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Background: This study assessed the cost-effectiveness of proton beam therapy (PBT) compared to conventional radiotherapy (CRT) for treating patients with brain tumors in Sweden. Methods: Data from a longitudinal non-randomized study performed between 2015 and 2020 was used, and included adult patients with brain tumors, followed during treatment and through a one-year follow-up. Clinical and demographic data were sourced from the longitudinal study and linked to Swedish national registers to get information on healthcare resource use. A cost-utility framework was used to evaluate the cost-effectiveness of PBT vs. CRT. Patients in PBT group (n = 310) were matched with patients in CRT group (n = 40) on relevant observables using propensity score matching with replacement. Costs were estimated from a healthcare perspective and included costs related to inpatient and specialized outpatient care, and prescribed medications. The health outcome was quality-adjusted life-years (QALYs), derived from the EORTC-QLQ-C30. Generalized linear models (GLM) and two-part models were used to estimate differences in costs and QALYs. Results: PBT yielded higher total costs, 14,639 US$, than CRT, 13,308 US$, with a difference of 1,372 US$ (95% CI, -4,914–7,659) over a 58 weeks' time horizon. Further, PBT resulted in non-significantly lower QALYs, 0.746 compared to CRT, 0.774, with a difference of -0.049 (95% CI, -0.195–0.097). The probability of PBT being cost-effective was < 30% at any willingness to pay. Conclusions: These results suggest that PBT cannot be considered a cost-effective treatment for brain tumours, compared to CRT. Trial registration: Not applicable. Novelty and Impact: This study informs on the cost-effectiveness of proton beam therapy (PBT) versus conventional radiotherapy (CRT) for patients with brain tumors in Sweden. Amidst global concerns regarding the cost-effectiveness of PBT, our investigation fills a notable gap by providing evidence from the Swedish healthcare landscape. Using real-world data, our study demonstrates the application of established health economic methodology to compare PBT and CRT for brain tumors, furthering research in this area. [ABSTRACT FROM AUTHOR]

Background: Currently, no available tool easily and effectively measures both the frequency, intensity and distress of symptoms among patients receiving radiotherapy. A core symptom set (fatigue, insomnia, pain, appetite loss, cognitive problems, anxiety, nausea, depression, constipation, diarrhoea and skin reaction) has been identified and assessed across oncology research to better understand the pattern of symptoms and treatment side effects. Aim: The aim was to develop a tool measuring the multiple‐symptom experience in patients undergoing radiotherapy and evaluate its psychometric properties (validity, reliability and responsiveness). Design: This study has a prospective, longitudinal and quantitative design. Methods: We developed a patient‐reported outcome questionnaire, the Radiotherapy‐Related Symptoms Assessment Scale to assess the frequency, intensity and distress associated with symptoms. Patients (n = 175) with brain tumours undergoing proton beam therapy completed the Radiotherapy‐Related Symptoms Assessment Scale and the health‐related quality of life questionnaire (EORTC QLQ‐C30) during treatment. We assessed the validity, reliability and responsiveness of the Radiotherapy‐Related Symptoms Assessment Scale and evaluated the validity against QLQ‐C30. Results: There were significant questionnaire–questionnaire correlations regarding selected items, primarily fatigue, insomnia and pain, indicating satisfactory criterion‐related validity. The Radiotherapy‐Related Symptoms Assessment Scale had fair to good retest reliability. Conclusion: The Radiotherapy‐Related Symptoms Assessment Scale is a valid instrument for assessing symptom intensity and distress in patients with brain tumour undergoing PBT, with psychometric properties within the expected range. The Radiotherapy‐Related Symptoms Assessment Scale provides nurses with substantial information on symptom experience but requires little effort from the patient. Additional studies are required to further assess the psychometric properties in patients with different cancer diagnoses receiving conventional radiotherapy. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To increase knowledge of what patients with incurable cancer have found consoling during the course of the disease.Design: Descriptive, cross-sectional analysis.Setting: Hospice in western Sweden.Sample: 10 patients (8 women, 2 men) aged 30-90 years.Methods: Data were collected through semistructured interviews and analyzed with the constant comparative method of analysis.Findings: Four categories emerged from the interview data: connection, self-control, affirmation, and acceptance. The core variable of the study was developed and defined as "being seen." To be seen and, therefore, consoled results from experiencing a sense of connection, self-control, affirmation, and acceptance. To be consoled is a step toward increased well-being. When patients feel their suffering is seen and understood by another person, they are filled with relief.Conclusions: Raising the issue of consolation and what consolation means to the patient is essential. Physical contact is not as important as mental presence. The act of listening is the most important factor when it comes to being seen, and what the nurse communicates is what defines the patient/nurse relationship. Nurses should be clear that they have the time and interest to deal with the patient. In addition, a nurse who is concerned with patients and has the courage to stay with them during difficult situations develops an attitude marked by presence, understanding, and commitment. Creativity, knowledge, and, most of all, courage are needed from the nurse as a caregiver to recognize the patient's need for consolation. Creativity and knowledge are needed to determine what point the patient has reached, and courage is needed to be present with the patient during difficult times. Results show that the caregiver, without having an established long-term relationship with the patient, can still bring consolation to the patient.Implications for Nursing: Creativity, knowledge, and courage are needed to comprehend and accept a patient's need for consolation. By using simple interventions, the nurse can console the patient with little effort. Words become less important when consolation is done through body language. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To explore the experience of participation in support groups for women recently diagnosed with ovarian cancer. Research Approach: Exploratory, qualitative. Setting: Oncology department in a hospital in western Sweden. Participants: 10 Swedish women, aged 42-76, who recently had been diagnosed with ovarian cancer and had participated in support groups. Methodologic Approach: Data were collected by semistructured interviews and analyzed using grounded theory. Main Research Variables: Ovarian cancer, support group experience. Findings: Three categories emerged from the data analysis: sharing experiences and emotions, exchanging informational support, and exchanging emotional support. The core category was the experience being in the same boat. Trust, openness, and willingness to create space for each other were experienced. Conclusions: Support groups offer an opportunity to share experiences and emotions as well as exchange information. They are also a possible source of emotional support and therefore can contribute to quality of life of patients with ovarian cancer. Interpretation: Knowing that others had similar symptoms and reactions, and that those experiences are normal, was very important support group participants. Nurses can reduce patients' fears and uncertainties by confirming normality. Oncology nurses need be aware that cancer support groups offer a unique opportunity interact with others in a similar situation. Participation in support groups can be an important source of emotional and informational support for patients. The support program in this study may be used a model when planning for extended emotional and informational support. [ABSTRACT FROM AUTHOR]

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Abstract: This paper reports on how patients with uterine cancer, receiving radiotherapy, experience fatigue, other symptoms and global quality of life. The results showed that fatigue increased significantly during the therapy. Also the other symptoms; loss of appetite, nausea/vomiting and diarrhoea increased significantly and were significantly correlated to general fatigue. Global quality of life decreased significantly during treatment compared to baseline. The variation of the level in general fatigue after completed therapy was only explained by the level of general fatigue experienced at baseline. The result can lead to a better understanding of the severity of symptoms experienced by patients with uterine cancer treated with radiotherapy. [Copyright &y& Elsevier]

Fatigue is one of the most prevalent and distressing symptoms of cancer, and is a common side-effect of many of the treatments available for the management of malignant disease. We critically assess the evidence for cancer-related fatigue and its treatment in adults. Little is known about the cause and mechanisms of fatigue, and research into methods of alleviating the condition has focused on treatment for anaemia and behavioural interventions, such as exercise, both of which are effective in reducing fatigue. Although research into the condition has increased considerably in the past decade, important gaps in knowledge remain. [ABSTRACT FROM AUTHOR]

PROBLEM IDENTIFICATION: Symptom experience in patients with cancer consists of several dimensions, often measured descriptively within various populations but seldom used as intervention outcomes. This review aims at describing symptom dimensions as outcomes of interventions designed to alleviate symptoms in patients with cancer and to describe these interventions' effects on at least two symptom dimensions. LITERATURE SEARCH: The PRISMA statement for reporting systematic reviews was used. Searches were undertaken in various indexing sites. DATA EVALUATION: Extracted data included design, participants, intervention and control group treatment, targeted symptom dimension, and summary of results. SYNTHESIS: 2,041 articles were identified and 15 were included. The symptom dimensions were intensity, distress, prevalence, frequency, consequences, and quality. Eleven interventions had significant effect on symptom dimensions, mostly on intensity and distress. IMPLICATIONS FOR PRACTICE: Oncology nurses need clinical skills to be able to understand patients' experiences through their narratives. Various interventions are targeted at symptoms, and these need to be implemented to provide evidence-based symptom management. [ABSTRACT FROM AUTHOR]