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  CANCER PATIENT ATTITUDES TOWARDS INFLUENZA VACCINATION AND THE PREVALENCE OF VACCINATION IN CANCER PATIENTS

  Dulude, Alexandra; The University of Arizona College of Medicine - Phoenix; Ramanathan, Ramesh (The University of Arizona., 2015-04-10)

  Introduction: Thousands of people die from influenza or its complications each year despite the fact that it is one of the few vaccine preventable diseases. Immunocompromised cancer patients are among the most vulnerable to this infection and flu‐related complications, and therefore vaccination is highly recommended in these patients; however, current vaccination rates and attitudes towards vaccination remain unknown. We hypothesize that immunization rates are lower than the 100% recommendation rate, and hope to understand the reasoning behind the discrepancy. The purpose of this study is to assess cancer patient attitudes towards influenza vaccination in an effort to minimize barriers to vaccination and eventually increase vaccination rates in this immunocompromised population. Methods: Cancer patients enrolled in phase I clinical oncology trials at the Virginia G Piper Cancer Center at Scottsdale Healthcare were invited to participate in a voluntary survey. The 15‐item survey consisted of demographic information, knowledge regarding the flu vaccine, vaccination status after cancer diagnosis and while on treatment, and general attitudes towards vaccination. A total of 84 cancer patients completed the survey. Results were stratified by age, gender, education level, and vaccination status. As this was a descriptive study, no statistical analyses were performed. Results: A total of 84 (n=84) advanced cancer patients enrolled in phase I clinical oncology trials completed the survey. Results indicate that although 71% of patients received the vaccine prior to cancer diagnosis, only 58% of patients have received the vaccine since their cancer diagnosis, and only 48% have been vaccinated while on cancer treatment. Of those vaccinated since cancer diagnosis, 94% reported doctor recommendation of the vaccine and most vaccinate to protect themselves from the virus. Of those not vaccinated since cancer diagnosis, only 37% report their doctor recommends the vaccine and the majority avoid vaccination because they believe the vaccine can cause the flu, they do not feel at risk of infection, and they do not believe the vaccine is effective. Conclusion: Our findings suggest that although the CDC strongly recommends influenza vaccination in cancer patients due to the risk of secondary complications and even death in these immunocompromised individuals, vaccination rates remain low. Our data demonstrates that patients who receive a doctor recommendation for the vaccine are more likely to be vaccinated, but not all doctors recommend the vaccine. Furthermore, false information regarding the vaccine, its efficacy, and its ability to cause infection continues to deter patients from vaccination. Together, this information offers profound insight into the cancer patient population and suggests the need for increased physician and patient education regarding the benefits of annual influenza vaccination to improve vaccination rates and decrease influenza infection and complications in the future.
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  Statistical controversies in cancer research: using standardized effect size graphs to enhance interpretability of cancer-related clinical trials with patient-reported outcomes

  Bell, M. L.; Fiero, M. H.; Dhillon, H. M.; Bray, V. J.; Vardy, J. L.; Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona (Oxford University Press, 2017-08)

  Patient reported outcomes (PROs) are becoming increasingly important in cancer studies, particularly with the emphasis on patient centered outcome research. However, multiple PROs, using different scales, with different directions of favorability are often used within a trial, making interpretation difficult. To enhance interpretability, we propose the use of a standardized effect size graph, which shows all PROs from a study on the same figure, on the same scale. Plotting standardized effects with their 95% confidence intervals (CIs) on a single graph clearly showing the null value conveys a comprehensive picture of trial results. We demonstrate how to create such a graph using data from a randomized controlled trial that measured 12 PROs at two time points. The 24 effect sizes and CIs are shown on one graph and clearly indicate that the intervention is effective and sustained.
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  Communication challenges experienced by migrants with cancer: A comparison of migrant and English-speaking Australian-born cancer patients

  Hyatt, Amelia; Lipson-Smith, Ruby; Schofield, Penelope; Gough, Karla; Sze, Ming; Aldridge, Lynley; Goldstein, David; Jefford, Michael; Bell, Melanie L.; Butow, Phyllis; et al. (WILEY, 2017-10)

  ObjectivesUnderstanding the difficulties faced by different migrant groups is vital to address disparities and inform targeted health-care service delivery. Migrant oncology patients experience increased morbidity, mortality and psychological distress, with this tentatively linked to language and communication difficulties. The objective of this exploratory study was to investigate the communication barriers and challenges experienced by Arabic, Greek and Chinese (Mandarin and Cantonese) speaking oncology patients in Australia. MethodsThis study employed a cross-sectional design using patient-reported outcome survey data from migrant and English-speaking Australian-born patients with cancer. Patients were recruited through oncology clinics and Australian state cancer registries. Data were collected regarding patient clinical and demographic characteristics and health-care and communication experiences. Data from the clinics and registries were combined for analysis. ResultsSignificant differences were found between migrant groups in demographic characteristics, communication and health-care experiences, and information and care preferences. Chinese patients cited problems with understanding medical information, the Australian health-care system, and communicating with their health-care team. Conversely, Arabic- and Greek-speaking patients reported higher understanding of the health-care system, and less communication difficulties. ConclusionsOur study findings suggest that migrant groups differ from each other in their health communication expectations and requirements. Lower education and health literacy of some groups may play a role in poorer health outcomes. Public health interventions and assistance provided to migrants should be tailored to the specific needs and characteristics of that language or cultural group. Future research directions are discussed.