scholarly journals Daily Collection of Self-Reporting Sleep Disturbance Data via a Smartphone App in Breast Cancer Patients Receiving Chemotherapy: A Feasibility Study (Preprint)

2014 ◽  
Author(s):  
Yul Ha Min ◽  
Jong Won Lee ◽  
Yong-Wook Shin ◽  
Min-Woo Jo ◽  
Guiyun Sohn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sleep Disturbance ◽  
Cancer Patients ◽  
Compliance Rate ◽  
Self Report ◽  
Smartphone App ◽  
Breast Cancer Patients ◽  
Individual Patient Level ◽  
Patient Level ◽  
Compliance Curve

BACKGROUND Improvements in mobile telecommunication technologies have enabled clinicians to collect patient-reported outcome (PRO) data more frequently, but there is as yet limited evidence regarding the frequency with which PRO data can be collected via smartphone applications (apps) in breast cancer patients receiving chemotherapy. OBJECTIVE The primary objective of this study was to determine the feasibility of an app for sleep disturbance-related data collection from breast cancer patients receiving chemotherapy. A secondary objective was to identify the variables associated with better compliance in order to identify the optimal subgroups to include in future studies of smartphone-based interventions. METHODS Between March 2013 and July 2013, patients who planned to receive neoadjuvant chemotherapy for breast cancer at Asan Medical Center who had access to a smartphone app were enrolled just before the start of their chemotherapy and asked to self-report their sleep patterns, anxiety severity, and mood status via a smartphone app on a daily basis during the 90-day study period. Push notifications were sent to participants daily at 9 am and 7 pm. Data regarding the patients&#8217; demographics, interval from enrollment to first self-report, baseline Beck&#8217;s Depression Inventory (BDI) score, and health-related quality of life score (as assessed using the EuroQol Five Dimensional [EQ5D-3L] questionnaire) were collected to ascertain the factors associated with compliance with the self-reporting process. RESULTS A total of 30 participants (mean age 45 years, SD 6; range 35-65 years) were analyzed in this study. In total, 2700 daily push notifications were sent to these 30 participants over the 90-day study period via their smartphones, resulting in the collection of 1215 self-reporting sleep-disturbance data items (overall compliance rate=45.0%, 1215/2700). The median value of individual patient-level reporting rates was 41.1% (range 6.7-95.6%). The longitudinal day-level compliance curve fell to 50.0% at day 34 and reached a nadir of 13.3% at day 90. The cumulative longitudinal compliance curve exhibited a steady decrease by about 50% at day 70 and continued to fall to 45% on day 90. Women without any form of employment exhibited the higher compliance rate. There was no association between any of the other patient characteristics (ie, demographics, and BDI and EQ5D-3L scores) and compliance. The mean individual patient-level reporting rate was higher for the subgroup with a 1-day lag time, defined as starting to self-report on the day immediately after enrollment, than for those with a lag of 2 or more days (51.6%, SD 24.0 and 29.6%, SD 25.3, respectively; <i>P</i>=.03). CONCLUSIONS The 90-day longitudinal collection of daily self-reporting sleep-disturbance data via a smartphone app was found to be feasible. Further research should focus on how to sustain compliance with this self-reporting for a longer time and select subpopulations with higher rates of compliance for mobile health care.

Identification of distinct subgroups of breast cancer patients based on self-reported changes in sleep disturbance

2012 ◽  
Vol 20 (10) ◽  
pp. 2611-2619 ◽  
Author(s):  
Christina Van Onselen ◽  
Bruce A. Cooper ◽  
Kathryn Lee ◽  
Laura Dunn ◽  
Bradley E. Aouizerat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sleep Disturbance ◽  
Cancer Patients ◽  
Breast Cancer Patients

scholarly journals Defense Mechanisms and Repressive Coping Among Male Breast Cancer Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Rainer Weber ◽  
Johannes C. Ehrenthal ◽  
Evamarie Brock-Midding ◽  
Sarah Halbach ◽  
Rachel Würstlein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Male Breast Cancer ◽  
Defense Mechanisms ◽  
Male Breast ◽  
Self Report ◽  
Repressive Coping ◽  
Breast Cancer Patients ◽  
Defensive Functioning ◽  
Fear Of Progression

Objectives: The concept of defense mechanisms has undergone extensive revision and expansion since Freud first described these processes. Initially formulated as an unconscious repression of unpleasant memories, with further development focusing on the role of defense mechanisms in the regulation of internal conflicts, the concept shifted and evolved to incorporate the adaptation to external demands, including intrapsychic and interpersonal handling of burden of illness. In addition to defense mechanisms, coping provides another perspective on human adjustment to difficult life events. While there is substantial research on both coping and defense mechanisms in various psychiatric and somatic diseases, including cancer, little is known about defensive regulation, coping, and their interaction in male breast cancer patients.Methods: The present study is part of the N-Male project conducted between 2016 and 2018 in Germany (Male breast cancer: patients' needs in prevention, diagnosis, treatment, rehabilitation, and follow-up care). Semi-standardized interviews with 27 male breast cancer patients were analyzed with regard to defense mechanisms. In addition, fear of progression and repressive coping was assessed by self-report.Results: There was considerable variety in levels of defensive functioning as well as repressive coping in our sample. We found no difference in overall levels of defensive functioning between men with vs. without repressive coping. However, patients with repressive coping demonstrated a decopupled association between fear of progression and defensive functioning as compared to patients without repressive coping.Discussion: The study provides the first evidence of disease processing in male breast cancer patients Knowledge of patients' defense patterns and repressive coping seems promising for better planning targeted intervention strategies.

scholarly journals Do Women With Breast Cancer Who Choose Adjunctive Integrative Oncology Care Receive Different Standard Oncologic Treatment?

2018 ◽  
Vol 17 (3) ◽  
pp. 874-884 ◽  
Author(s):  
Leanna J. Standish ◽  
Fred Dowd ◽  
Erin Sweet ◽  
Linda Dale ◽  
M. Robyn Andersen
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Surveillance ◽  
Self Report ◽  
Prognostic Indicators ◽  
Breast Cancer Patients ◽  
Additional Information ◽  
Antiestrogen Therapy ◽  
Oncologic Treatment ◽  
To Receive

Purpose: To determine if women with breast cancer who choose adjunctive naturopathic oncology (NO) specialty care receive different standard oncologic treatment when compared with breast cancer patients who receive only standard care. Participants: Women with breast cancer stages 0 to 4, aged 18+ who spoke English and sought care from outpatient naturopathic doctor clinics were enrolled in an observational study of clinical and quality of life outcomes. Women who sought NO care 2 or more times within the first 2 years postdiagnosis were identified as NO cases. A matched comparison group of breast cancer patients were identified using the Western Washington Cancer Surveillance System(CSS). Methods: A longitudinal cohort design. In addition to self-report data, the CSS provided data on demographics, stage at the time of diagnosis, and initial treatment. Oncology medical records were abstracted in order to provide additional information on standard oncologic treatment for all participants. Results: Cohorts were well matched with regard to demographic, histologic, and prognostic indicators at the time of diagnosis. Approximately 70% of women in both cohorts received standard oncologic care that met the National Comprehensive Cancer Network guidelines. There were no statistically significant differences between the cohorts in treatment received. Fewer women in the NO cohort with estrogen receptor–positive breast cancer appear to have received antiestrogen therapy. Conclusions: Women in both cohorts appear to receive guideline-concordant care. However, women who receive adjunctive NO care may be less likely to receive antiestrogen therapy.

scholarly journals Status and manifestations of sleep disorders and the status of drugs used to help fall sleep in Chinese breast cancer women at initial diagnosis and during chemotherapy

2019 ◽  
Author(s):  
Baoshan Zou ◽  
Hong Li ◽  
Jiashuo Liu ◽  
Zhou Xu ◽  
Haoran Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Cancer Patients ◽  
Sleep Latency ◽  
Initial Diagnosis ◽  
Sleep Efficiency ◽  
Breast Cancer Patients ◽  
The Status ◽  
Chemotherapy Patients

Abstract Purpose This study was designed to investigate the status and manifestations of sleep disorders and the status of drugs used to help fall sleep in Chinese breast cancer women at initial diagnosis and during chemotherapy. Patients and Methods Totally 308 primary breast cancer women were enrolled. The status and manifestations of sleep disorders and the status of drugs used to help fall sleep in the above breast cancer patients were assessed via the Pittsburgh Sleep Quality Index (PSQI). Result The prevalence of sleep disorders in patients at the time of initial diagnosis with breast cancer was approximately 50% (97/194), which was significantly lower than that (65.8%, 75/114) in breast cancer patients before the last cycle of chemotherapy (p＜0.05) . However, both groups of patients rarely used drugs to help them fall sleep (P>0.05). The mean scores for sleep latency, habitual sleep efficiency, sleep disturbance, and daytime dysfunction (1.68, 1.08, 1.65, 1.37) in breast cancer patients prior to the last cycle of chemotherapy were obviously worse than those (1.29, 0.71, 1.26, 1.01) in breast cancer patients at the time of initial diagnosis (p<0.05). Conclusion Chemotherapy mainly affects the sleep latency, habitual sleep efficiency, sleep disturbance, daytime dysfunction in breast cancer patients. Chinese breast cancer patients rarely use drugs to intervene sleep disorders.

scholarly journals Use of Mental Health Apps by Breast Cancer Patients and Their Caregivers in the United States: Protocol for a Pilot Pre-Post Study (Preprint)

2018 ◽  
Author(s):  
Philip I Chow ◽  
Shayna L Showalter ◽  
Matthew S Gerber ◽  
Erin Kennedy ◽  
David R Brenin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mental Health ◽  
Mobile Phone ◽  
Cancer Patients ◽  
The United States ◽  
Mobile App ◽  
Self Report ◽  
Phase Iii ◽  
Breast Cancer Patients ◽  
Health Apps

BACKGROUND Over one-third of cancer patients experience clinically significant mental distress, and distress in caregivers can exceed that of the cancer patients for whom they care. There is an urgent need to identify scalable and cost-efficient ways of delivering mental health interventions to cancer patients and their loved ones. OBJECTIVE The aim of this study is to describe the protocol to pilot a mobile app–based mental health intervention in breast cancer patients and caregivers. METHODS The IntelliCare mental health apps are grounded in evidence-based research in psychology. They have not been examined in cancer populations. This pilot study will adopt a within-subject, pre-post study design to inform a potential phase III randomized controlled trial. A target sample of 50 individuals (with roughly equal numbers of patients and caregivers) at least 18 years of age and fluent in English will be recruited at a US National Cancer Institute designated clinical cancer center. Consent will be obtained in writing and a mobile phone will be provided if needed. Self-report surveys assessing mental health outcomes will be administered at a baseline session and after a 7-week intervention. Before using the apps, participants will receive a 30-min coaching call to explain their purpose and function. A 10-min coaching call 3 weeks later will check on user progress and address questions or barriers to use. Self-report and semistructured interviews with participants at the end of the study period will focus on user experience and suggestions for improving the apps and coaching in future studies. RESULTS This study is ongoing, and recruitment will be completed by the end of 2018. CONCLUSIONS Results from this study will inform how scalable mobile phone-delivered programs can be used to support breast cancer patients and their loved ones. CLINICALTRIAL ClinicalTrials.gov NCT03488745; https://clinicaltrials.gov/ct2/show/NCT03488745 INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11452

Resource and quality information provided by compliance with NCCN hereditary breast cancer guidelines.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 5-5
Author(s):  
Peter J. Levonian ◽  
Jeffrey Landercasper ◽  
Choua Vang ◽  
Kristen Marcou ◽  
Rima Al Hajj ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Counseling ◽  
Cancer Patients ◽  
Compliance Rate ◽  
Cost Of Care ◽  
Breast Cancer Patients ◽  
Brca Testing ◽  
Genetic Risk Assessment ◽  
Nccn Guidelines ◽  
Assessment And Testing

5 Background: NCCN provides guidelines for breast cancer genetic risk assessment and testing. Measuring compliance with NCCN Guidelines (NG) can identify quality gaps. Methods: After IRB approval, a retrospective review of a prospective database of breast cancer patients was conducted to measure compliance with NG for genetic counseling and BRCA testing. Entry criteria were breast cancer patients with diagnosis and treatment at our center, during the 3 year period ending 12/31/11. Genetic counselors (GC) used NG and BRCAPRO modeling in all patients. Surgeon and GC pedigree analyses were compared. Results: Surgeons constructed pedigrees in 675 breast cancer patients and referred 42% (286/675) to the GC. The decision to refer was NCCN compliant in 671/675 (99%). The GC corrected the pedigree in 14% (39/286); nearly all due to the GC identifying extra breast or ovarian cancers. The mean BRCAPRO probability in referred patients was 7.2%. Fifty-nine percent (170/286) of patients seen by the GC received a recommendation for BRCA testing. The NG compliance rate for testing was 98% (170/174). Of 174 BRCA tests offered to patients, 74% (128/174) underwent testing. In tested patients, there were 4% BRCA1+, 5% BRCA 2+, and 1% uncertain variants. Total patient charges for 128 tests were $696,000 ($4,000/test). If the threshold for testing was BRCAPRO > 5% or >10%, then 69 ($276,000) and 45 ($180,000) (p<0.001) patient charges would have occurred, and no patient with BRCA + status would have been missed. Conclusions: High rates of NCCN guideline compliance for genetic counseling and testing are achievable. Our GC's improve accuracy of pedigree assessment and demonstrate adherence to NCCN guidelines, resulting in more testing compared to BRCAPRO modeling. The balance between different methods to trigger testing, their sensitivity, and cost deserves more study, but the observational data contained herein provides information for provider and payer stakeholders regarding estimated GC resources and cost of care.

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