Increasing Readiness for Early Integrated Palliative Oncology Care: Development and Initial Evaluation of the EMPOWER 2 Intervention

Perry, Laura M.; Malhotra, Sonia; Alonzi, Sarah; Kim, Seowoo; Voss, Hallie M.; Rogers, James L.; Robinson, William S.; Harris, Kendra; Shank, Jessica; Morrison, David G.; Lewson, Ashley B.; Fuloria, Jyotsna; Miele, Lucio; Lewis, Brian; Mossman, Brenna; Hoerger, Michael

doi:10.1016/j.jpainsymman.2021.03.027

Cited by 13 publications

(6 citation statements)

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“…This research also has important implications for palliative care psychoeducation as an avenue to decouple the relationship between emotional distress and avoidance. Some research has shown that educational interventions can significantly improve attitudes toward palliative care, as many individuals either do not know about palliative care or equate it with hospice, and informing individuals about its existence and correcting common misconceptions about its purpose and efficacy can, in turn, promote more positive attitudes 11,37 . While it is prudent to educate all patients about palliative care in pursuit of attitudinal improvement, this study shows it is particularly important to educate and improve these attitudes among those with higher levels of emotional distress.…”

Section: Discussionmentioning

confidence: 73%

“…Some research has shown that educational interventions can significantly improve attitudes toward palliative care, as many individuals either do not know about palliative care or equate it with hospice, and informing individuals about its existence and correcting common misconceptions about its purpose and efficacy can, in turn, promote more positive attitudes. 11,37 While it is prudent to educate all patients about palliative care in pursuit of attitudinal improvement, this study shows it is particularly important to educate and improve these attitudes among those with higher levels of emotional distress. Specifically, among emotionally distressed patients, it may be helpful to acknowledge patients' reluctance to seek supportive services, especially when overwhelmed, and emphasize the positive psychological benefits that may result from receiving palliative care.…”

Section: Discussionmentioning

confidence: 82%

“…Future research on emotional distress and palliative care avoidance should include more representative samples and examine whether these associations extend to in‐clinic scenarios, such as lower acceptance rates of referrals to palliative care among those who are experiencing anger or other symptoms of emotional distress. A randomized controlled trial is ongoing 37 …”

Section: Discussionmentioning

confidence: 99%

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Emotional distress predicts palliative cancer care attitudes: The unique role of anger

et al. 2023

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Objective: Although palliative care can mitigate emotional distress, distressed patients may be less likely to engage in timely palliative care. This study aims to investigate the role of emotional distress in palliative care avoidance by examining the associations of anger, anxiety, and depression with palliative care attitudes.Methods: Patients (N = 454) with heterogeneous cancer diagnoses completed an online survey on emotional distress and palliative care attitudes. Emotional distress was measured using the Patient-Reported Outcomes Measurement Information System anger, anxiety, and depression scales. The Palliative Care Attitudes Scale was used to measure palliative care attitudes. Regression models tested the impact of a composite emotional distress score calculated from all three symptom measures, as well as individual anger, anxiety, and depression scores, on palliative care attitudes. All models controlled for relevant demographic and clinical covariates.Results: Regression results revealed that patients who were more emotionally distressed had less favorable attitudes toward palliative care (p < 0.001). In particular, patients who were angrier had less favorable attitudes toward palliative care (p = 0.013) while accounting for depression, anxiety, and covariates. Across analyses, women had more favorable attitudes toward palliative care than men, especially with regard to beliefs about palliative care effectiveness. Conclusions:Anger is a key element of emotional distress and may lead patients to be more reluctant toward timely utilization of palliative care. Although psychooncology studies routinely assess depression or anxiety, more attention to anger is warranted. More research is needed on how best to address anger and increase timely utilization of palliative cancer care.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Emotional distress predicts palliative cancer care attitudes: The unique role of anger

et al. 2023

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“…Out of the 66 PPI articles, 16 originated in the United Kingdom, 31–46 14 in the United States, 47–60 12 in Australia, 61–72 7 in Canada, 73–79 2 in China, 80,81 and 1 in Japan 82 . European countries included: Switzerland ( n = 2), 83,84 The Netherlands ( n = 2), 85,86 and Spain ( n = 1), 87 as well as two studies comprising several countries ( n = 2) 88,89 .…”

Section: Resultsmentioning

confidence: 99%

Patient and public involvement in cancer research: A scoping review

Colomer‐Lahiguera,

Steimer,

Ellis

et al. 2023

Cancer Medicine

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IntroductionPatient and public involvement (PPI) in research emphasizes the importance of doing research with, rather than for people with lived health/illness experience(s). The purpose of this scoping review is to investigate the breadth and depth of scientific literature on PPI in cancer research and to identify how is PPI applied and reported in cancer research.MethodsWe searched MEDLINE, Embase, CINAHL, and PsycInfo up to March 2022. All titles/abstracts and full‐text results were screened by two reviewers. Data were analyzed and are presented in both narrative and tabular format.ResultsWe screened 22,009 titles/abstract, reviewed 375 full‐text articles, of which 101 studies were included in this review. 66 papers applied PPI; 35 used co‐design methodologies. PPI in cancer research in published research has increased steadily since 2015 and often includes those with a past diagnosis of cancer or relatives/informal caregivers. The most common applied methods were workshops or interviews. PPI was generally used at the level of consultation/advisor and occurred mainly in early stages of research. Costs related to PPI were mentioned in 25 papers and four papers described training provided for PPI.ConclusionsResults of our review demonstrate the nature and extent of PPI expansion in cancer research. Researchers and research organizations entering the fray of PPI should consider planning and reporting elements such as the stage, level, and role type of PPI, as well as methods and strategies put in place to assure diversity. Furthermore, a thorough evaluation of whether all these elements meet the stated PPI purpose will help to grasp its impact on research outcomes.Patient or Public ContributionTwo patients participated in the stakeholder consultation as part of the scoping review methodology, contributed to the discussion on refining the results, and critically reviewed the manuscript. Both are co‐authors of this manuscript.

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“…Here, we found that greater patients’ knowledge about PC was indeed associated with a more positive perception of PC. Interventions to improve knowledge about PC are not only acceptable and feasible, 34 but also result in increased PC knowledge, 34 reduced barriers, and more exposure to PC. 28 , 35 When PC was clearly explained, up to 86% of HSCT recipients decided to enroll in a trial to test the efficacy of inpatient PC for improving outcomes in patients hospitalized for HSCT.…”

Section: Discussionmentioning

confidence: 99%

What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients

et al. 2023

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Palliative care (PC) benefits patients undergoing hematopoietic stem cell transplantation (HSCT) but remains under-utilized. Whereas transplant physicians report concerns regarding how patients perceive PC, HSCT recipients' perceptions about PC remain unaddressed. We conducted a multi-site cross-sectional survey of autologous and allogeneic HSCT recipients 3-12 months post-transplant to assess their familiarity, knowledge, and perception of PC, as well as their unmet PC needs. We computed a composite score of patients' perceptions of PC and used a generalized linear regression model to examine factors associated with these perceptions. We enrolled 69.6% (250/359) of potential participants (Median age = 58.1; 63.1% autologous HSCT). Overall, 44.3.8% (109/249) reported limited knowledge about PC and 52% (127/245) endorsed familiarity with PC. Most patients felt hopeful (54%) and reassured (50%) when they heard the term PC; 83% saw referral as a sign their doctor cared about what was happening to them. In multivariate analyses, patients who were more knowledgeable about PC were more likely to have positive perceptions of PC (B = 7.54, SE=1.61, P < 0.001). Patients' demographics, HSCT features, quality of life, and symptom burden were not significantly associated with perceptions of PC. HSCT recipients have positive perceptions of PC, though many have limited knowledge about its role. Patients who were more knowledgeable about PC were more likely to have positive perceptions of PC. These data do not support transplant physicians' negative concerns about how patients perceive PC and underscore the need to further educate patients and transplant physicians about PC.

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Increasing Readiness for Early Integrated Palliative Oncology Care: Development and Initial Evaluation of the EMPOWER 2 Intervention

Cited by 13 publications

References 53 publications

Emotional distress predicts palliative cancer care attitudes: The unique role of anger

Emotional distress predicts palliative cancer care attitudes: The unique role of anger

Patient and public involvement in cancer research: A scoping review

What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients

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