Quality of Life Among Cancer Survivors (eBook)

Tanya Fitzpatrick, Ph.D., MSW, RN received her doctoral degree in social work from Boston College in 1992 and completed post-doctoral studies through Boston University focusing on issues relating to health and social outcomes among older adults. She is the director of research at Hope & Cope (H&C), the Jewish General Hospital (JGH), with an appointment at McGill University. Prior to her employment at McGill, she was an associate professor from 2000 until 2008, and is professor emeritus from Arizona State University, Department of Social Work, with a background in nursing, social work, and gerontology. She is a member of the Gerontological Society of America, Society for Social Work Research, National Association of Social Workers, Canadian Association of Psychosocial Oncology, and American Society on Aging.

Brief Summary 5
Introduction 6
References 8
Contents 10
Contributors 12
Chapter 1: Theoretical Perspectives 16
Cancer Survivorship and Quality of Life 16
Stress and the Coping Mechanism 17
Activity Theory 17
Social Support and the Stress-Buffering Model 18
Summary 19
References 19
Chapter 2: Play, Leisure Activities, Cognitive Health, and Quality of Life Among Older Cancer Survivors 21
Introduction 21
Cancer, Chemotherapy, and Cognitive Health 22
Theoretical Perspectives and Conceptual Models 22
Social Support Theory 23
The Stress and Coping Mechanism 24
The Stress-Buffering Hypothesis and Model 24
Therapeutic Interventions 25
State of Play 26
Leisure Activities 26
Leisure Activities, Cognitive Health, and Cancer 27
Physical Fitness Activities 28
Psychological Interventions 28
Social Support and Group Therapy 28
Neurology and Oncology 29
Educational Activities to Maintain Brain Fitness 30
Summary of the Literature 31
Implications for Clinical Practice and Research 32
References 33
Chapter 3: The Influence of Acculturation and Health-Related Quality of Life Among Chinese Elderly Cancer Survivors 37
Introduction 37
Literature Review 38
Health-Related Quality of Life Among Cancer Survivors 38
Cancer Among Immigrant and Ethnic Minorities 38
Acculturation and Quality of Life 39
Cancer in Chinese Immigrants and Cultural Beliefs 40
Acculturation in Chinese Elderly Immigrants 41
Summary 42
Methodology 42
Design 42
Sample 42
Recruitment and Site 44
Site 44
Data Collection 44
Measurement 45
Data Recording 45
Standards of Quality and Verification 45
Analyses 46
Results 46
Cultural Seclusion and Social Support 46
Impression of Healthcare System 47
Challenges During Cancer 48
Language and Access to Services 48
Financial Challenges 50
Geography and Transportation 50
General Well-Being 51
Discussion 52
Limitations 55
Implications for Clinical Practice 56
Appendix 1 Questionnaire for Interview Based on Modified EAAM, GEQ, and HRQOL 14 57
References 58
Chapter 4: Ethical Issues in Cancer Patients 63
Case 1 71
Recommendations of Ethics Consultant 72
Follow-Up 73
Case 2 73
Recommendations of Ethics Consultant 74
Follow-Up 75
Case 3 75
Recommendations of Ethics Consultant 76
Follow-Up 77
Case 4 77
Recommendations of Ethics Consultant 78
Follow-Up 79
Conclusions 79
References 80
Additional References on the Ethical Foundation of Medicine 80
Chapter 5: Genetic Mutations in Cancer Susceptibility Genes: A Family History of Cancer 81
Introduction 81
Hereditary Breast Cancer 81
Pretest Genetic Counseling 82
Cancer Risks in Those Already Diagnosed as Well as Unaffected Family Members 83
Results Disclosure 86
Reproductive Options 86
Breast Cancer Risk and Options for Surveillance and Surgery 87
Concern for Family Members 88
Pediatric Cancer Complexities 91
Introduction 91
Pre-test Genetic Counseling 91
Uncertainty Related to Future Cancers in Those Already Diagnosed 94
Options for Cancer Surveillance 95
Reproductive Options 95
Concern for Family Members at Risk 96
Results Disclosure 96
Conclusions 97
References 97
Chapter 6: Quality of Life Among Patients With Tongue Cancer: Primary Closure Versus Free Flap Reconstruction 100
Introduction 100
Anatomy 101
Quality of Life 102
Techniques 103
Functional Outcomes of Glossectomy, Reconstruction, and Quality of Life 103
Speech: Determinants of Functional Outcome 104
Speech: Assessment Methods 105
Swallowing: Determinants of Functional Outcome 108
Swallowing: Assessment Methods 109
Evidence for Primary Closure 110
Evidence for Free Flap Reconstruction 112
Functional Reconstruction 114
Conclusions 115
References 116
Chapter 7: Psychosocial Considerations for Cancer Patients in a Pediatric Intensive Care Unit at a Large, Freestanding Children’s Hospital 122
Introduction 122
Overview: Pediatric Cancer Patients 123
PICU Oncology Patients of a High-Volume Tertiary Care Facility 125
Psychosocial Issues 127
Communication 130
Environmental Stressors 131
Implications for Clinical Practice 132
References 133
Chapter 8: The Impact of Childhood Cancer on the Quality of Life Among Healthy Siblings 138
Introduction 138
Sample Demographics 139
Literature Review 139
Health-Related Quality of Life 139
Quality of Life Among Healthy Siblings 140
Theories of Sibling Relationships 140
Attachment Theory 141
Adler’s Theory of Individual Psychology 142
Health-Related Quality of Life 143
Emotional Functioning 143
Physical Functioning 145
Social Functioning 146
School Functioning 147
Summary of Literature Review 148
Therapeutic Interventions 148
Communication 149
Social Support and Ventilation of Feelings 149
Counseling 149
Hobbies 150
Keeping Consistent Routines 150
Implications for Healthcare Providers 151
Discussion 151
References 152
Chapter 9: The Effect of Physical Activity on Post-­Traumatic Stress Disorder Among Parents of Pediatric Cancer Survivors 156
Introduction 156
Post-Traumatic Stress Disorder (PTSD) 157
Theoretical Perspectives 158
Pediatric Oncology Patients 160
Parents of Pediatric Oncology Patients 161
Physical Activity as an Important Intervention 162
Physical Fitness in Canada 162
Physical Activity and PTSD 163
Discussion 163
Implications for Clinical Practice 164
References 165
Chapter 10: Theoretical Perspectives of Post-Traumatic Stress Disorder and Quality of Life Among Young Adult Survivors of Childhood Cancer 168
Introduction 168
Theoretical Perspectives 169
Gender and Trauma 172
Family Functioning and Perceived Social Support 173
Treatment Type and Intensity 174
Post-Traumatic Growth 175
Age at Diagnosis 176
Prevalence of Post-Traumatic Stress Symptoms 176
Implications for Subjective Quality of Life (SQOL) and Independence 177
Conclusions 178
References 179
Chapter 11: Family Functioning and Therapeutic Interventions When a Parent Has Cancer 182
Introduction 182
Beginning with Breast Cancer in a Mother to Understand Family System Response 183
The Children’s and Adolescents’ Experience with Cancer in a Parent 185
Parent with Cancer and Children and Adolescents’ Reactions 185
Relationship Between Family Functioning and Parents’ and Children’s Responses 186
Screening and Assessment 187
Likelihood that Patient with Cancer Has Children at Home 187
Interventions Designed to Assist the Ill Parent and Their Family Members 188
Information Resource 188
Psychosocial Educational Interventions 188
Strengthening Support Networks 189
Educational and School-Based Interventions 190
Summary and Discussion 191
Implications for Clinical Practice and Future Research 191
References 192
Chapter 12: When Cancer Returns: Survivors, Caregivers, and the Family System 196
Purpose 196
Introduction 196
Literature Review 197
Survivorship 197
Fear and Relapse 198
Social Support 198
Family Caregiving and Caregiver Needs 198
Family Systems 199
Application to Survivorship and Recurrence 200
Implications for Practice at the End of Life 200
Conclusions 202
References 202
Chapter 13: Experiencing Cancer Services: A Personal Story of Survival 206
The Initial Reaction 206
The Treatment Begins 207
The Cancer Clinic 208
The Feeding Tube 208
Conflicting Narratives 209
The Throat Surgeon 210
The Oncologist 210
Nurses and Other Health Professionals 211
Chemotherapy 212
A Surprising E-Mail 213
Recommendations for Clinical Practice, Patients, and Family Members 213
References 214
Index 215