Browsing by Author "Reynolds, Kathleen"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
- ItemOpen AccessDocumenting patients’ and providers’ preferences when proposing a randomized controlled trial: a qualitative exploration(2022-03-06) Oberoi, Devesh; Kwok, Cynthia; Li, Yong; Railton, Cindy; Horsman, Susan; Reynolds, Kathleen; Joy, Anil A.; King, Karen M.; Lupichuk, Sasha M.; Speca, Michael; Culos-Reed, Nicole; Carlson, Linda E.; Giese-Davis, JanineAbstract Background With advances in cancer diagnosis and treatment, women with early-stage breast cancer (ESBC) are living longer, increasing the number of patients receiving post-treatment follow-up care. Best-practice survivorship models recommend transitioning ESBC patients from oncology-provider (OP) care to community-based care. While developing materials for a future randomized controlled trial (RCT) to test the feasibility of a nurse-led Telephone Survivorship Clinic (TSC) for a smooth transition of ESBC survivors to follow-up care, we explored patients’ and OPs’ reactions to several of our proposed methods. Methods We used a qualitative study design with thematic analysis and a two-pronged approach. We interviewed OPs, seeking feedback on ways to recruit their ESBC patients for the trial, and ESBC patients, seeking input on a questionnaire package assessing outcomes and processes in the trial. Results OPs identified facilitators and barriers and offered suggestions for study design and recruitment process improvement. Facilitators included the novelty and utility of the study and simplicity of methods; barriers included lack of coordination between treating and discharging clinicians, time constraints, language barriers, motivation, and using a paper-based referral letter. OPs suggested using a combination of electronic and paper referral letters and supporting clinicians to help with recruitment. Patient advisors reported satisfaction with the content and length of the assessment package. However, they questioned the relevance of some questions (childhood trauma) while adding questions about trust in physicians and proximity to primary-care providers. Conclusions OPs and patient advisors rated our methods for the proposed trial highly for their simplicity and relevance then suggested changes. These findings document processes that could be effective for cancer-patient recruitment in survivorship clinical trials.
- ItemOpen AccessThe Cancer Journey Among Survivors of Pediatric Acute Lymphoblastic Leukemia(2023-04-28) Cho, Sara Kaitlyn; Schulte, Fiona; Reynolds, Kathleen; Fay-McClymont, TarynPediatric acute lymphoblastic leukemia (ALL) is the most common form of pediatric cancer. Treatment for ALL has advanced recently, contributing to the impressive increase in cancer survival. Early treatments used cranial radiation therapy (CRT) which has been linked to debilitating late effects. Modern treatments (e.g., chemotherapies) have moved away from CRT, maximizing central nervous system (CNS) drug exposure while attempting to minimize drug toxicity. However, we do not understand modern therapies effects on several psychosocial late effects, including social adjustment. First, a systematic review was conducted to examine current literature on social adjustment in survivors of pediatric ALL. Four databases were searched and 43 articles were included in the final review. Findings from the articles indicated survivors of pediatric ALL experienced social adjustment difficulties when compared to control groups. However, treatment and non-treatment related factors require further elucidation. Secondly, a qualitative exploration of survivors and their caregivers’ memories was conducted. Nineteen dyads insights were captured through semi-structured, one-on-one interviews. Reflexive thematic analysis following principles of qualitative description generated two themes contingent on role (survivor or caregiver): difficulties remembering the cancer experience and managing their child’s cancer experience, and two unified themes: the role of others in getting through the cancer experience, and the lasting impact of the cancer diagnosis and experience. Findings indicate the need for whole family interventions. Additionally, caregivers, with the help of healthcare providers, should strive for open and developmentally appropriate communication with their children around cancer care and survivorship. Evidence from this thesis will help guide future research, highlighting the need for theoretically grounded research, and patient-identified priorities to advance the field of psychosocial research among this population.