Jae-Yung Kwon, PhD RN
University of Victoria
From the day they are diagnosed to after treatment ends, patients with cancer undergoing radiation therapy experience both highs and lows in respect to their mental health and well-being. Unfortunately, many clinical and evaluation studies regarding radiation therapy assume all cancer patients are essentially the same and experience the same ‘average’ health trajectory. That’s a problem because the results from these studies could inadvertently lead clinicians to prescribe a ‘one-size-fits-all’ treatment for these patients that ignores the unique circumstances affecting the individual and their health trajectory.
I gravitated towards this research topic based on what I was hearing from patients. While they said that the quality of care they were receiving was good, the kind of care they were receiving was one-dimensional. Time and again, I heard from patients that their care was completely centred on laboratory results or scan findings, while their mental and social needs were being ignored. The fact that these were being overlooked was undoubtedly frustrating for patients but also quite puzzling from a research perspective, since it is quite well established that poor mental health and well-being are common in such patients.
If researchers and clinicians don’t understand how to identify differences in symptom trajectories in diverse populations, they will not be able to deliver person-centred care that considers the uniqueness and complexity of individuals. Seeking to meet caregivers halfway, we wanted to find out if the lab results and scan findings revealed the need to listen to patient voices. If a closer look at “the numbers” revealed multiple trajectories, then the one-size-fits-all response simply wasn’t justified. Anticipating that the mental health trajectories of cancer patients would not be the same in diverse populations, we wanted to identify distinct subgroups and measure whether socio-demographic variables were associated with these trajectories.
As anticipated, in this study we found that patients had multiple mental health symptom trajectories instead of everyone fitting into an ‘average’ pathway. We also found that different symptom trajectories were not differentiated simply by clinical factors but also by socio-demographic differences (e.g., gender, neighborhood income, rurality, proportion of foreign-born). For example, one subgroup of patients whose initial symptoms were severe, but showed substantial improvement over time, had the lowest income and lived in highest proportion of foreign-born immigrants compared to other subgroups.
This finding may resonate with the ISOQOL community because it highlights how broader socio-demographic differences are linked to patient-reported symptoms associated with mental health and well-being in radiation treatment. Clinicians and health care leaders can use this information to deliver interventions targeted to priority populations (e.g., those disadvantaged by social inequities). Future researchers can also explore additional differences in mental health trajectories in different populations using additional socio-demographic factors (e.g., individual-level data and lifestyle behaviours). These could be helpful in further specifying person-centred treatment and symptom management strategies (e.g., early preventative interventions and patient education strategies).
Abstract will be presented in Oral Session 105 on Thursday, 20 October, 1:45 pm – 3:15 pm.
This newsletter editorial represents the views of the author and does not necessarily reflect the views of ISOQOL.
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