Winnie K.W. So

Randomized controlled trial comparing treatment outcome of two compression bandaging systems and standard care without compression in patients with venous leg ulcers.

Background  In Hong Kong, at the time of the study, compression treatment was not considered usual care for venous leg ulcer patients.

Fatigue and quality of life among Chinese patients with hematologic malignancy after bone marrow transplantation

Fatigue is reported to be a major symptom for many patients with cancer. However, little is known about this symptom among Chinese people who have cancer. A cross-sectional design was used to examine the intensity of fatigue in patients who underwent bone marrow transplantation for a hematologic malignancy, and to determine whether fatigue affected the quality of life in a Chinese sample (N = 157). The Revised Piper Fatigue Scale-Chinese Version was used to measure fatigue, and the Chinese version of the SF-36 Health Survey was used to measure quality of life. Overall, the subjects perceived a moderate level of fatigue (mean total fatigue score, 4.7 ± 1.7). More than 15% reported experiencing a high level of fatigue. Subjects more likely to perceive a high level of fatigue were older, married, not employed, and on lower incomes. On post hoc tests, the group with a high level of fatigue scored significantly lower on quality-of-life domains than the other two groups (P < .05). The results may help nurses working with Chinese populations in identifying patients at risk for increased fatigue and in planning fatigue-relieving strategies.

Anxiety, depression and quality of life in Chinese women with breast cancer during and after treatment: a comparative evaluation.

PURPOSE OF THE RESEARCH To compare the psychological health and quality of life (QoL) of women with breast cancer, and to determine the relationship between anxiety, depression and QoL during treatment and one year afterwards. METHODS AND SAMPLE For this secondary analysis, 269 women undergoing adjuvant therapy for breast cancer, and 148 women with breast cancer who had completed all treatment within the last year completed a self-report questionnaire covering the Hospital Anxiety and Depression Scale-Cantonese/Chinese version, Functional Assessment of Cancer Therapy-General, and demographic and clinical characteristics. KEY RESULTS The ongoing-therapy group showed higher levels of anxiety and depression and lower levels of all QoL dimensions than the post-therapy group. Linear regression results showed that both anxiety and depression were significantly related to physical and functional well-being, while depression was associated with social/family well-being in both groups. In the case of emotional well-being, anxiety had a strong significant association in both groups and depression a significant relationship only in the ongoing-therapy group. CONCLUSIONS The psychological health of women with breast cancer is affected during and after treatment. Psychological distress in these patients, including anxiety and depression, has independent associations with impaired emotional, functional, physical and social well-being. The results highlight the importance of timely detection of anxiety and depression, and their proper management, during the treatment and survivorship phases of the breast cancer trajectory.

Quality of life and most prevalent unmet needs of Chinese breast cancer survivors at one year after cancer treatment

PURPOSE This study aims to examine the supportive care needs of Chinese breast cancer survivors, and investigate the relationships with participant characteristics and quality of life. METHODS A total of 163 participants were recruited from a local public hospital and completed a self-administered questionnaire: the 34-item Supportive Care Needs Survey, the supplementary module of access to healthcare and ancillary support services, and the Functional Assessment of Cancer Therapy. RESULTS The five most commonly reported unmet needs were all in the health system information domain (range: 55-63%), and the majority (84%) reported at least one unmet need in relation to information on healthcare. Stepwise multivariable regression analyses revealed that the time spent on travelling from home to hospital, receiving hormonal therapy, and physical and psychological unmet needs were independently associated with poorer quality of life among the participants. CONCLUSIONS Breast cancer survivors perceive various unmet needs, and health system information is the most common one. Those who have more unmet needs in the physical and psychological domains were more likely to perceive a poorer quality of life.

Colorectal cancer screening behaviour and associated factors among Chinese aged 50 and above in Hong Kong – A population-based survey

PURPOSE This study reports the uptake rate of colorectal cancer screening among Chinese people aged 50 or above and the identified factors associated with the likelihood of undergoing such screening. METHODS A cross-sectional population-based telephone survey was conducted in Hong Kong during the period 2 to 28 May 2007. The survey covered demographics, perceived health status and susceptibility to cancer, utilisation of complementary medicine, family history of cancer and cancer screening behaviour. RESULTS The survey was completed by 2004 Hong Kong Chinese residents aged 50 or older (response rate = 66.6%). The uptake rate of a fecal occult blood test and a colonoscopy was 12% and 19% respectively. Factors associated with colorectal cancer screening behaviour included: male participants, ex-smokers, with cancer or other serious disease, a family history of cancer, perceived health status fair or poor, regular visits to a doctor to look after health, and utilisation of complementary medicine. CONCLUSIONS The uptake rate of this study population was low though an increasing trend did appear. Heath education and promotion programmes may focus on these identified factors to facilitate colorectal cancer screening in a Chinese population.

Perceived unmet needs and health-related quality of life of Chinese cancer survivors at 1 year after treatment.

Background: Although advanced cancer treatments prolong survivors’ lives, a significant proportion experienced poorer health-related quality of life (HRQoL) than general populations. Identifying their needs is essential to develop a health service delivery model to improve patient outcomes. Objective: The objective of this study was to examine the perceived unmet needs and HRQoL of Chinese cancer survivors who completed treatment less than 1 year ago. Methods: Three hundred seventy-six participants completed a self-report survey: the 34-item Supportive Care Needs Survey, the supplementary module of access to healthcare and ancillary support services, and the Functional Assessment of Cancer Therapy: General. Descriptive statistics were used to examine the prevalence of unmet needs. Multivariable logistic regressions were conducted to identify participants’ characteristics that were associated with unmet needs. Multiple linear regression was used to delineate which domains of unmet needs were significantly associated with HRQoL with adjustment for potential confounding factors. Results: Healthcare information was the most common unmet needs among the survivors. Age, stage of cancer, and remission were significantly associated with 1 or more unmet need domains. Participants with unmet needs in physical, psychological, and patient care domains, on average, have poorer HRQoL. Conclusions: Chinese cancer survivors have various unmet needs that might have adverse effects on their HRQoL. Younger age, more advanced stages of cancer, and remission were factors contributing to further unmet needs. Implications for Practice: The results provided useful information on the special needs of survivors that may affect their HRQoL, enabling clinicians to plan better how to allocate existing limited resources to those who most require them.

Health-related quality-of-life and psychological distress of young adult survivors of childhood cancer in Hong Kong.

Previous literatures on young adult survivors of childhood cancer show inconsistent findings with regards to their psychological distress and health‐related quality of life (HRQOL). Much of the available data focus on negative patient outcomes following cancer treatments prescribed from 1970 to 1990. In the present study, HRQOL and psychological distress of young adult survivors in Hong Kong was examined. It focused on subjects who had received cancer treatments prescribed in the last two decades.

Effects of Acupuncture and Acupressure on Cancer-Related Fatigue: A Systematic Review

PURPOSE/OBJECTIVES To critically examine the evidence for acupuncture and acupressure in the management of cancer-related fatigue (CRF) in adult patients with cancer. DATA SOURCES 18 databases were searched for randomized, controlled trials published in English and Chinese through April 2014. DATA SYNTHESIS Given the heterogeneity of data, meta-analysis was not conducted. A six-step thematic analysis method was used to synthesize the results. CONCLUSIONS Although results are inconclusive, acupuncture and acupressure tend to be effective in relieving CRF, with the former producing a greater improvement. Future research is recommended to contribute further evidence. IMPLICATIONS FOR NURSING Nurses should know about the relative effectiveness of acupuncture and acupressure in the management of CRF to educate and support their patients.

Web-based interventions for caregivers of cancer patients: A review of literatures.

Diagnosed with cancer is a traumatic event; it does not only affect the diagnosed patients, but also their caregivers. It brings along negative impacts on biopsychosocial health to the caregivers. Supportive interventions are essential for the caregivers to go through the cancer trajectory. In the past, interventions were being delivered in either face-to-face format or delivering written documents. Although Internet becomes a popular platform for delivering interventions given its substantial growth in usage, the effectiveness of this mode of intervention delivery is unclear. The aim of this review is to review existing literatures regarding efficacy of web-based interventions in psychological outcomes of cancer caregivers. A Literature search was performed in December 2012 from seven databases, including, Ovid MEDLINE, EMBASE, PsycINFO, CINHAL, ERIC, British Nursing Index and EBM Reviews. The following keywords were used in the search but were not limited to “paediatric”, “parent”, “caregiver”, “cancer”, “web-based”, and “psycho education”. Totally 4668 citations were identified, after excluding the duplicated and irrelevant citations; finally six studies were included in this review. A review of the literatures identified that the web-based interventions including either online support group only or a combination of informational website and online support group significantly improved coping skills, in a way reduced anxiety, stress, depression, burden, as well as negative mood and perceived bonding in cancer caregivers. It is concluded that a web-based format as a potential platform for delivering intervention to the caregivers of cancer patients for its unique advantage of easy accessibility, and no geographic or time barriers.

The Effectiveness of Psychoeducational Intervention on Managing Symptom Clusters in Patients With Cancer: A Systematic Review of Randomized Controlled Trials.

Background: Managing symptom clusters instead of single symptoms could be more beneficial in cancer care. Psychoeducational intervention (PEI) has been highlighted as a promising symptom intervention, but the effect of PEI in the management of cancer symptom clusters remains unknown. Objective: The aim of this study was to evaluate the effectiveness of PEI on managing symptom clusters in patients with cancer. Methods: Six databases were searched, together with hand searching, to identify eligible randomized controlled trials from the year 2001 to July 2014. Data selection, quality appraisal of studies, and data extraction were conducted independently by 2 reviewers. Data were synthesized by use of a systematic narrative approach, and meta-analysis was conducted when this was possible. Results: Four eligible studies involving 343 cancer patients were included in the review. The methodological quality of the studies was generally fair. Symptom clusters seemed to improve with the provision of PEI. Meta-analysis shows significant improvement in functional performance. Conclusions: The evidence that PEI could alleviate cancer symptom clusters is encouraging but inconclusive in this review. Future well-designed investigations testing some commonly used PEI such as progressive muscle relaxation and patient education on various types of cancer symptom clusters are warranted. Implications for Practice: This review suggests a promising role of PEI in managing cancer symptom clusters. Healthcare providers should increase their awareness of managing symptom clusters using PEI to yield more effective and efficient cancer care.