[Nursing scientist counsels women about breast cancer risk: "For you it is like the end of a long journey with great fear" (interview by Katrin Balzer)].
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Biomedical subjects
Publications and source records attributed to Agnes Glaus.
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GOALS OF WORK: The aim of this study was to evaluate the occurrence of chemotherapy-induced nausea and vomiting (CINV) and its effect on patients' ability to carry out daily life activities following moderately to highly emetogenic, first-cycle chemotherapy in routine practice in cancer centers of four different European countries. PATIENTS AND METHODS: This was a prospective, cross-sectional, nonrandomized, self-assessment study in 249 patients enrolled from cancer centers in Spain, Austria, Germany, and Switzerland. The study population consisted of 78% women, with a mean age of 54. Breast, lung, and ovarian cancers made up 75% of all cancers in the study. Patients received a mean of 2.0 chemotherapy agents and 2.5 antiemetic drugs. MAIN RESULTS: A total of 450 emetic episodes experienced by 243 patients was recorded over 5 days following chemotherapy, with an average of 1.8 episodes per patient (range: 0-28). A higher percentage of patients (38%) suffered from delayed compared to acute emesis (13%). Between 42% and 52% of all patients suffered from nausea (visual analogue scale > or = 5 mm) on any one day, peaking at day 3. Using the Functional Living Index for Emesis (FLIE) questionnaire, 75% of patients with nausea and 50% with vomiting reported a negative impact of these conditions on performance of daily living. CONCLUSIONS: CINV remains a significant problem in routine practice, particularly in the delayed phase posttreatment. Overall, CINV had a negative impact on patients' daily life.
UNLABELLED: Swiss women show, together with women from the Netherlands, France, Belgium, Sweden, Finland, England and Germany, a very high incidence of breast cancer in Europe. Whilst the evidence for primary cancer prevention is slowly growing, its strategies can not yet be implemented in clinical prevention programmes. Therefore, secondary prevention, early detection of cancer, remains the main focus for reducing breast cancer mortality. This is especially true because of the proven relationship between mortality and size of the primary tumour as well as the status of the axilla. Despite these facts, in contrast to the French part of Switzerland, breast cancer screening has not yet been implemented in the German and Italian part of Switzerland. METHODS: It was the aim of this study to identify prevention measures used by women living in the German-, Italian- and French-speaking part of Switzerland and to explore their attitude towards breast cancer prevention measures. It was asked what these women knew about breast cancer prevention, what type of secondary prevention they used and who motivated them to do so. The investigation included 1721 women from three language regions of Switzerland. Data were collected with a postal survey questionnaire. Descriptive, uni- and multivariate methods were used for data analysis. RESULTS: The response rate was 34%. Statistically significant differences in breast self-examination were observed between the three regions (p = < 0.001) and defined age-groups (p = < or = 0.001). In all three regions of the country, 90% of women age 50-59 had mammograms, whereas in comparison to the other regions, fewer women from the German part of Switzerland, aged 60-69, had undergone mammography screening. Significant differences in mammography screening again were observed between language regions (p = < or = 0.001) and age-groups (p = < or = 0.001). Eighty-four percent of women were motivated by the gynaecologist to have a mammography, 11% by the family doctor and 10% of the women decided by themselves. More than half of this female Swiss study population wished to see a health policy providing mammography-screening in Switzerland and about one third wished to be more informed about the intervention. An increased need for information and education about prevention and early detection was observed in individuals who had a relative with cancer. CONCLUSIONS: The majority of women in this study wished to see a health policy in Switzerland which includes a mammography screening programme. Opportunistic mammography screening, lacking systematic quality control and data collection for epidemiological purposes, was widely used in the Italian and in the German speaking region. Data show that there is a need for public and professional information and education about prevention and early detection of breast cancer to prevent misconceptions regarding the effect of breast self-examination and mammography-screening. Womens' organisations and nurses may be in a good position to take up a leading role in breast cancer prevention.
Cancer-related fatigue is a symptom with great implications for the quality of life of those that experience it. It is regarded as one of the most distressing symptoms that people with cancer develop. Its aetiology is complex, and although the mechanisms underlying fatigue have not been fully clarified it is evident that it is exacerbated by treatments intended to cure or palliate the disease. Patients at risk of cancer-related fatigue need access to information that will enable them to manage it effectively. There are a growing number of materials available to patients in different European countries on this topic, but it is unclear how useful patients find these. This study was undertaken to explore this through conducting focus groups with patients in the United Kingdom and Switzerland. One focus group was conducted in each country. Findings from these determined that individuals voiced common concerns: fatigue had not been addressed in the clinical setting - individuals surmised why this occurred; participants had not accessed materials on cancer-related fatigue previously; they made recommendations for future resources for patients. However, what was evident was that unless patients can access materials on this topic, their quality becomes purely an academic issue.
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UNLABELLED: In the course of a cancer trajectory, many patients suffer from distressing fatigue. In past years, research has shown that care givers tend to underestimate or even to ignore this frequent phenomenon. Despite increasing knowledge, fatigue seems to remain an orphan topic in symptom management. AIM: A qualitative research strategy was used to explore the perception of cancer patients regarding the awareness of fatigue in professionals and the way they deal with it. Patients also evaluated the usefulness of some currently available information material about fatigue. METHODS: The expert-opinion of cancer patients in Switzerland and England was analysed. Convenient sampling guided the selection process of seven patients in each country. A tape-recorded focus-group interview served as method to collect and transcribe data. Data were analysed according to the framework analyses by Richie & Spencer. RESULTS: Results were very similar in both countries. Patients stated a great need for more information regarding fatigue. They feel that care givers are not sufficiently aware of it and that a specific support is not part of current standard practice. The information material was well received and generally judged as very good and helpful. CONCLUSIONS: Communication barriers in professionals as well as in patients continue to exist. Patients wish to be better informed by care givers. The available information material serves well to support this information as they provide words for the unmentioned phenomenon. Far more professional fatigue education is needed to raise care givers' awareness.
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