures and the Family Impact Module of the Pediatric Quality of Life Inventory. Reliability, construct validity, known-group validity and concurrent validity were examined. The revised Hospitalization Impact Scale included six factors containing 34 items. It demonstrated sound concurrent validity with the Family Impact Module of the Pediatric Quality of Life Inventory and excellent internal consistency. The revised Hospitalization Impact Scale met the standard psychometric criteria for reliability and validity. Thus, it could be applied in paediatric oncology departments to help nurses assess and identify families experiencing major impacts during a child's hospitalization for cancer treatment.

Nursing Pain Management—A Qualitative Interview Study of Patients with Pain, Hospitalized for Cancer Treatment

Pain is a significant symptom in cancer patients. Understanding of patients' experiences in relation to pain management is important in evidence-based nursing in the field of pain. The aim of this study was to explore cancer patients' experiences of nursing pain management during hospitalization for cancer treatment. Eighteen cancer patients participated in the study, all with advanced cancer, including skeleton metastases. The female participants all had breast cancer, and the male participants all had prostate cancer. Data were collected by in-depth interviews, and qualitative description was used to entail low-inference interpretation to reach an understanding of the essence of pain and nursing pain management. Patients found it somewhat difficult to express their expectations of nursing pain management and competencies. However, 1) being present and supportive; 2) giving information and sharing knowledge; 3) taking care of medication; and 4) recognizing the pain emerged as themes in nursing pain management. Although patients believed that nurses were caring persons, they perceived differences between nurses in the ways they handled pain management. Furthermore, some patients experienced a lack of information from nurses in relation to pain management. Although cancer patients' experiences showed the importance of nurses in pain management, it seems that nurses should have a clearer role in cancer pain management in relation to counseling and patient education. The results from this study can increase nurses' awareness of their role in pain management as a first step in improving pain management for patients.