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Patients' information coping styles influence the benefit of a survivorship care plan in the ROGY Care Trial: New insights for tailored delivery.

ABSTRACT: BACKGROUND:In efforts to improve the implementation of survivorship care plans (SCPs), the authors assessed whether the impact of SCPs on patient-reported outcomes differed between patients with an information-seeking coping style (monitoring) versus those with an information-avoiding coping style (blunting). METHODS:In the Registration System Oncological Gynecology (ROGY) Care Trial, 12 hospitals in the Netherlands were randomized to deliver SCP care or usual care. All patients with newly diagnosed endometrial and ovarian cancer in the SCP care arm received an SCP that was generated automatically by their oncology provider through the web-based ROGY registration system. Outcomes (satisfaction with information provision and care, illness perceptions, and health care use) were measured directly after initial treatment and after 6, 12, and 24 months. Information coping style was measured at 12 months after initial treatment. RESULTS:Among patients who had a monitoring coping style (N = 123), those in the SCP care arm reported higher satisfaction with information provision (mean score: 73.9 vs 63.9, respectively; P = .04) and care (mean score: 74.5 vs 69.2, respectively; P = .03) compared with those in the usual care arm. Among patients who had a blunting coping style (N = 102), those in the SCP care arm reported a higher impact of the disease on life (mean score: 5.0 vs 4.5, respectively; P = .02) and a higher emotional impact of the disease (mean score: 5.4 vs 4.2, respectively; P = .01) compared with those in the usual care arm. CONCLUSIONS:SCPs may be beneficial for patients who desire information about their disease, whereas SCPs may be less beneficial for patients who avoid medical information, suggesting a need for tailored SCP delivery to improve survivorship care.

SUBMITTER: de Rooij BH

PROVIDER: S-EPMC6587821 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Project description:Individual stress coping style has profound effects on how animals respond to environmental change, and individuals within a population strikingly differ in how gene expression shifts in response to challenge. This study used a wild type Zebrafish (Danio rerio) population to: 1) identify and screen for individual coping style using a screening protocol for risk taking in groups and 2) do global transcriptomics of brains from proactive, reactive or randomly chosen individuals (n=10/group) under control conditions. Results show that within our population proactive and reactive individual coping styles can be accurately identified and may represent 10-30% of individuals within the population. Microarray data analyses identify fundamental differences between the three different groups where variance in gene expression values are reduced by using coping style as an explanatory variable. Furthermore, significant differences in mRNAs and related biological processes suggest that even under identical environmental conditions the molecular mechanisms that underpin physiological processes are very different between proactive and reactive individuals within a population. Experimental tank was an 18 litre glass aquarium (dimensions (LxWxH): 40 X 25 X 20cm) lined on three sides with white paper; the front wall was not covered to allow the observer to record the behaviour and divided at 1/3 of his length with a black PVC screen with a 3cm diameter hole in the middle. All the tank surfaces around this third area of the tank were covered with dark paper and closed on the upper part with a removable lid to provide a shelter for the animals. The hole was covered with the same PVC plastic material and removed once the screening started to allow the fish enter the novel environment. Food was not supplied the day before to ensure that during the test the fish were hungry and they had to make the decision to leave a safe area in order to forage. Boldness was measured as the time taken by individual fish to leave a group from a safe, darkened area. It hence represents the willingness of a fish to explore a new, potentially dangerous environment, or boldness. Tests were conducted with groups of 9 randomly-selected fish from stocking tanks. Fish were familiar to each other in the sense that they were previously held in the same stocking tank. Test started with a 10 min. habituation period in the sheltered area with the hole closed with a PVC screen and the top of the sheltered area of the tank also covered to provide a complete quiet place. Then the lid covering the hole was gently removed. Either the first 3 fish to exit the shelter or fish with latency times inferior to 10 minutes were considered bold fish and were removed gently with a fish net from the test tank and placed apart in another tank. Latency times of emergency from the sheltered area were recorded individually. Next 3 animals to emerge before 15 minutes were considered intermediate and also removed gently. At the end of this last 15 minutes, animals that still remained inside the sheltered area were considered shy. Intermediates were discarded and fish selected for different coping strategies where placed in different tanks for posterior molecular analysis. Selected animals were killed by an overdose of MS-22 and the brains were sampled. Individual tissue samples were homogenized into 0.3 ml of Tri-Reagent and stored at -80C for further molecular analysis.

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Patients' information coping styles influence the benefit of a survivorship care plan in the ROGY Care Trial: New insights for tailored delivery.

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