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- Remziye Semerci (Edirne, Turkey)
Sexual wellbeing in cancer care
- Lorraine Grover (London, United Kingdom)
Malta: How cancer carers live with their own chronic conditions
- Daren Chircop (Msida, Malta)
What really matters to you? A Delphi study on priority patient-reported outcomes to evaluate when caring for people with advanced liver or advanced renal cancer
- Celia Díez de los Ríos de la Serna (Barcelona, Spain)
CN60 - OptiBra study: An RCT, optimal postoperative bra support after breast cancer surgery
- Malin Backman (Stockholm, Sweden)
Abstract
Background
Following breast cancer (BC) surgery, approximately 60% of women report some degree of postoperative pain. Analgesics, early physical mobilization, various types of bandaging are effective relieving pain after surgery. No randomized trial has evaluated whether bra support can reduce pain and other symptoms after BC surgery. This study’s aim was to examine if a stable bra with compression was superior to a soft bra on the impact of pain, occurrence of complications, comfort and satisfaction for women having BC surgery.
Methods
A randomized controlled trial included women planned for BC surgery (breast conserving surgery (BCS), mastectomy or mastectomy with implant-based breast reconstruction combined with sentinel node biopsy (SNB) or axillary clearance). The women were randomized to either a soft bra (SB) or a stable bra with compression (SBwC) to be used 24 hours/day for 3 weeks. The primary outcome measure pain, measured by Numerical Rating Scale, analgesic use and daily brause rate was recorded by the participating women.
Results
Two hundred and one women were randomized and 184 completed the follow-up. The average age was 60 years old, 60% had a university education and more than 90% used a bra daily pre-diagnosis, with a majority using cup size B or C. Sixty five percent underwent BCS with SNB surgery. Overall, no significant differences between groups were found considering pain rating over time, neither day 1-14 (p=0.098) nor after 3 weeks (p=0.77). However, 68% of all participants, regardless of group, reported some degree of pain during the first 14 days. After 3 weeks 46% of participants still reported pain in the operated breast. For the women who reported pain those using SBwC reported significantly lower pain score than women who used SB (p 0.018). Women who used SBwC reported significantly higher levels of; comfort (p=0.027), sense of security during activity (p=0.032), less difficulty moving the arm (p=0.031) as well as support and stability for the operated breast (p<0.001) compared to those using the SB.
Conclusions
Women reporting any degree of pain 3 weeks after surgery report significantly less pain with a SBwC. The SBwC is perceived to be more comfortable and contributes to higher satisfaction.
Legal entity responsible for the study
Malin Backman PI Academic study at Karolinska University hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
CN59 - A scoping review to establish the utility of patient reported outcome measures in blood cancer
- Suriya Kirkpatrick (Bristol, United Kingdom)
Abstract
Background
Blood cancers can have devastating effects on patients’ physical, emotional, and psychosocial health. With improvements in therapies, patients are living longer. There is growing evidence to support the use of Patient Reported Outcome Measures (PROMs) in capturing cancer care sequel as they measure a patient’s perception of their own health status and needs through validated tools. While PROMs are widely adopted in oncology, it is felt that uptake in haematology remains limited in routine outpatient supportive care. Therefore, the objective of this scoping review is to explore, and identify the utility of patient reported outcome measures (PROMs) in blood cancer and to understand the extent and type of evidence in relation to benefits of PROMs to patients within routine clinical practice.
Methods
This review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews (Peters et al. 2020) and the PRISMA- ScR (Preferred Reporting Items for Systematic Reviews and Meta analysis) model for organising information (Tricco et al. 2018).
Results
Initial searches identified 7977 papers, 21 full texts were reviewed and eight papers that met the final inclusion criteria were included in the review. The findings were placed in categories of papers and included: acceptability and usability, self-efficacy, patient experience, implementation and impact of PROMs.
Conclusions
The papers identified the area of interests to be the implementation process of PROMS, within routine care, where the dominance was implementation of electronic versus paper, for routine symptom management and only one paper addressed impact of PROMS on patient outcomes. This highlights the collation of data but not how the data is used in routine care to improve the quality of life when living with a chronic Haematology illness trajectory. To conclude there is limited to non-existent evidence on the impact of using PROMs to support delivery of personalised supportive care.
Legal entity responsible for the study
S. Kirkpatrick and K. Campbell.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
CN62 - Patient and public involvement in cancer research: The needs and perceptions of older adults living with and after cancer
- Amanda Drury (Dublin, Ireland)
Abstract
Background
Patient and public involvement (PPI) is a movement to involve and engage people affected by research, and members of the public, in the development, conduct and reporting of health and social care research. PPI is a relatively new development in health research and there is relatively limited understanding of the perceptions and needs of older adults affected by cancer to enable meaningful engagement in cancer research. Therefore, this study aims to explore the perceptions of PPI and percieved facilitators and barriers of PPI for older adults living with and after cancer.
Methods
Qualitative semi-structured interviews were conducted with sixteen older adults over the age of sixty-five who were living with or after a diagnosis of cancer. Participants were recruited via an advocacy organization and a regional cancer center in Ireland. During each interview, participants were presented with an outline of PPI activities and were asked to discuss their preferences for PPI, and the issues which they believed could facilitate or prevent their engagement in the PPI process. Interviews were recorded, transcribed, and analysed according to the principles of thematic analysis.
Results
Thematic analysis of the interview data yielded three themes describing the opportunities, barriers, and needs of older adults related to PPI. While participants believed that PPI could enhance the process and outputs of research, personal and systemic barriers to PPI presented limitations for older adults' involvement, including perceived inexperience and lack of knowledge in research, and the ad hoc nature of PPI opportunities. To ensure accessibility and sustainability of PPI, participants highlighted needs related to training, support, and accommodations which considered the impact of acute and late effects of cancer on older adults' capacity to be involved in PPI.
Conclusions
While PPI is becoming integral in research design, this study highlights a variety of potential barriers to older adults' willingness and opportunity to become PPI research partners. Future efforts to integrate PPI in research efforts must be cognisant of the factors which may prevent or discourage older adults' involvement as PPI partners in research.
Legal entity responsible for the study
University College Dublin.
Funding
Irish Research Council.
Disclosure
A. Drury: Financial Interests, Personal, Full or part-time Employment: University College Dublin; Financial Interests, Institutional, Research Grant, I am a collaborator on the Pfizer-funded project ABC4Nurses, which is coordinated and managed by EONS: Pfizer; Non-Financial Interests, Invited Speaker: European Oncology Nursing Society; Non-Financial Interests, Advisory Role, I am an advisor on several EONS projects, including ABC4Nurses and RCC & HCC PROMS: European Oncology Nursing Society. All other authors have declared no conflicts of interest.
CN63 - Intervention pathways for low anterior resection syndrome after sphincter-saving rectal cancer surgery: A systematic scoping review.
- Eva Pape (Gent, Belgium)
Abstract
Background
An increased number of rectal cancer survivors are living with disordered bowel function, which is called low anterior resection syndrome. There is no gold standard in treatment so to manage their bowel function, patients search for strategies and compromises but rely mostly on trial and error. Several intervention pathways for LARS are suggested in the literature. The problem is that there is a great discrepancy between the treatment options within the pathway. This systematic scoping review aims to map the range of intervention pathways for LARS after sphincter-saving rectal cancer surgery.
Methods
A systematic search was performed through four databases (CINAHL, EMBASE, PubMed, and Web of Science) plus exploration of reference lists of included papers. Any type of paper was included if it described an intervention pathway of bowel problems after sphincter-saving rectal cancer surgery. Exclusion criteria were absence of full paper, no intervention pathway, not being written in English or Dutch and patients with a stoma. A narrative synthesis of the results of included studies is presented.
Results
Of 373 identified papers, 12 were included in this scoping review. Despite similarities in treatment options there were variations in which treatments are included, when treatments should be instigated and even which patients should be treated. Treatment pathways included different steps (ranging from 2 to six) and different interventions (ranging from 5 to 9), commonly starting with conservative treatment and dietary alterations and ending with a discussion about stoma formation. Some intervention pathways also described preoperative and/or pre-stoma reversal interventions.
Conclusions
There is no single definitive treatment pathway, and additionally, multimodal treatments are described. Nonetheless, guidance is necessary for HCPs and patients to ensure that appropriate care is provided. However, there is a lack of evidence to support many potentially useful interventions in a bowel symptom management pathway for people after rectal cancer surgery, particularly for conservative treatment. Additional work is necessary to determine how best to recognize, assess and address symptoms.
Clinical trial identification
The study was registered with Open Science Framework (10.17605/OSF.IO/JB5H8).
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.