Dietary Intake Is Not Associated with Body Composition nor with Biochemical Tests but with Psychological Status of Cancer Patients Receiving Chemotherapy

Chemotherapy can negatively affect cancer patients’ eating patterns, psychological status, body composition, and quality of life. In this study, we aimed to investigate the correlations between dietary intake/care and the psychological status of cancer patients treated with chemotherapy. An observational study was conducted on 75 participants during their first cycle of chemotherapy treatment, and they were followed up for three cycles. Each participant completed a reliable validated questionnaire, psychological questionnaire, quality of life questionnaire, and three-day food records. Dietary intake was considered adequate if there was an adherence of participants to dietary recommendations offered by the dietitian and was confirmed by ESHA analysis software (version 10.6.3). Seventy-five percent of participants had inadequate nutrition intake. All anthropometric measurements decreased after 2 months of chemotherapy regardless of patients’ dietary intake. Approximately half of the participants reported depression and anxiety. There were significant differences between all nutrient intake levels when compared to the recommended dietary allowance except for fat, unsaturated fatty acids, and iron. Also, there were associations between nutritional intake and life quality and depression. In conclusion, poor dietary intake was associated with depression and insufficient macro- and micronutrient intake. Emotional and nutritional support from healthcare providers and family are highly necessary.The authors received a funding from the Deanship of Research—Jordan University of Science and Technology (459/2017)

Care Needs and Symptoms Burden of Breast Cancer Patients in Jordan:A Cross-Sectional Study

Breast cancer is the most common malignancy in Jordan. Rigorous needs assessment for breast cancer patients can prioritize both cancer care and palliative care to propose the appropriate services effectively. We conducted a cross-sectional study of breast cancer patients in a cancer center in Jordan. We assessed symptom burden, comorbidities, and performance using the Edmonton Symptom Assessment System (ESAS), the Charlson Comorbidity Index (CCI), and the Australia-modified Karnofsky performance scale (AKPS). Descriptive analysis and regression models to predict the highest symptom burden were used. A total of 233 participants were enrolled: curative vs. palliative intent groups (147 (63%) vs. 86 (37%) patients), respectively. Tiredness was the most reported symptom in 189 patients (81%), while nausea was the least in 61 patients (26.2%). A relationship between the AKPS score and total ESAS was seen (correlation coefficient of −0.487; p < 0.0001). The prevalence of anxiety (p = 0.014), lack of appetite (p = 0.002), poor well-being (p < 0.001), and sleep disorder (p = 0.035) was higher in the palliative care intent group than in the curative one. We identified unmet needs in breast cancer patients. Both groups showed a prevalence of distressing symptoms suggesting that even those with non-palliative intent have high needs and should receive integrated palliative care

Decision-Making Preferences among Advanced Cancer Patients in a Palliative Setting in Jordan

Understanding patients’ decision-making preferences is crucial for enhancing patients’ outcomes. The current study aims to identify Jordanian advanced cancer patients’ preferred decision-making and to explore the associated variables of the passive decision-making preference. We used a cross-sectional survey design. Patients with advanced cancer referred to the palliative care clinic at a tertiary cancer center were recruited. We measured patients’ decision-making preferences using the Control Preference Scale. Patients’ satisfaction with decision-making was assessed with the Satisfaction with Decision Scale. Cohen’s kappa statistic was used to assess the agreement between decision-control preferences and actual decision-making, and the bivariate analysis with 95% CI and the univariate and multivariate logistic regression were used to examine the association and predictors of the demographical and clinical characteristics of the participants and the participants’ decision-control preferences, respectively. A total of 200 patients completed the survey. The patients’ median age was 49.8 years, and 115 (57.5%) were female. Of them, 81 (40.5%) preferred passive decision control, and 70 (35%) and 49 (24.5%) preferred shared and active decision control, respectively. Less educated participants, females, and Muslim patients were found to have a statistically significant association with passive decision-control preferences. Univariate logistic regression analysis showed that, being a male (p = 0.003), highly educated (p = 0.018), and a Christian (p = 0.006) were statistically significant correlates of active decision-control preferences. Meanwhile, the multivariate logistic regression analysis showed that being a male or a Christian were the only statistically significant predictors of active participants’ decision-control preferences. Around 168 (84%) of participants were satisfied with the way decisions were made, 164 (82%) of patients were satisfied with the actual decisions made, and 143 (71.5%) were satisfied with the shared information. The agreement level between decision-making preferences and actual decision practices was significant (ⱪ coefficient = 0.69; 95% CI = 0.59 to 0.79). The study’s results demonstrate that a passive decision-control preference was prominent among patients with advanced cancer in Jordan. Further studies are needed to evaluate decision-control preference for additional variables, such as patients’ psychosocial and spiritual factors, communication, and information sharing preferences, throughout the cancer trajectory so as to inform policies and improve practice

Validation of the Arabic Version of the Edmonton Symptom Assessment System

Quality cancer care is a team effort. In addition, patients’ symptoms change over the course of treatment. As such, the Edmonton Symptom Assessment System (ESAS) is a simple tool designed to quickly monitor symptom change. Here, we present the results from a two-phase study aimed at validating the Arabic version of the ESAS (ESAS-A). Phase one involved the creation of two versions of the ESAS with both reverse and forward translations by bilingual, native Arabic speakers as well as evaluation by an expert panel. The reconciled version was then administered to 20 patients as a pilot from which to create the final version, which was then used with 244 patients. Phase two for the ESAS—involved an ESAS-based validation of 244 adults aged 18 years and older who were diagnosed with advanced cancer; then, further validation was completed in conjunction with two other symptom survey tools, the EORTC-Pal 15 and the HADS. The ESAS-A items possessed good internal consistency with an average Cronbach’s alpha of 0.84, ranging from 0.82 to 0.85. Moreover, the results of ESAS-A showed good agreement with those of EORTC QLQ- 15 PAL (r = 0.36 to 0.69) and HADS (r = 0.60 and 0.57) regarding anxiety and depression. We found the ESAS-A to be responsive to symptom change and a median time to completion of 3.73 min. The results of our study demonstrate that the ESAS-A is a reliable, valid, and feasible tool for the purposes of monitoring symptom change over the course of cancer treatment