july 2023 WOUND AND OSTOMY JOURNAL
Clinical and Demographic Differences Among Cancer Survivors With
Ostomies With and Without Informal Caregivers
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1. Describe the method used by the author of the study
ReplyDeleteThe method used by the author of the study is a sub-analysis from the Ostomy Telehealth for Cancer Survivors study. The original study is a 3-year, multi-site, randomized controlled trial for cancer survivors with ostomies and their caregivers. Subgroup analyses involve splitting all the participant data into subgroups, often to make comparisons between them. Subgroup analyses may be done for subsets of participants or subsets of studies.
1. Discuss the sample size used in the study.
Participants were recruited from the University of Pennsylvania, Yale University, and City of Hope. Eligible participants are 21 years of age or older and at least six weeks post-ostomy surgery. The total numbers of eligible participants were 216.
1. Discuss the sample size used in the study:
ReplyDelete216 participants from 3 different hospitals were used for this study. In my opinion, this is a very small sample of people compared to the cited 750,000 - 1 million persons who live with ostomies in the US. While this is a very specific study looking at cancer survivors with ostomies, I believe that a larger sample would glean more information representative of all cancer survivors with ostomies in the US.
2. Describe the method used by the author of the study:
This study was based on a randomized controlled trial of persons who were cancer survivors with temporary or permanent ostomies. In terms of method choice, I believe a RCT is the best option for obtaining the information the authors were looking for.
1. Discuss the sample size used in the study
ReplyDeleteThe sample size used in this study included 216 cancer survivors with ostomies. Participants in this study were recruited from the University of Pennsylvania, Yale University, and City of Hope. Specific criteria to participate in this study included being 21 years of age or older and be at least 6 weeks post-ostomy surgery with either a fecal or urinary diversion. The participants caregiver could be either a family or friend but must be unpaid and also 21 years of age or older at the time of the study.
2. How does this research article compare to our practice, policy and/or procedure?
This research article compares to our practice at St. Joseph’s because we always encourage new post-operative ostomy patients to have a family member or friend attend ostomy teaching/ education. Having a family member or friend attend post-operative ostomy teaching helps a new ostomate adapt and cope with lifestyle changes that will occur when discharged home. For example, this study found that participants “with caregivers reported better management of leaking and diarrhea, suggesting that perhaps caregivers were attenuating the challenge of managing these aspects of ostomy self-care.”
1. Describe the sample size used in the study?
ReplyDeleteThe sample size is from the Ostomy TeleHealth for cancer survivors study which is a 3 year, multi-size, randomized controlled trial for cancer survivors with ostomies and their caregivers. Participants were recruited from University of Pennsylvania, Yale University and City of Hope. To be eligible for the study, participants must be 21 years old or older and at least 6 weeks post-ostomy surgery. The study sample was split into those who reported having an informal caregiver and those who did not.
2. Discuss the limitations of the article; limited sample, size, design
flaws and author bias?
The article reported study limitations on sample size because recruitment was not optimized and may not have enough power to detect differences between the caregiver and no caregiver groups. Also, paid caregivers and home health aides were not considered on this analysis and therefore their support was not accounted for.
1. Discuss the sample size used in the study.
ReplyDeleteThe study included participants recruited from multiple sites: the University of Pennsylvania, Yale University, and City of Hope. The sample size consisted of cancer survivors with ostomies and their caregivers, with eligibility criteria based on age, time post-ostomy surgery, and caregiver status. The specific number of participants in the sample isn't mentioned in the provided text. The use of a multi-site approach can enhance the generalization of the findings by capturing a diverse range of experiences and perspectives among cancer survivors with ostomies and their caregivers.
2. Was the correct method used? Why or why not?
The method employed, utilizing a sub-analysis from the larger Ostomy Telehealth for Cancer Survivors study, is appropriate for investigating the specific aspects of ostomy self-management, activation, self-efficacy, and quality of life outcomes. The original randomized controlled trial design allowed for the comparison of the OSMT program intervention with usual care, offering a structured approach to assess the effectiveness of the telehealth-enabled group intervention. I do think the correct method was used because the multi-site recruitment strategy further enhances the study's external validity, capturing a broader range of experiences among cancer survivors with ostomies and their potential caregivers.
Describe the method used by the author of the study
ReplyDeleteThe method used to gather data on the research study “Clinical and Demographic Differences Among Cancer Survivors with Ostomies with and without Informal Caregivers” was taken from a sub-analysis from the Ostomy Telehealth for Cancer Survivors study. The data collected and analyzed for the study were taken from the participant’s baseline information which included demographics and medical issues. Also included were the baseline surveys: City of Hope Quality of Life – Ostomy (COH-QOL O), Patient Activation Measure (PAM), Self Efficacy (SE), Hospital and the Anxiety Depression Scale (HADS). The sub-analysis split the study sample into those who reported having a caregiver and those who did not.
Discuss the sample size used in the study
The sample size consisted of 216 cancer survivors who were a subset of Ostomy Telehealth for Cancer Survivors study. The criteria for enrollment included informed consent, cancer survivors with permanent or temporary ostomy and their caregivers, 21 years of age and older to participate, and at least post 6 weeks post ostomy surgery (fecal or urinary), no maximum time since surgery, and the caregivers were defined as family or friend chosen by the cancer survivor that were not going to receive pay and must have been over age 21 years at time of enrollment. Participants in the sub-analysis were recruited from the University of Pennsylvania, Yale University, and City of Hope.
I think a sample size of 216 people was not sufficient to make significant conclusions about informal caregivers who provide care and support to those with ostomies. A study with a significantly much larger sample size should have been considered in order to validate conclusions. There was no breakdown of those who participants who had temporary ostomies vs. permanent ostomies, which I think would make a difference in the survey responses; based on whether a person would have to face this new way of life for a short term vs. indefinitely. Also no breakdown as to which participants received the OSMT intervention on ostomy self-management vs. those who only received the usual care. Those who received the 5 session group intervention would have greatly benefited from this learning compared to the usual care (which was not defined). In a group setting it allows many people to share their concerns, unexpected fears and coping mechanisms which may help or benefit others in the group, whereas when learning alone some important aspects may not be addressed or overlooked.
Overall we know that the higher educated and the higher income individuals with ostomies will probably have a caregiver and get help when needed but it is the low income and lower educated individuals with or without caregivers who should receive and have easy guidance to resources, learning opportunities to ostomy self care and most importantly follow-up once they are discharged from the hospital to address any needs that were not met and steps to remedy the situation.
Response by Eileen Laureano, RN
1. Discuss the sample size used in the study
ReplyDeleteThe research involved individuals who were enlisted from various locations: the University of Pennsylvania, Yale University, and City of Hope. The group size comprised of individuals who had survived cancer and undergone ostomy procedures, along with their caregivers. The criteria for inclusion were centered around factors such as age, time since the ostomy surgery, and the role of being a caregiver. The precise quantity of participants within the sample is not indicated in the supplied text. Employing a multi-facility strategy can augment the applicability of the results by encompassing a wide spectrum of encounters and viewpoints among cancer survivors with ostomies and their caregivers.
2. Was the correct method used? Why or why not?
The approach adopted, which involves a sub-analysis derived from the broader Ostomy Telehealth for Cancer Survivors study, is well-suited for examining particular facets of managing ostomies, levels of engagement, self-confidence in one's abilities, and the outcomes regarding quality of life. The original design of a randomized controlled trial enabled a comparison between the OSMT program intervention and standard care, providing a systematic framework to gauge the efficacy of the group intervention facilitated by telehealth. In my view, the chosen methodology is appropriate due to the utilization of a multi-site recruitment strategy, which further amplifies the study's external validity by encompassing a wider array of experiences among cancer survivors with ostomies and their prospective caregivers.
Sample size:
ReplyDeleteTwo hundred and sixteen cancer survivors recruited from the University of Pennsylvania, Yale University and City of Hope were included in this study. To be eligible to participate, participants must have been 21 years of age or older and at least 6 weeks post ostomy surgery. Those with temporary ostomies were also eligible and there was no maximum time since surgery. An informal caregiver was not required in order to participate however for a caregiver to be included in this study they were also required to be 21 years of age at the time of the study. As noted in the limitations sections of the article, recruitment was not optimized for this sub-analysis and “there may not have been enough power to detect difference between the caregiver and no caregiver group” indicating that a larger sample size may have been beneficial to provide a clearer outcome to this study.
Method:
The method utilized in the study was a sub-analysis from the Ostomy Telehealth for Cancer Survivors study, which was a 3-year, multi-site randomized controlled trial for cancer survivors with ostomies and their caregivers. These participants were randomized to receive the OSMT program or usual care. OSMT is a telehealth-enabled five session group intervention that coaches participants on ostomy self-management to improve activation, self-efficacy, and quality of life outcomes.
1. Discuss the sample size used in the study.
ReplyDeleteThe sample size used in this study included 216 cancer survivors with ostomies. Participants in this study were recruited from the University of Pennsylvania, Yale University, and City of Hope. he sample size consisted of cancer survivors with ostomies and their caregivers, with eligibility criteria based on age, time post-ostomy surgery, and caregiver status. In order to be considered for the study pt. had to be 6 weeks post up surgery.
What is the method used in this study?
This study is a sub-analysis from the Ostomy Telehealth for Cancer Survivors study, a 3-year, multi-site, randomized controlled trial for cancer survivors with ostomies and their caregivers. Cancer survivors with a permanent or temporary ostomy 6 weeks post up and their caregivers were enrolled. While caregivers were eligible for this study, having a caregiver was not required. The OSMT is a telehealth-enabled, five-session group intervention that coaches participants on ostomy self-management to improve activation, self-efficacy, and quality of life (QOL) outcomes.
Discuss the sample size used in the study.
ReplyDelete- This study had 216 participants recruited from the University of Pennsylvania, Yale University, and City of Hope. All participants were cancer survivors, were at least 6 weeks post op ostomy surgery and 21 years of age or older. There were 83 males with a caregiver, 30 without. There were 41 females that had a caregiver, 62 without.
Describe the method used by the author of the study
- This study is a sub-analysis from the Ostomy Telehealth for Cancer Survivors study, a 3-year, multi-site, randomized controlled trial for cancer survivors with ostomies and their caregivers
Discuss the sample size used in the study.
ReplyDeleteThe sample size consisted of 216 cancer survivors from University of Pennsylvania, Yale University, and City of Hope. participants must have been 21 years of age or older and at least 6 weeks post-ostomy surgery. Those with temporary ostomies were eligible, and there was no maximum time since surgery. Caregivers were defined as a family member or friend identified by the survivor as a person they want in this role for the study so long as the person is unpaid and were over 21 years of age at the time of enrollment.
Describe the method used by the author of the study
The study is a sub-analysis from the Ostomy Telehealth for Cancer Survivors study, a 3-year, multi-site, randomized controlled trial for cancer survivors with ostomies and their caregivers. Following consent, baseline data for participants were collected which are the basis for this analysis. This included demographic information and basic medical issues. Baseline surveys included the City of Hope Quality of Life – Ostomy (COH-QOL O) survey, Patient Activation Measure (PAM), Self-Efficacy (SE) to Manage Chronic Disease Scale, and Hospital Anxiety and Depression Scale (HADS). For the purposes of this sub-analysis, the study sample was split into those who reported having an informal caregiver and those who did not. Fischer's exact and chi-squared tests were used to compare patient demographic and clinical characteristics at baseline and p < 0.05 is considered statistically significant. A logistic regression with caregiver status (yes or no) as the dependent variable and demographic variables as categorical independent variables was used to estimate odds ratios for the impact of covariates on likelihood of having a caregiver.
Describe the Method used by the author of the study.
ReplyDeleteThis study is a sub-analysis from the Ostomy Telehealth for Cancer Survivors study, a 3-year, multi-site, randomized controlled trial for cancer survivors with ostomies and their caregivers . Cancer survivors with a permanent or temporary ostomy and their caregivers were enrolled. Following consent, baseline data for participants were collected which are the basis for this analysis (democraphigc info, basic medical issues). Baseline surveys included: City of Hope Quality of Life – Ostomy (COH-QOL O) survey, Patient Activation Measure (PAM), Self-Efficacy (SE) to Manage Chronic Disease Scale, and Hospital Anxiety and Depression Scale (HADS). COH-QOL-O consists of 43 scaled questions (0–10) in four domains (physical, psychological, social, and spiritual) as well as questions about demographic and clinical characteristics including age, BMI, sex, sexual function, smoking history, education level, income level, race, and ethnicity.
Sample Size:
216 cancer survivors were included in this analysis from the University of Pennsylvania: 124 (57.4%) patients identified a caregiver and 92 (42.6%) did not. Among hte patients who were considered cancer survivors with a caregiver, 81 were men and 41 were women. For those that did not identify as a caregiver, 30 were men and 2 were women.
Discuss the sample size used in the study;
ReplyDeleteThe sample of this research is 216 cancer survivors with ostomy, which contain 124 participants with a caregiver and 92 without a caregiver. 81 were men and 41 were women for cancer survivors with a care giver and 30 were men and 62 were women for those without a care giver. The average age of the participants were 64.4 years for those cancer survivors with a care giver and were 62 years for those without a care giver. They were recruited from the University of Pennsylvania, Yale University and City of Hope (Duarte, CA). 192 participants of this study were white.
Discuss the limitations of the article:
This randomized controlled trial for cancer survivors with ostomies and their caregivers shows interesting results, such as those cancer survivors with a care giver have high rate of health problems, such as heart disease, diabetes and mobility problems. Furthermore, having mobility problems has a significant effect of having a caregiver statistically. However, I see some possible biases/limitations. Since 88.9% of this study, which was 192 participants out of 216, were Caucasian, this unbalanced racial number can cause biased results. The population of this study may have rather high income and higher education. Recruiting the participants from 2 prestigious University hospitals, it may contribute a skewed result. The author connects the tendency of female cancer survivors to not have a caregiver with traditional gender roles in the USA, which is interesting, but I wish they had more thoroughly examined the reasons why female cancer survivors might not have a caregiver to begin with. Demographically speaking female persons tend to live longer and male persons tend to die earlier from disease, so it is also likely that the female cancer survivor’s spouse already passed away.
How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteRegardless of whether or not the stoma surgery was planned, the patient will be overwhelmed by the physical changes in their body, which may lead to emotional issues. Home care will be frightening, their quality of life may seem threatened, and in general, recovery from the effects of surgery take time. However, the immediate adjustment process can set a positive tone for all involved.The differences among cancer survivors with ostomies that do and do not identify informal caregivers may be of interest to clinicians in terms of improving ostomy survivorship care. It is very important identified of post-discharge education and support for cancer survivors with ostomies who do not have caregivers, and the effect of caregivers on cancer survivors. As our policy states at PSJMC, as nurse we need make sure the patient and caregiver they understand the instructions upon discharge.
what are the advantages and disadvantages to the proposed recommendations in the article?
For caregivers, whether they’re professionals, children, spouses, or parents of the ostomate, it’s important to learn how to provide proper ostomy support. The advantage is that most of these teaching are simple and fallow step by step. The disadvantage would be the degree of engagement on the caregiver.
Describe the method used by the author of the study
ReplyDeleteThe researchers used a sub-analysis study from the Ostomy Telehealth for Cancer survivors over a three year period. With this information, they ran a randomized control trial for cancer survivors with permanent or temporary ostomy along with their caregivers receiving an OSMT program intervention or usual care guide.
Discuss the sample size used in the study
The participants of the study were recruited from the University of Pennsylvania, Yale University, and City of Hope. The group size consisted of individuals who had survived cancer and undergone ostomy procedures, along with their caregivers. The criteria for inclusion were centered around factors such as age, time since the ostomy surgery, and the role of being a caregiver. Eligible participants were in the age category of 21 years of age or older and at least six weeks post-ostomy surgery. The total numbers of eligible participants were 216.
what are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe recommendation in this article was caregiver education should be developed and follow up with comorbidities is needed. Furthermore, it was also recommended that female patients should be educated on the need for a caregiver since the traditional role has been females being the caregiver. I see this as being advantageous for the patients and healthcare system alike since this study pointed out a shortage and this recommendation will address a problem, and hopefully influence better patient outcomes.
Was the correct method used? Why or why not?
I believe the correct method was used because it was analyzing data already used and analyzed it. It is a cost effective way of conducting a study and the study was able to find short comings in current care.
1. Discuss the sample sieze used in the study:
ReplyDeleteThe study included 216 Cancer survivors in this analysis.
2. Describe the method used by the author of the study:
of the This study is a sub-analysis of the Ostomy Telehealth for Cancer Survivors study, which was a 3-year, multi-site, randomized controlled trial for cancer survivors with ostomies and their caregivers. The study involved cancer survivors with permanent or temporary ostomies and their caregivers who were enrolled and randomized to receive the OSMT program intervention or usual care. Caregivers were eligible for participation but not required. The OSMT program is a telehealth-enabled group intervention aimed at improving ostomy self-management, activation, self-efficacy, and quality of life outcomes.
Participants were recruited from the University of Pennsylvania, Yale University, and City of Hope. Eligible participants were 21 years or older and at least 6 weeks post-ostomy surgery, with temporary ostomies also included. Caregivers were defined as unpaid family members or friends identified by the survivor. Baseline data were collected upon consent, including demographic information, medical issues, comorbidities, and surveys assessing quality of life, patient activation, self-efficacy, anxiety, and depression levels. The analysis in this study is based on this baseline data.
Discuss the sample size used in the study:
ReplyDeleteThe study included 216 cancer survivors with ostomies, all of which had to be over the age of 21 and 6 week post ostomy surgery.
Discuss the method used by the author of the study:
This study is a sub-analysis from the Ostomy Telehealth for Cancer Survivors study, which was a 3 year, multi site, randomized controlled trial for cancer survivors with ostomies. The sample size was cut into two, those with informal caregivers and those without. Fischer's exact and chi-squared tests were used to compare patient demographic and clinical characteristics at baseline.
1. Discuss the sample size used in the study.
ReplyDelete216 cancer survivors with fecal or urinary ostomies were recruited from 3 different organizations: City of Hope - Duarte, Yale-New Haven and University of Pennsylvania.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
There were a few limitations with this study. The sample size was small, only 216 recruits. The biggest limitation, though was design flaws. It looked at how cancer patients with ostomies fare with caregivers compared with those who did not have caregivers. One of the limitations is that it excluded paid caregivers. Another flaw was that they state that those with caregivers are generally sicker that those without - this specifically made it seem like they were comparing apples to oranges. I don't feel like the study authors met their goals or gained the information they were hoping for. The authors state at the end of the article that this topic bears further research/discussion.
1. Discuss the study’s sample size.
ReplyDeleteThe study involved a cohort of 216 cancer survivors who were drawn from the University of Pennsylvania, Yale University, and City of Hope. To be eligible for participation, individuals had to be 21 years of age or older and have undergone ostomy surgery at least six weeks prior. Temporary ostomies were also included, and there were no restrictions based on the duration since surgery. Caregivers, defined as unpaid family members or friends chosen by the cancer survivors, were also enrolled in the study if they were over 21 years old at the time of enrollment.
2. Describe the research methodology employed by the author.
This study constitutes a sub-analysis derived from the broader Ostomy Telehealth for cancer Survivors study, which spanned three years and was a randomized controlled trial conducted across multiple sites involving cancer survivors with ostomies and their respective caregivers. Following the participants’ consent, baseline data were gathered, forming the foundation for this analysis. This dataset encompassed demographic particulars and fundamental medical considerations. Baseline questionnaires encompassed the City of Hope Quality of Life-Ostomy survey, the PAM, SE to Manage Chronic Disease Scale, and the HADS. For the sub-analysis at hand, the study population was divided into two groups: those who reported having an informal caregiver and those who did not. Statistical analyses were conducted using Fischer’s exact and chi-squared tests to compare baseline patient demographic and clinical characteristics, with statistical significance set at p<0.05. A logistic regression was employed to assess the impact of covariates on the likelihood of having a caregiver, with a caregiver status serving as the dependent variable and demographic variables categorized as independent variables.
1. Discuss the sample size used in the study:
ReplyDeleteThe sample size for this study consisted of 216 cancer survivors recruited from the University of Pennsylvania, Yale, and City of Hope in Duarte, CA. The participants also had to be at least 21 years of age and 6-weeks post ostomy surgery (fecal or urinary).
2. Describe the method used by the author of the study:
This study is a sub-analysis from the Ostomy Telehealth for Cancer Survivors study, a 3-year, multi-site, randomized controlled trial for cancer survivors with ostomies and their caregivers. The OSMT is a telehealth-enabled, five-session group intervention that coaches participants on ostomy self-management to improve activation, self-efficacy, and quality of life (QOL) outcomes.