Biomedical subjects

A Molassiotis

Publications and source records attributed to A Molassiotis.

At least 19 recordsLinked to original sources

PubMed2006

Complementary and alternative medicine use in patients with head and neck cancers in Europe.

The aim of the present study was to examine the patterns of complementary and alternative medicine (CAM) use in a sample of head and neck cancer patients, forming part of a larger study. A cross-sectional survey design was used collecting data through a descriptive 27-item questionnaire in nine countries in Europe. The participants were 75 patients with head and neck cancers. The prevalence rate of CAM use was 22.7%. The most common therapies used were herbal medicine (47%), medicinal teas (23.5%), use of vitamins/minerals (11.8%) and visualization (11.8%). Use of CAM dramatically increased after the diagnosis with cancer (i.e. eightfold increase in the use of herbs). A profile of CAM users was not evident in this sample. Patients used CAM for a variety of reasons together, with counteracting the ill effects from cancer and its treatment being the most common one. Information about CAM was obtained mostly from friends and family. As one in five head and neck cancer patients use CAM it is important that clinicians explore practices with their patients, improve communication about CAM with them and assist those who want to use CAM in using appropriate and safe therapies.

Complementary Therapies↗

PubMed2005

Use of complementary and alternative medicine in cancer patients: a European survey.

BACKGROUND: The aim of this study was to explore the use of complementary and alternative medicine (CAM) in cancer patients across a number of European countries. METHODS: A descriptive survey design was developed. Fourteen countries participated in the study and data was collected through a descriptive questionnaire from 956 patients. RESULTS: Data suggest that CAM is popular among cancer patients with 35.9% using some form of CAM (range among countries 14.8% to 73.1%). A heterogeneous group of 58 therapies were identified as being used. Herbal medicines and remedies were the most commonly used CAM therapies, together with homeopathy, vitamins/minerals, medicinal teas, spiritual therapies and relaxation techniques. Herbal medicine use tripled from use before diagnosis to use since diagnosis with cancer. Multivariate analysis suggested that the profile of the CAM user was that of younger people, female and with higher educational level. The source of information was mainly from friends/family and the media, while physicians and nurses played a small part in providing CAM-related information. The majority used CAM to increase the body's ability to fight cancer or improve physical and emotional well-being, and many seemed to have benefited from using CAM (even though the benefits were not necessarily related to the initial reason for using CAM). Some 4.4% of patients, however, reported side-effects, mostly transient. CONCLUSIONS: It is imperative that health professionals explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.

Adolescent↗

PubMed2005

Use of complementary and alternative medicine in patients with cancer: a UK survey.

Over the past decade Complementary and Alternative Medicine (CAM) use in the UK has increased dramatically. However, little research appears to exist regarding its use in patients diagnosed with cancer. The study was descriptive using a survey design. Questionnaire data was collected from 127 adult patients with a diagnosis of cancer from both Scotland and England. CAM use was reported by 29% of the sample. The use of relaxation, meditation and the use of medicinal teas were the most frequently used therapies. Findings suggest that CAM use within patients diagnosed with cancer in the UK has increased which has implications for patient and health care professional education.

Adult↗

PubMed2004

Fatigue patterns in Chinese patients receiving radiotherapy.

Fatigue has been reported as the most frequently occurring symptom in cancer patients receiving chemoradiotherapy. The purpose of the current descriptive study was to explore the pattern, associated factors, and experience of fatigue in Chinese cancer patients receiving radiotherapy. Twenty-seven subjects from an out patient clinic of a university hospital in Hong Kong participated in the study. They were asked to complete three times daily (morning, afternoon and evening) a diary over a period of two weeks from the beginning of their therapy. The diary incorporated a 10-cm horizontal visual analogue scale (VAS) for measuring fatigue intensity. Further, the Chinese version of the fatigue subscale of the Profile of Mood States was completed before the radiotherapy, at the end of the first week post-treatment, and at the end of the second week. Most patients (44-80.8%) undergoing radiotherapy in this study experienced fatigue at some point during their treatment. The pattern of fatigue was that of repeated curves, with higher levels observed in the afternoons and evenings, and at the end of the first week or the end of the second week. Qualitative data indicated the universal sensations of fatigue and also some culturally specific descriptors. A variety of methods were used by the patients to cope with their fatigue but the effects of such methods were not always positive. It is important for clinical practice to assess the individual patterns and perceptions of fatigue, identify those patients at risk for developing fatigue and initiate interventions to combat fatigue.

Activities of Daily Living↗

PubMed2004

Perceptions of older people with cancer of information, decision making and treatment: a systematic review of selected literature.

BACKGROUND: Several studies have identified inadequacies in the care and treatment received by older patients with cancer, as opposed to their younger counterparts. These include over or under diagnosis, ineffective symptom management and lower survival rates in older people with cancer. Despite these inadequacies, there is a lack of evidence of older peoples' perspectives regarding their cancer diagnosis and treatment. MATERIALS AND METHODS: Studies for review were identified from systematic searches of literature published between January 1990 and November 2003, using PubMed, CINAHL and PsycINFO. Studies were selected for inclusion by using a number of criteria (i.e. date and language of publication, age of participants and thematic area). The aims of the review were to summarize and evaluate previous evidence on the views of older patients with cancer, regarding information, decision making and treatment. RESULTS: Eighteen studies of various methodologies met the criteria of the present review. In summary, older people with cancer are generally content with the information they receive, but not entirely satisfied with the quantity and quality of care and contact. They present with various needs, which are not always well met. Finally, they wish to be kept informed of their cancer diagnosis and treatment progress, but often do not wish to be told about progression of their illness and length of survival. CONCLUSIONS: Previous research has suffered a number of limitations regarding sampling procedures and methods of data collection. Other limitations included lack of consideration of the heterogeneity of older people with cancer and lack of a well-defined theoretical framework to guide design and data analysis. These may compromise not only rigour and the ability to generalize findings, but also the provision of patient-focused care. The difficulties of doing research in this area are also discussed and suggestions for future research are made.

Aged↗

PubMed2003

A pilot study of the effects of a behavioural intervention on treatment adherence in HIV-infected patients.

A pilot study was carried out in a group of six HIV-infected non-adherent men testing the effects of a behavioural medication management intervention on adherence with antiretroviral drugs. The study was prospective, using a one-group repeated-measures design. Adherence was measured using two self-reports. The intervention was a behaviourally-based programme that lasted for three months and included individualized education about antiretroviral medication and their side effects; positive reinforcement and encouragement; individualized counselling weekly; follow-up calls; and lifestyle assessment and the identification of adherence barriers. Assessments were carried out at recruitment, immediately after the initiation of the intervention, one month, three months and six months later. Results suggested that the intervention enhanced adherence rates from a mean percentage of 80.27 at baseline to a mean of 97.5% at the end of follow-up (six months time point). Similar improvement was observed in the scores of the scale measuring adherence difficulties. Further, CD4+ counts also slightly improved. Interviews with four of the participants at the end of the study highlighted the problems experienced by patients in taking their medication and supported the usefulness of the intervention. Because of the complexity of the factors behind adherence, it is important that patients are supported with individualized medication management programmes.

Adult↗

PubMed2003

Needs assessment and social environment of people living with HIV/AIDS in Hong Kong.

The present study examined the needs and perceived social environment among people living with HIV/AIDS (PLWHA) in Hong Kong (N=289). Sizeable demands were expressed for medical treatment, provision of HIV-related information, financial assistance and psychological counselling. Physical health (about 38%) and social discrimination (about 24%) were the two commonly named 'most difficult aspects' of their life. In addition, over 50% felt that they were discriminated in different settings such as in the workplace and in social relationships. Social support was also often lacking among many PLWHA in Hong Kong. Nearly 80% were worried/very worried about others knowing their HIV-positive status and 16% of them did not disclose the matter to any person.

Acquired Immunodeficiency Syndrome↗

PubMed2002

An analysis of the antiemetic protection of metoclopramide plus dexamethasone in Chinese patients receiving moderately high emetogenic chemotherapy.

This descriptive study aimed to evaluate the antiemetic protection of metoclopramide plus dexamethasone in a sample of 33 Chinese breast cancer patients who were receiving doxorubicin and cyclophosphamide. The antiemetic protection effect was not satisfactory. The results showed that the worst nausea and vomiting was experienced on the third day, with 87.9% of patients reporting nausea and 63.6% experiencing vomiting on that day. In almost one-third of the sample antiemetic medication failed to protect against either acute vomiting or delayed vomiting (i.e. patients continued to experience more than five emetic episodes). Complete protection from acute vomiting was seen in 36.4% of patients, whereas complete protection from delayed vomiting was seen in only one-third of the patients. There was an association between acute nausea/vomiting and delayed nausea/vomiting. Different types of antiemetics need to be offered to Chinese patients receiving chemotherapy (i.e. 5-HT3 receptor antagonists or a combination of antiemetics), but more research should be directed to this area.

Adult↗

PubMed2002

An oral care protocol intervention to prevent chemotherapy-induced oral mucositis in paediatric cancer patients: a pilot study.

The likelihood of paediatric cancer patients experiencing oral mucositis has increased significantly as high-dose and multiple chemotherapy agents are used in the treatment of childhood cancer in recent years. The resulting oral ulcerative lesions can cause significant pain, dysphagia, alteration in nutritional status and increased risk for localized infections that could disseminate systemically. The purpose of this pilot study was to determine the clinical benefits of an oral care protocol intervention on the prevention and reduction of the severity of oral mucositis in paediatric patients receiving chemotherapy. Fourteen children were enrolled in the study; there were seven children in the control and seven in the experimental group. In the experimental group, children received a preventive oral care protocol consisting of tooth brushing, normal saline rinse and 0.2% chlorhexidine mouth rinse. Children in the control group received usual care according to the study's clinical setting. Data were collected at baseline, then twice a week for 3 weeks. The incidence of ulcerative lesions, severity of oral mucositis and the related pain intensity were used as the main outcome variables. The experimental group exhibited fewer and less painful oral mucositis lesions. The results of this study support the preventive use of oral care protocols in paediatric patients undergoing chemotherapy for cancer treatment.

Journal Article↗

PubMed2002

A pilot study of the effects of cognitive-behavioral group therapy and peer support/counseling in decreasing psychologic distress and improving quality of life in Chinese patients with symptomatic HIV disease.

Forty-six Chinese patients with symptomatic human immunodeficiency virus (HIV) participated in a comparative study assessing the effectiveness of cognitive-behavioral group therapy (CBT) and peer support/counseling group therapy (PSC) in relation to improving mood and quality of life and decreasing uncertainty in illness as compared to a group receiving routine treatment with no formal psychosocial intervention. The CBT group consisted of 10 subjects, the PSC group of 10 subjects, and the comparison group of 26 subjects. There was a 24% attrition rate. The intervention groups received 12 weekly sessions of therapy over 3 months. Assessment of mood states was carried out before randomization (baseline data), immediately postintervention (3-month time point) and followed-up 3 months later (6-month time point). Assessment of quality of life and uncertainty in illness was carried out before randomization and at the 6-month follow-up time point. Results indicated that the mood of the participants in the CBT group improved in terms of anger, tension-anxiety, depression, confusion, and overall mood. The quality of life in this group was significantly improved compared to the other two groups, as was uncertainty in illness. In the PSC group a worsening of psychologic functioning was observed immediately postintervention, but this picture dramatically improved at the follow-up assessment with improvements of up to 34%. Quality of life also improved over time in this group by almost 5%, but results did not reach statistical significance. This study demonstrated that psychologic interventions could decrease psychologic distress and improve quality of life in symptomatic HIV patients, indicating their use should be incorporated in the management of care of people living with HIV/AIDS.

Adult↗

PubMed2001

Pretreatment factors predicting the development of postchemotherapy nausea and vomiting in Chinese breast cancer patients.

A prospective longitudinal study was designed to assess the role of pretreatment proneness to nausea and vomiting (NV) in the development of postchemotherapy NV in a group of Chinese breast cancer patients receiving moderately highly emetogenic chemotherapy. Seventy-one chemotherapy-naive subjects participated in the study. Patients were assessed the day before chemotherapy with measurements of their anxiety level, depression, fatigue and proneness to NV, motion sickness, NV experienced in past pregnancies, history of labyrinthitis, expectation of developing NV and expectation of developing pain. Patients also completed daily assessments of frequency, duration and intensity of NV for the 7 days after chemotherapy. Regression analyses revealed that nonpharmacological factors explained part of the variance of NV, the most common predictors being a history of labyrinthitis, expectation of developing NV after chemotherapy, younger age, stage of disease, and state anxiety. The explanatory power of the models ranged from 6% to 23% of the variance of the independent variable. There were different explanatory models for acute and delayed NV. Results indicate that consideration of the role of nonpharmacological factors in the development of NV could lead to more effective management of NV induced by chemotherapy.

Acute Disease↗

PubMed2001

The impact of fatigue on Chinese cancer patients in Hong Kong.

Fatigue is probably the most common symptom affecting sufferers of cancer and cancer treatments. The aim of this study was to gain an initial understanding of the impact of fatigue on Chinese cancer patients in Hong Kong. Twenty-two chemotherapy patients and 15 radiotherapy patients completed semi-structured interviews by the end of the 2nd week after commencement of their treatment. Chemotherapy patients reported greater severity of fatigue than did radiotherapy patients. Six themes emerged from the study's qualitative data that illustrated the impact of fatigue on patients' lives. These themes were: work and role functioning, daily routines, social life, mental ability, emotional status, and appetite and oral intake. The findings are discussed within the Chinese cultural context, and the need for regular assessment of fatigue in cancer patients is suggested.

Adult↗

PubMed2001

Evaluation of an oral care protocol intervention in the prevention of chemotherapy-induced oral mucositis in paediatric cancer patients.

Oral mucositis is the most frequent and severe complication of chemotherapy in children with cancer that can aggravate the child's clinical condition and increase the risk of infection. This prospective comparative study was designed to determine the effectiveness of a preventive oral care protocol in reducing chemotherapy-induced oral mucositis in children with cancer. During an 8-month period, 42 children aged 6 to 17 years with haematological malignancies or solid tumours were evaluated. The 21 children who were included in the first 4-month period of the study constituted the control group. Another 21 children were enrolled in the subsequent 4 months and were assigned to the experimental group, in which they were given an oral care protocol intervention. The oral care protocol consisted of tooth brushing, 0.2% chlorhexidine mouth rinse and 0.9% saline rinse. Children in both groups were evaluated twice a week for 3 weeks. The incidence of ulcerative lesions, severity of oral mucositis and the related pain intensity were used as the main outcome variables. A 38% reduction in the incidence of ulcerative mucositis was found in children using the oral care protocol compared with children in the control group. The severity of oral mucositis (P=0.000002) and the related pain (P=0.0001) were significantly reduced with the intervention. These results support the preventive use of the oral care protocol in paediatric cancer patients who undergo chemotherapy for cancer treatment.

Adolescent↗

PubMed2001

A pilot study on the effect of progressive muscle relaxation training of patients after stoma surgery.

Eighteen patients who had undergone stoma surgery were assessed with respect to their anxiety level and self-reported quality of life (QoL) on three occasions; namely, immediately after surgery, 5 weeks after surgery, and 10 weeks after surgery. The patients were randomised into a control group (n = 10) and an experimental group (n = 8). A 20-min set of audiotaped instructions on progressive muscle relaxation training (PMRT) was given to the patients in the experimental group for home practice. Assessment instructions included the Chinese State-Trait Anxiety Inventory (C-STAI), the Quality of Life Index for Colostomy (QoL-Colostomy) and the Hong Kong Chinese version of the World Health Organisation Quality of Life Scale (WHOQoL). Results indicated that there was a significant decrease in both the C-STAI score (F = 4.66, P < 0.05) and the WHOQoL score (F = 4.74, P < 0.05) in the experimental group. Among the domains of WHOQoL, a significant difference was shown in physical health/independence and general perception of QoL, with the experimental group demonstrating better functioning. For the QoL-Colostomy, however, there was no significant difference between the control and experimental groups. The results suggest that the use of PMRT could enhance quality of life and decrease state anxiety in patients after stoma surgery.

Aged↗

PubMed2001

An exploration of the relationships between uncertainty, psychological distress and type of coping strategy among Chinese men after cardiac catheterization.

The experience of cardiac catheterization (CC) has included feelings of uncertainty, stress, fear and anxiety in many patients. However, conflicting findings from previous research have been reported. Chinese patients who undergo CC may experience psychological distress in a different way to other cultures as a result of traditional beliefs. Moreover, little research examining the impact of CC among Hong Kong Chinese has been carried out. Therefore, the aim of the study was to explore relationships between uncertainty, psychological distress and coping strategy in Chinese men after CC, using Mishel's model of uncertainty in illness as a framework. A convenience sample of 27 men hospitalized for cardiac catheterization participated in this study using a descriptive, correlational research design. Ethical approval was obtained from the Ethics Committee of the Medical Faculty at the Chinese University of Hong Kong and from the Executive Committee of the hospital. Participation was on a voluntary basis with patient confidentiality assured. Self-report questionnaires included Chinese versions of Mishel's Uncertainty in Illness Scale (MUIS), the Profile of Mood States (POMS), the State-Trait Anxiety Inventory (STAI) and the Chinese Coping Scale (CCS) for data collection. Data were analysed using the Statistical Package for Social Sciences. High mean scores for uncertainty (mean=101.4, SD=11.49) and variables measuring psychological distress (mood disturbance mean=36.6, SD=33.6, state-anxiety mean=39.1, SD=8.95, trait-anxiety mean=43.7, SD=8.1) among these participants suggest that Hong Kong Chinese men experience uncertainty and psychological distress when undergoing cardiac catheterization. Strong relationships between uncertainty and mood disturbance (r=0.57, P=0.01), trait-anxiety and mood disturbance (r=0.65, P=0.01) and state-anxiety and external coping strategies (r=0.50, P=0.05) were found. These findings suggest that relationships between uncertainty, psychological distress and external coping strategies exist in Chinese men hospitalized for cardiac catheterization. Moreover, these findings may help nurses' design culturally specific interventions for their patients.

Adaptation, Psychological↗

PubMed2001

Fatigue patterns in Chinese patients receiving chemotherapy.

A descriptive study was conducted to explore the patterns, risk factors and experience of fatigue in Chinese cancer patients receiving chemotherapy. Forty-two adult patients from an out-patient clinic of a university hospital in Hong Kong participated in the study. They were asked to complete a diary over a period of 2 weeks from the beginning of their chemotherapy cycle. The diary incorporated a 10cm horizontal visual analogue scale (VAS) for measuring fatigue intensity and a marked space next to the VAS for recording body temperature. Further, the Chinese version of the fatigue subscale of the Profile of Mood States was completed before the chemotherapy session, at the end of the first week post-treatment and at the end of the second week. Sociodemographic, physiological and disease/treatment-related information was obtained from the medical records. A semi-structured, open-ended interview was conducted with 18 of these patients. Most Chinese cancer patients (73.8%-90.5%) receiving chemotherapy in this study experienced fatigue. The peak level of fatigue was reported at day 3 post-treatment and it was more evident in the evenings. Female patients, patients with stage I cancer and those with nasopharyngeal carcinoma reported higher levels of fatigue (P<0.05). No relationship was found between body weight and fatigue, and some association existed between febrile illness and fatigue (P<0.001). Qualitative data affirmed the pattern of fatigue intensity and various descriptions about the experience and coping techniques of fatigue were found. Individualized and repeated assessment of patients with fatigue, as well as correcting the treatable factors that contribute to fatigue are suggested.

Journal Article↗

PubMed2001

Assessment of needs of adult symptomatic HIV patients in Hong Kong.

A cross-sectional survey was designed to assess the physical, psychosocial, health behaviour and informational needs of symptomatic HIV patients in Hong Kong, using both quantitative and qualitative data collection methods. Forty-six consenting adults from an outpatient clinic of a hospital in Hong Kong participated in the study. Results showed that up to 67.3% of the sample had partially or completely unmet needs in one or more areas of functioning. Major needs were related to income, social networking, family processes, money management and financial assistance. Only half the sample was satisfied with the information received related to their HIV infection and its management. Unsafe sexual practices were common, as well as smoking. Meeting these needs through policy making or practice could contribute to the enhancement of the quality of care and support provided to people living with HIV/AIDS in Hong Kong.

Adult↗

PubMed2001

Correlates of quality of life in symptomatic HIV patients living in Hong Kong.

This cross-sectional study assessed quality of life (QOL), coping styles, mood and uncertainty in illness in a non-random sample of 46 (out of 91 eligible) symptomatic HIV patients living in Hong Kong. QOL was moderate and the main concerns were related to the environmental aspects of QOL, spirituality and social relationships. Considerable mood disturbance was demonstrated in the sample, especially with regards to depression, fatigue and tension/anxiety. High levels of uncertainty in illness were also reported. A median split of the uncertainty score demonstrated that high uncertainty was related to lower levels of overall QOL (p = 0.04), higher psychological dysfunction (p = 0.05), worse adjustment with the environment (p < 0.001) and higher mood disturbance (p = 0.008). The sample predominantly used internal coping, which also correlated well with higher QOL scores. Through regression analysis it was shown that QOL could be predicted with the combined effects of uncertainty in illness and fatigue (adjusted R2 = 0.51, p < 0.001). Findings indicate that efforts should be directed towards improving QOL issues in the Chinese HIV patients and interventions could be introduced to alleviate those factors that were found to affect QOL. It is suggested that such interventions may include group or individual psychological therapies, management of fatigue and teaching patients more effective coping techniques.

Adaptation, Psychological↗