Factors influencing Non-Hodgkin Lymphoma survivors' quality of life

Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy. Survivors of NHL are living longer, and their adaption to the disease long-term is a needed research area. Therefore, this retrospective, cross-sectional analysis using a preexisting data set (1) explored demographic and disease characteristics associated with quality of life (QOL) for NHL survivors, (2) tested a conceptual model to determine if adaptation to NHL mediated the relationship between the demographic and disease characteristics of that QOL, and (3) determined whether age moderated demographic and disease characteristics and examined their relationships with QOL. The model framework was adapted from the cancer survivor adaptation model (Naus, Ishler, Parrott, & Kovacs, 2009). It was proposed and tested to determine statistically significant relationships among the three components of cancer survivorship: personal characteristics, adaptation, and outcomes. The NHL survivors were predominantly Caucasian, married/living with a partner, 62 years old on average, and 10 years past diagnosis on average. The second aim used a SEM model and provided adequate goodness-of-fit indices with direct effects from personal characteristics on QOL: current age, income, total comorbidity score, and years since diagnosis. The other three effects were partially mediated by either negative adaptation (comorbidity, years since diagnosis) or both negative adaptation and positive adaptation (current age). The remaining personal characteristics had no direct effects on QOL, but they had fully mediated effects through negative adaptation (bone marrow transplant), positive adaptation (gender), or both (education and current treatment status). A moderation model was used to determine how personal characteristics impacted QOL using age as a moderator for the third aim. The analyses included a comparison of younger (< 65 years of age) and older (≥ 65 years of age) participants and differences in interaction effects on them. Younger age was associated with a greater likelihood of being female, earning less than $30,000 annually, and poorer QOL outcomes. Income was most strongly correlated with age and was negatively associated with QOL for younger survivors. This study's results suggest that both positive and negative perceptions mediate relationships between demographic and disease characteristics and QOL for NHL survivors

Comorbidity, Physical Function, and Quality of Life in Older Adults with Acute Myeloid Leukemia

Purpose of review: To describe the pathology, impact of comorbidities, functional limitations, symptoms, and quality of life (QOL) related to treatment of acute myeloid leukemia (AML) in older adults. Recent findings: AML is a rare aggressive hematologic disease that occurs most often in older adults. The prognosis for older patients with AML is markedly worse due to genetic mutations and patient characteristics such as comorbidities and functional limitations. Patient characteristics may influence treatment decisions, as well as impact symptoms, functional ability, health-related outcomes and (QOL). Summary: As the population continues to age, the number of people diagnosed with AML is expected to increase. Better management of comorbidities is imperative to improving QOL and other treatment related outcomes. Prospective, longitudinal and multi-site studies are warranted to further understand the interaction between these characteristics on symptoms, outcomes and QOL

Self-Care Recommendations of Middle-Aged and Older Adults with Sickle Cell Disease

Self-care management is an important part of living with a chronic illness. Sickle cell disease (SCD) is a chronic disease with acute, painful exacerbations that often results in a shortened life expectancy. Some middle-aged and older adults with SCD lived with the disease prior to having a diagnosis and without modern advances. The purpose of this study is to share the self-care recommendations of middle-aged and older adults with SCD. Using descriptive qualitative methods, data were gathered through semistructured interviews from 11 individuals living with SCD, including 6 women and 5 men. Self-care recommendations themes included physiological, psychological, and provider-related. The self-care recommendations may be seen as an additional resource or “words of wisdom” for younger adults with SCD who can use the recommendations to better manage their own disease. Additionally, providers may be able to use these recommendations to inform their practice

The Evolution of Gero-Oncology Nursing

This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer

Exercise Promotion in Geriatric Oncology

Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals

A systematic review of patient reported outcomes in phase II or III clinical trials of myelodysplastic syndromes and acute myeloid leukemia

The purpose of this systematic literature review was to identify clinical trials of MDS and AML that included patient-reported outcome (PRO) instruments, and to summarize the symptom and other health related quality of life (HRQOL) concepts most frequently assessed and the PRO instruments that were used. Sixteen manuscripts describing 14 distinct trials met all criteria (i.e., phase 2 or 3 clinical trial for MDS or AML which included PRO assessment) and were published between 1996-2017. In trials evaluating anemia, PRO scores showed significant improvement in relevant domains (e.g. fatigue, function) among patients identified as responders. In trials evaluating the impact of anti-cancer therapies, improvements the baseline to end of treatment were observed in physical functioning and HRQOL, however the rates of missing data in many of the trials was high or unreported. PRO instruments have the ability to capture changes over time in patients’ function and well-being, and PRO instruments and guidance documents are available to support the assessment of HRQOL in AML/MDS clinical trials

Quality of life domains among non-Hodgkin lymphoma survivors: an integrative literature review

Survival rates of individuals with non-Hodgkin lymphoma (NHL) have increased in the past several years, as has the prevalence of older adults who are managing late and long-term effects of the disease and its treatment. In this integrative review, the state of the science for determining the quality of life (QOL) among NHL survivors is outlined. An online search of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and the Cochrane Library databases was conducted using the following Keywords: non-Hodgkin lymphoma, health-related quality of life, quality of life, and impact of cancer. Eighteen studies published between 2000 and 2010 are reviewed. Of these, 17 were descriptive, cross-sectional designs, and one was a systematic review. The studies included participants of varying ages and years post-diagnosis as reported in several countries. Importantly, many used one or more QOL measures as outcome variables. Future research is needed on older and minority cancer populations and should include longitudinal and interventional studies

A Systematic Review of Psychometric Properties of Health-Related Quality-of-Life and Symptom Instruments in Adult Acute Leukemia Survivors

Acute leukemia represents 4% of cancer cases in the United States (US) annually. There are over 302,000 people living with acute and chronic leukemia in the US. Treatment has been shown to have both positive and negative effects on health-related quality of life (HRQOL)

Cancer-Related Fatigue: Scientific Progress Has Been Made in 40 Years

Cancer-related fatigue (CRF) is a distressing, persistent symptom that is experienced by survivors during and after treatment. Unsurprisingly, many early CRF studies were conducted by nurses. These studies included a look at patients receiving localized radiation treatment (Haylock & Hart, 1979); an exploration of fatigue as a conceptual approach to a clinical problem (Aistars, 1987); the development of a nursing theory focused on fatigue mechanisms (Piper, Lindsey, & Dodd, 1987); an examination of fatigue mechanisms (St Pierre, Kasper, & Lindsey, 1992), as well as of fatigue in advanced cancer (Bruera & MacDonald, 1988) and in non-small cell lung cancer (Sarna, 1993); and a description of fatigue and potential nursing interventions (Nail & King, 1987). Winningham et al. (1994) wrote a state-of-the-science article about fatigue in the cancer experience for the Oncology Nursing Forum, and Mock et al. (1997) was one of the first to conduct an exercise study regarding the effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Nurse scholars from the 1970s-2000s were pivotal in advancing the science of fatigue in various cancers and have provided a scientific foundation for those four decades.

Comparison of Methods for Determining Aerobic Exercise Intensity Using Heart Rate in Acute Leukemia Patients Prior to Induction Chemotherapy

Cardiopulmonary exercise testing (CPET), the gold standard of cardiopulmonary evaluation, is used to determine VO2 levels at different aerobic exercise training intensities; however, it may not be feasible to conduct CPET in all clinical settings