| 581. |
- Wasteson, Elisabet, et al.
(författare)
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Comparison of a questionnaire commonly used for measuring coping with a daily-basis prospective coping measure
- 2006
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 61:6, s. 813-820
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Much research have investigated the relation between stress and health, with focus on the role of coping as a moderator. The use of the concept of coping is in need of more stringency since it is often used in a more or less careless manner. A contributory cause of the confusion within the research field is the often-negligent interpretation of results from the Mental Adjustment to Cancer (MAC) Scale (i.e., results are discussed in terms of coping strategies instead of mental adjustment). Furthermore, checklists are often used in research but seldom specify the stressor that patients are attempting to cope with. METHODS: Consecutive patients newly diagnosed with gastrointestinal (GI) cancer were included in this study. Of 151 eligible patients, 95 (63%) participated. As soon as their physical condition so permitted, patients were asked to assess their coping by way of two methods: an instrument commonly used for measuring coping (MAC Scale) and a daily-basis prospective coping measure [Daily Coping Assessment (DCA)]. The study investigated the relations between these two methods, which are used to evaluate different ways of coping with cancer, and related these to specified stressful events and psychologic distress outcomes [Hospital Anxiety and Depression Scale (HADS)]. RESULTS: Among patients with GI cancers, a comparison of the DCA with the MAC Scale renders important differences regarding the use of coping strategies. Furthermore, coping as measured by the DCA is more clearly separated from both stressors such as psychologic aspects and psychologic distress outcomes as measured by the HADS. DISCUSSION: A comparison between the two measures renders differences regarding the use of coping strategies among patients with GI cancers. The daily-basis prospective coping measure seems to be better separated from both stressful events and psychologic distress outcomes. The DCA offers a promising alternative to the use of coping checklists. The difference between the measures is in accordance with the original intention that the MAC Scale be used to measure mental adjustment rather than coping (i.e., the results do not support the use of the MAC Scale as a coping measure).
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| 582. |
- Wasteson, Elisabet, et al.
(författare)
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Daily assessment of coping in patients with gastrointestinal cancer
- 2002
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 11:1, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Ninety-five patients with gastrointestinal (GI) cancer participated in a study concerning stressful events, coping and emotional well-being. Participants were either potentially cured (n=62) after radical surgery or non-cured (n=33). For a period of 1 week, close to being informed about their diagnosis, they performed daily recordings of stressful events, the distress occasioned by these events and their perception of control over them, coping, worry and happiness/sadness. Anxiety and depression were assessed by a single retrospective assessment at the end of the week (Hospital Anxiety and Depression (HAD) scale). The most commonly recorded stressful events were 'Somatic aspects' and 'Everyday concerns'. 'Somatic aspects', 'Social aspects' and 'Other consequences of the disease' were rated as most bothersome. Patients perceived that they had the highest degree of control over 'Returning home after hospital stay', whereas 'Contact with the medical services' was assigned low control. The most commonly used coping strategies were 'Acceptance' and 'Relaxation', and the least used was 'Religion'. Significant positive correlations between the occurrence of stressful events and the use of coping strategies were demonstrated between 'Somatic Aspects' and 'Acceptance'/'Direct Action', and between 'Social Aspects' and 'Seeking Social Support'. Daily assessment of stress-coping relationships represents a promising approach to the understanding of adaptation among cancer patients.
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| 583. |
- Wasteson, Elisabet, 1969-
(författare)
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Living and Coping with Cancer : Specific Challenges and Adaptation
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aims of this thesis were to prospectively investigate how specific challenges among patients with commonly occurring cancers are related to adaptation and well-being, to predict later well-being using a range of psychosocial aspects and to compare two ways of measuring coping with cancer. This was studied at diagnosis in patients with gastrointestinal cancers and their spouses and at termination of cancer treatment and during follow-up in a heterogeneous group of cancers. At diagnosis, higher levels of psychological distress were accompanied both by more coping attempts and less perceived control over the stressful events. Somatic aspects and Everyday concerns were frequent stressful events. The most frequently used coping strategies were emotion-focused. The Daily Coping Assessment (DCA) rendered a varied picture of ways of handling the stressful events (Study I). When studying coping as a process, the DCA has advantages compared to the commonly used measure MAC, since DCA better separates coping from both the stressful event and outcome. A comparison of the DCA and the MAC rendered differences regarding the usage of coping strategies (Study II). Patients with higher levels of anxiety/depression also had higher discrepancies between attainment and importance for most life values compared to patients with less anxiety/depression. For the patients, but not for the spouses, the discrepancies for several life values along with anxiety and depression decreased over time (Study III). Anxiety/depression at termination of treatment are strong predictors for anxiety/depression and QoL at follow-up. However, other variables like psychiatric history, the bother an event caused, the coping strategy Acceptance, the stressful event Thoughts/affects and emotional and instrumental aspects of social support contributed to the prediction (Study IV). Thus, it is concluded that detailed information regarding specific and frequent situations among cancer patients is possible to reveal and necessary for a better understanding of what influences well-being.
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| 584. |
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| 585. |
- Wei, Q., et al.
(författare)
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EGFR, HER2 and HER3 expression in primary colorectal carcinomas and corresponding metastases : Implications for targeted radionuclide therapy
- 2011
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Ingår i: Oncology Reports. - : Spandidos Publications. - 1021-335X .- 1791-2431. ; 25:1, s. 3-11
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Tidskriftsartikel (refereegranskat)abstract
- Members of the epidermal growth factor receptor, EGER, family are interesting as targets for radionuclide therapy using targeting agents labeled with alpha- or beta-emitting radionuclides, especially when EGFR-positive colorectal carcinomas, CRC, are resistant to EGFR inhibiting agents like cetuximab and various tyrosine kinase inhibitors. The expression of EGFR, HER2 and HER3 was therefore analyzed in CRC samples from primary tumors, corresponding lymph node metastases and, in a few cases, liver metastases. The expression of HER2 and EGFR was scored from immunohistochemical preparations using the HercepTest criteria 0, 1+, 2+ or 3+ for cellular membrane staining while HER3 expression was scored as no, weak or strong cytoplasm staining. Material from 60 patients was analyzed. The number of EGFR 2+ or 3+ positive primary tumors was 16 out of 56 (29%) and for lymph node metastases 8 out of 56 (14%) whereas only one out of nine (11%) liver metastases were positive. Thus, there was lower EGFR positivity in the metastases. Only one among 53 patients was strongly HER2 positive and this in both the primary tumor and the metastasis. Eight out of 49 primary tumors (16%) were strongly HER3 positive and the corresponding numbers for lymph node metastases were 9 out of 49 (18%) and for liver metastases 2 out of 9 (22%). The observed number of strongly EGFR positive cases was somewhat low but EGFR might be, for the cases with high EGFR expression in metastases, a target for radionuclide therapy. HER2 seems not to be of such interest due to rare expression, neither HER3 due to mainly expression in the cytoplasm. The requirements for successful EGFR targeted radionuclide therapy are discussed, as well as patient inclusion criteria related to radionuclide therapy.
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| 586. |
- Weibull, Caroline E., et al.
(författare)
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CRCBaSe : a Swedish register-based resource for colorectal adenocarcinoma research
- 2023
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 62:4, s. 342-349
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To facilitate high-quality register-based research on colorectal cancer (CRC) in Sweden by constructing a database consisting of CRC patients, matched comparators, and relatives.MATERIAL AND METHODS: Patients with adenocarcinoma in the colon and/or rectum were identified in the Swedish Colorectal Cancer Register, a nationwide quality-of-care register. For each patient, six comparators from the general population were matched on birth year, sex, year of CRC diagnosis, and county. Comparators were free from CRC at the time of matching, but could later become cases. For both patients and comparators, first-degree relatives (parents, siblings, and children) were identified. Information from nationwide population-based registers was retrieved and linked to each individual in the database using the personal identification number unique to all Swedish residents.RESULTS: A total of 76,831 CRC patients diagnosed between 1995 and 2016 were identified (51% colon, 49% rectal; before 2007 only rectal cancer patients were included). Among all patients, 37% were stage I-II, 22% stage III, and 22% stage IV. The median follow-up time was 11.9 years (inter-quartile range, IQR: 8.6-15.3). Together with comparators and relatives, the database contains 2,413,139 individuals with information on demographics, dates and causes of death, in- and outpatient healthcare records, cancer diagnoses, prescribed and dispensed drugs, childbirths (among women), and social security information (such as sick leave and early retirement).CONCLUSION: The Colorectal Cancer Database Sweden (CRCBaSe) is a large and unique register-based data research platform, which opens up for clinically important, large epidemiological studies with innovative design in the field of colorectal adenocarcinoma.
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| 587. |
- Wettergren, Lena, et al.
(författare)
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Comparing two versions of the Schedule for Evaluation of Individual Quality of Life in patients with advanced cancer
- 2011
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 50:5, s. 648-652
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Tidskriftsartikel (refereegranskat)abstract
- Background. The aim was to compare two individualized patient reported outcomes or the Schedule for the Evaluation of Individual Quality of Life - Direct Weighting (SEIQoL-DW) measuring quality of life in general, and the disease-related version (SEIQoL-DR) measuring quality of life related to disease. Both instruments have been used in clinical practice settings within oncology. The instruments were compared with regard to feasibility, the areas nominated by patients as important and patients' ratings of how they were doing in these areas (Index scores). Material and methods. The study included 40 patients with gastrointestinal cancer. All patients completed both versions of the instrument on a touch screen computer in relation to a medical consultation. Firstly, the participants were invited to nominate the five domains she/he currently considered to be most important in life. Secondly, they were asked to rate how they were doing in each of these domains. Finally, they were asked to quantify the relative importance of each area. Cohen's effect sizes were calculated to illuminate the clinical importance of mean value differences. Results. Both instruments took less than ten minutes to complete and the procedure was considered feasible by both patients and interviewers. The proportion of patients nominating the same areas in the two versions did not differ, however, the SEIQoL-DW Index score was significantly higher than the corresponding score for the SEIQoL-DR. The detected difference in the mean score measured by effect size was medium. Conclusion. The magnitude of the effect size of the difference in Index score imply that the two versions tap into different constructs, i.e. quality of life (QoL) versus health-related QoL (HRQL), supporting the construct validity of the two versions of the instrument. The SEIQoL-DW and the SEIQoL-DR should be considered as complementary rather than interchangeable when used in patients with cancer.
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| 588. |
- Wettergren, Lena, et al.
(författare)
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Comparison of two instruments for measurement of quality of life in clinical practice - a qualitative study
- 2014
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Ingår i: BMC Medical Research Methodology. - : Springer Science and Business Media LLC. - 1471-2288. ; 14, s. 115-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The study aimed to investigate the meaning patients assign to two measures of quality of life: the Schedule for Evaluation of Individual Quality of Life Direct Weighting (SEIQoL-DW) and the SEIQoL-DW Disease Related (DR) version, in a clinical oncology setting. Even though the use of quality of life assessments has increased during the past decades, uncertainty regarding how to choose the most suitable measure remains. SEIQoL-DW versions assesses the individual's perception of his or her present quality of life by allowing the individual to nominate the domains to be evaluated followed by a weighting procedure resulting in qualitative (domains) as well as quantitative outcomes (index score). Methods: The study applied a cross-sectional design with a qualitative approach and collected data from a purposeful sample of 40 patients with gastrointestinal cancer. Patients were asked to complete two measures, SEIQoL-DW and the SEIQoL-DR, to assess quality of life. This included nomination of the areas in life considered most important and rating of these areas; after completion patients participated in cognitive interviews around their selections of areas. Interviews were audiotaped and transcribed verbatim which was followed by analysis using a phenomenographic approach. Results: The analyses of nominated areas of the two measures resulted in 11 domains reflecting what patients perceived had greatest impact on their quality of life. Analysis of the cognitive interviews resulted in 16 thematic categories explaining the nominated domains. How patients reflected around their quality of life appeared to differ by version (DW vs. DR). The DW version more often related to positive aspects in life while the DR version more often related to negative changes in life due to having cancer. Conclusions: The two SEIQoL versions tap into different concepts; health-related quality of life, addressing losses and problems related to having cancer and, quality of life, more associated with aspects perceived as positive in life. The SEIQoL-DR and the SEIQoL-DW are recommended in clinical practice to take both negative and positive aspects into account and acting on the problems of greatest importance to the patient.
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| 589. |
- Whither, Stine Braendegaard, et al.
(författare)
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Reduced-dose combination chemotherapy (S-1 plus oxaliplatin) versus full- dose monotherapy (S-1) in older vulnerable patients with metastatic colorectal cancer (NORDIC9) : a randomised, open-label phase 2 trial
- 2019
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Ingår i: The Lancet Gastroenterology & Hepatology. - : ELSEVIER INC. - 2468-1253. ; 4:5, s. 376-388
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older or vulnerable patients with metastatic colorectal cancer are seldom included in randomised trials.The multicentre NORDIC9 trial evaluated reduced-dose combination chemotherapy compared with full-dose monotherapy in older, vulnerable patients.Methods: This randomised, open-label phase 2 trial was done in 23 Nordic oncology clinics and included patients aged 70 years or older with previously untreated metastatic colorectal cancer who were not candidates for full-dose combination chemotherapy. Patients were block randomised (1: 1) using a web-based tool to full-dose S-1 (30 mg/m(2) orally twice daily on days 1-14 every 3 weeks) followed by second-line treatment at progression with irinotecan (250 mg/m(2) intravenously on day 1 every 3 weeks or 180 mg/m(2) intravenously on day 1 every 2 weeks) or reduceddose combination chemotherapy with S-1 (20 mg/m(2) orally twice daily on days 1-14) and oxaliplatin (100 mg/m(2) intravenously on day 1 every 3 weeks) followed by second-line treatment at progression with S-1 (20 mg/m(2) orally twice daily on days 1-14) and irinotecan (180 mg/m(2) intravenously on day 1 every 3 weeks). Use of bevacizumab (7.5 mg/kg intravenously on day 1 of each cycle) was optional. Treatment allocation was not masked and randomisation was stratified for institution and bevacizumab. The primary outcome was progression-free survival. Survival analyses were by intention to treat and safety analyses were done on the treated population. This trial is registered with EudraCT, number 2014-000394-39, and is closed to new participants.Findings: From March 9, 2015, to Oct 11, 2017, 160 patients with a median age of 78 years (IQR 76-81) were randomly assigned to full-dose monotherapy (n=83) or reduced-dose combination chemotherapy (n=77). At data cutoff (Sept 1, 2018; median follow-up 23.8 months [IQR 18.8-30.9]), 81 (98%) patients in the full-dose monotherapy group and 71 (92%) patients in the reduced-dose combination group had progressed or died. Median progression-free survival was significantly longer with reduced-dose combination chemotherapy (6.2 months [95% CI 5.3-8.3]) than with full-dose monotherapy (5.3 months [4.1-6.8]; hazard ratio [HR] 0.72 [95% CI 0.52-0.99]; p=0.047). Toxicity was evaluated in 157 patients who received treatment. Significantly more patients in the full-dose monotherapy group (51 [62%] of 82 patients) experienced at least one grade 3-4 adverse event than in the reduced-dose combination group (32 [43%] of 75 patients; p=0.014). Grade 3-4 diarrhoea (12 [15%] vs two [3%]; p=0.018), fatigue (ten [12%] vs three [4%]; p=0.083), and dehydration (five [6%] vs none; p=0.060) were more frequent in the full-dose monotherapy group than in the reduced-dose combination group. Treatment-related deaths occurred in three patients during firstline treatment and three patients during second-line treatment (two in the full-dose monotherapy group vs one in the reduced-dose combination group in both cases).Interpretation: Reduced-dose combination chemotherapy with S-1 and oxaliplatin for older, vulnerable patients with metastatic colorectal cancer was more effective and resulted in less toxicity than full-dose monotherapy with S-1. Reduced-dose combination chemotherapy could be a preferred treatment for this population.
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| 590. |
- Winterling, Jeanette, et al.
(författare)
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Expectations for the recovery period after cancer treatment – a qualitative study
- 2009
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 18:6, s. 585-593
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore what expectations patients have concerning the recovery period after completed curative cancer treatment and the degree to which these expectations were realized slightly more than 1 year later. A purposeful sample of 16 patients was selected from a larger study and those patients were interviewed 16 months after treatment completion. The interviews were analysed using the phenomenographic method. Patients' expectation for their recovery period was generally to become well, but they often lacked plans for how to recover. If the recovery period was perceived as 'smooth' expectations were always met. However, if the period was perceived as 'tough' expectations were often unfulfilled, but most of these patients were satisfied with their current life anyway owing to positive changes and it was only a small proportion of the patients that still felt unwell. Even though most of the patients had managed to adjust well to the situation slightly more than 1 year after completed treatment, several patients had not been aware of how tough recovery could be and requested further support from the healthcare system.
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