Details of a Researcher - Yagasaki, Kaori

Papers - Yagasaki, Kaori

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Unmet Needs and Health-Related Quality of Life Among Patients With Relapsed/Refractory Indolent Non-Hodgkin Lymphoma: A Mixed-Methods Study

Sugimoto M., Yagasaki K., Matsuki E., Shimizu T., Sakurai M., Kataoka K., Doorenbos A.Z.

Psycho-Oncology 34 ( 2 ) e70103 2025.02

Accepted, ISSN 10579249

Objective: Patients with relapsed or refractory (r/r) indolent non-Hodgkin lymphoma (iNHL) live with incurable disease for a long-term, experiencing multiple relapses and treatments that impair their health-related quality of life (HRQOL). We aimed to better understand the unmet needs and HRQOL of patients with r/r iNHL. Methods: This convergent mixed-methods study evaluated patients with r/r iNHL who received treatment. Unmet needs and HRQOL were assessed quantitatively using self-administered questionnaires and analyzed statistically. Qualitative data were collected through face-to-face semi-structured interviews for reflexive thematic analysis. Quantitative and qualitative findings were integrated through narrative discussion and joint display. Results: Questionnaire respondents (50 participants, mean age: 72.42 years) reported unmet needs in the health system and information and psychological domains and a negative association between unmet needs and HRQOL. Interviews (20 participants, mean age: 72.75 years) identified four themes: “unremarkable symptoms,” “anxiety of progression in the near future,” “make the best of life,” and “means to live with uncertainty.” Integration revealed that participants accepted their low HRQOL and attempted to make the best of life, influencing their perception of unmet needs. Conclusions: Throughout the long course of r/r and repeated treatment, patients with iNHL accepted their low HRQOL, valued their current situations, and endeavored to make the best of life. In this situation, support in the psychological and health system and information domains is crucial. Support for the unmet needs of patients with r/r iNHL is essential as they strive to live their best lives while maintaining a favorable HRQOL.

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Extravasation associated with cancer drug therapy: multidisciplinary guideline of the Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology.

Matsumoto K, Ryushima Y, Sato J, Aizawa Y, Aoyama T, Akaishi Y, Okamoto R, Sato Y, Sugano K, Tazumi K, Tsuji M, Fujikawa N, Bun S, Yagasaki K

ESMO open 9 ( 10 ) 103932 2024.10

Accepted

Background: Extravasation (EV), or the leakage of anticancer drugs into perivascular and subcutaneous tissues during intravenous administration, can cause serious conditions that may require surgical intervention. Therefore, updated guidelines for EV based on systematic review are needed. Additionally, classifications for anticancer drugs that cause EV are not standardized across the current guidelines, and some novel drugs have not been classified. Therefore, this study aimed to formulate guidelines using evidence-based information for shared decision making on prevention, early detection, treatment, and care for EV in Japan and provide additional classification for tissue injury based on systematic review. Materials and methods: The members of the Japanese Society of Cancer Nursing (JSCN), Japanese Society of Medical Oncology (JSMO), and Japanese Society of Pharmaceutical Oncology (JASPO) were surveyed about significant clinical challenges related to EV, and 17 clinical questions (CQs) were formulated. PubMed and ICHUSHI Web were searched using the Patient, Intervention, Comparison, and Outcomes terms listed in each CQ as key words. For the classification of new drugs, articles published through February 2021 were selected using the search terms ‘extravasation’, ‘injection-site reaction’, ‘adverse events’, and the names of individual drugs as key words. Results: Recommendations based on the results of randomized controlled trials (RCTs) were made with regard to the selection of central venous (CV) devices (CQ2, CQ3a, CQ3b, and CQ3c), regular replacement of peripheral venous catheters (CQ5), and use of fosaprepitant (CQ7). These CQs are novel and were not mentioned in previous guidelines. Warm compression monotherapy (CQ10b) and local injection of steroids (CQ12) are discouraged for the management of EV. Ten new drugs were classified for EV tissue injury. Conclusions: This study provides updated guidelines for the prevention and treatment of EV, which can be used to help health care providers and patients and their families practice better EV management.

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Process of inner change in advanced age: a qualitative study of older adults in their early 90 s

Komatsu H., Niimura H., Yagasaki K.

BMC Geriatrics (BMC Geriatrics) 22 ( 1 ) 945 2022.12

Accepted

Background: The number of nonagenarians is growing globally. The promotion of mental wellbeing is increasingly important. The aim of this study was to explore mental wellbeing and psychological experiences of older adults in their early 90 s who were living at home. Methods: We conducted a qualitative study using semi-structured face-to-face interviews with 20 older adults in their early 90 s. A thematic analysis, according to Braun and Clarke, was used to analyze data. Results: An inner process of older adults in their early 90 s was revealed; its three themes were the “reality of aging,” “seeking emptiness of the mind,” and “still moving on.” Older adults in this study experienced functional decline, regret, and loneliness. They were tired of life and nearly gave up. Emptying their minds helped them reset their attitudes and find a way to move on. After realizing that negative thinking did not help anything, they focused on what they could do and their daily routines. Perceived social usefulness validated participants’ self-worth. However, a few were consistently active without negative perceptions of aging. Conclusion: Understanding the psychological process and mental wellbeing in later life aids in the development of practical healthcare policies to assist the growing oldest-old population in cope with age-related challenges and improve their mental wellbeing.

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Cancer survivorship care for post-treatment cancer survivors in Japan: A secondary analysis of a multinational study across Asia–Pacific countries

Yamamoto S., Arao H., Yagasaki K., Komatsu H.

Asia-Pacific Journal of Oncology Nursing (Asia-Pacific Journal of Oncology Nursing) 9 ( 11 ) 100121 2022.11

Accepted, ISSN 23475625

Objective: The global understanding of cancer survivorship care leads to optimal care delivery for cancer survivors. This study aimed to assess the perceptions of Japanese oncology nurses regarding cancer survivorship care and explore the factors influencing the provision of survivorship care. Methods: A questionnaire survey of oncology nurses was conducted as part of a multinational, cross-sectional survey. A 29-item measurement scale with four subscales regarding survivorship care was used to assess nurses’ perceptions regarding responsibility, confidence, and frequency of practice for cancer survivors. Additionally, we investigated a list of 16 factors influencing the provision of survivorship care. Results: Among 181 oncology nurses, the mean adjusted scores for survivorship care items were 65.6–84.7, 16.8–44.7, and 29.2–47.2 for responsibility, confidence, and frequency, respectively. Significant correlations were observed in the subscales for frequency of care with responsibility (r = 0.315–0.385, P < 0.001) and confidence (r = 0.428–0.572, P < 0.001). Participants with >10 years of experience in cancer care reported more frequent performance on surveillance than those with ≤ 5 years of experience (P = 0.03). The major barriers for providing survivorship care by oncology nurses were lack of knowledge and skills (87.8%), lack of time (81.8%), and not seeing the value of survivorship care (79.6%). Conclusions: Oncology nurses face many challenges regarding survivorship care, even though they recognize their responsibility. Educational support for oncology nurses is warranted to overcome impeding factors and improve confidence.

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Impact of a web-based educational program on Japanese nurses tobacco cessation practice and attitudes in oncology settings

Mizuno M., Yagasaki K., Imai Y., Ueta I., Bando T., Takahashi A., Komatsu H., Asanuma C., Sarna L., Wells M., Brook J., Floegel-Shetty A., Bialous S.

Journal of Nursing Scholarship (Journal of Nursing Scholarship) 54 ( 3 ) 315 - 323 2022.05

Accepted, ISSN 15276546

Purpose: To evaluate the effects of a short web-based educational program on Japanese nurses’ self-reported attitudes toward tobacco cessation and their use of interventions to help smokers to quit. Design: Prospective, single-group design with a pre-educational survey, a short web-based educational program, and a follow-up survey at 3 months. Methods: Clinical nurses were asked to view two prerecorded webcasts about helping smokers quit. They completed two online surveys, one at baseline and one at a 3-month follow-up. Generalized linear models were used to determine changes in nurses’ self-reported routine practice after the study intervention. Findings: A total of 1401 nurses responded to the baseline survey, 678 of whom completed the follow-up survey. Compared with baseline, nurses at follow-up were more likely to advise smokers to quit (odds ratio [OR] = 1.45, 95% confidence interval [CI: 1.15, 1.82]), assess patients’ interest in quitting (OR = 1.46, 95% CI [1.01, 1.04]), and assist patients with smoking cessation (OR = 1.34, 95% CI [1.04, 1.72]). However, the proportion of nurses who consistently recommended resources for tobacco cessation did not significantly improve at follow-up. Conclusions: This study provides preliminary evidence that a web-based educational program can increase nurses’ implementation of tobacco dependence interventions in cancer care practice. Sustaining these educational efforts could increase nurses’ involvement in providing these interventions, encourage nurses to refer patients to cessation resources, and support nurses’ attitudes towards their role in smoking cessation. Clinical relevance: Our short web-based educational program can increase nurses’ use of tobacco-dependence interventions in cancer care practice. This role can be enhanced with additional information about existing cessation resources that nurses could use to refer patients for support post-discharge. Japanese nurses, when properly educated, are willing and significant contributors to promote tobacco use cessation for cancer patients. The contribution can be facilitated through nursing care protocol that integrate tobacco use cessation interventions within evidence-based cancer care approaches.

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The relationship between work-related outcomes and symptoms in early breast cancer survivors receiving adjuvant endocrine therapy

Nakao M., Komatsu H., Hayashida T., Takahashi M., Seki T., Yagasaki K.

Asia-Pacific Journal of Oncology Nursing (Asia-Pacific Journal of Oncology Nursing) 9 ( 3 ) 174 - 178 2022.03

Accepted, ISSN 23475625

Objective: This study examined the relationship between symptom burdens and work-related outcomes, including work participation and overall work impairment (OWI) among breast cancer survivors (BCS) receiving adjuvant endocrine therapy (AET). Methods: This was a cross-sectional study with 140 BCS of working age receiving AET. Data were collected using self-report questionnaires that included an assessment of symptoms and their employment status, and OWI. Data were analyzed using descriptive statistics and multiple logistic regression analysis. Results: A total of 111 (79%) survivors reported being employed at the time of the survey. Symptom burdens were not associated with unemployment. Of the 110 working BCS receiving AET, symptom burdens were significantly related to a higher degree of OWI (OR = 2.14, 95% CI, 1.58–2.89, P ≤ 0.001). Conclusions: Participating BCS receiving AET continued to work while experiencing symptoms, with survivors who experienced high symptom burdens being negatively affected in their work life. Healthcare providers need to assess and manage symptoms and their impact on work, with the help of employers, to improve the quality of work life of BCS receiving AET.

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Rediscovering the Joy of Eating in Older Adults With Gastrointestinal Cancer Undergoing Treatment: A Qualitative Study

Yagasaki K, Komatsu H, Hamamoto Y.

Cancer Care Research Online. 2 ( 1 ) e017 2022

Research paper (scientific journal), Joint Work, Accepted

Background: Cancer treatment significantly impacts the diet of older adults with cancer. Professional support is required for such patients to manage their eating problems at home.
Objective: To explore the dietary experiences of older adults with gastrointestinal cancer undergoing treatment, and their perceptions of how the disease and its treatment affected their eating.
Interventions/Methods:Semi-structured interviews were conducted with 21 older patients (aged ≥ 70 years) with gastrointestinal cancer in Japan. Interview data were analyzed using thematic analysis.
Results:Three key themes were identified: impact on daily life, significance of eating, and rediscovering the joy of eating. Participants experienced dietary changes and reduced social interactions. Challenging situations allowed them to reassess their eating values and habits. By seeking their own coping strategies, they rediscovered the pleasure of eating.
Conclusions:Older adults with gastrointestinal cancer tried to cope with dietary changes based on their reaffirmed values while seeking the joy of eating.
Implications for Practice: A multidisciplinary healthcare team can support patients’ self-management by seeking to understand patients’ eating values and habits rather than focusing only on patients’ weight control and nutritional status.

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A Comparative Study of CIPN Symptom Estimation Methods Based on Machine Learning

Hamanaka S., Sasaki W., Okoshi T., Nakazawa J., Yagasaki K., Komatsu H.

UbiComp/ISWC 2021 - Adjunct Proceedings of the 2021 ACM International Joint Conference on Pervasive and Ubiquitous Computing and Proceedings of the 2021 ACM International Symposium on Wearable Computers (UbiComp/ISWC 2021 - Adjunct Proceedings of the 2021 ACM International Joint Conference on Pervasive and Ubiquitous Computing and Proceedings of the 2021 ACM International Symposium on Wearable Computers) 117 - 120 2021.09

Accepted

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of anticancer medicines that causes muscular weakness and falls in cancer patients. Therefore, we compared the methods for identifying and estimating the factors that cause symptoms in CIPN based on factor analysis and four different machine learning algorithms. The results of factor analysis showed that the latent factors causing CIPN can be classified into three categories: "Morning body condition", "Pain in the legs"and "Dizziness". We chose models for machine learning based on the premise of multi-task learning and built numerous machine learning models to estimate various CIPN symptoms. According to the results of the comparison studies, TabNet has the best generalization performance.

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The role and attitude of senior leaders in promoting group-based community physical activity: A qualitative study

Komatsu H., Yagasaki K., Oguma Y., Saito Y., Komatsu Y.

BMC Geriatrics (BMC Geriatrics) 20 ( 1 ) 2020.10

Background: In the context of worldwide public health, it is very important to promote physical activity among the older people. This study explored the roles and attitudes of senior leaders in promoting group-based exercise in their local communities, specifically to determine the level and extent to which to elderly participation was encouraged. Methods: This study conducted semi-structured face-to-face in-depth interviews and employed a subsequent thematic analysis. Participants included 10 club leaders and five sub-leaders who were working at senior clubs in Fujisawa-city, Kanagawa, Japan, from July to September 2018. Results: Four themes emerged from the interview responses, including "unwavering attitude/conviction in relation to the vision,""leaders must set an example,""a search for balance in delegating responsibilities to members,"and "creating and fostering culture and environment of mutual help."Further, each participant outlined several aims, including "achieving healthy longevity for the entire local community,""having older people promote healthy activities among the older people,"and "creating a pro-health town."Conclusions: Findings indicate that policymakers, public health workers, and healthcare providers should recognize the pivotal roles that senior group leaders play in promoting healthy activities for the older people. These efforts should be strongly considered when developing policies and strategies designed to promote overall healthy longevity from a general community perspective.

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Estimating symptoms caused by CIPN using mobile and wearable devices

Sasaki W., Ozawa R., Okoshi T., Nakazawa J., Yagasaki K., Komatsu H.

UbiComp/ISWC 2020 Adjunct - Proceedings of the 2020 ACM International Joint Conference on Pervasive and Ubiquitous Computing and Proceedings of the 2020 ACM International Symposium on Wearable Computers (UbiComp/ISWC 2020 Adjunct - Proceedings of the 2020 ACM International Joint Conference on Pervasive and Ubiquitous Computing and Proceedings of the 2020 ACM International Symposium on Wearable Computers) 696 - 699 2020.09

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of anticancer drugs that causes muscle weakness in the cancer patients, causing them to fall. Therefore, we constructed "FD-AWARE", a system to understand the users' fall context and users' CIPN symptoms as the first step in preventing these falls. This system can collect the various sensor data from the iPhone and the Apple Watch, self-reported fall information data, self-reported user status data of CIPN symptoms, and their physical condition. We conducted a 2-week in-the-wild experiment with 8 patients who were actually suffering from CIPN. We constructed the machine learning models for estimating the users' status of CIPN symptoms and successfully achieved high accuracy of performance for several estimating models.

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Effects of a nurse-led medication self-management programme in women with oral treatments for metastatic breast cancer: A mixed-method randomised controlled trial

Komatsu H., Yagasaki K., Yamaguchi T., Mori A., Kawano H., Minamoto N., Honma O., Tamura K.

European Journal of Oncology Nursing (European Journal of Oncology Nursing) 47 2020.08

ISSN 14623889

Purpose: Adherence to medication is the most important challenge facing patients receiving oral anticancer treatment. This study aimed to evaluate the effects of a patient-centred medication self-management support programme in patients with metastatic breast cancer undergoing oral anticancer treatment. Methods: This trial was a two-phased mixed-method randomised controlled study. Eligible participants were 155 patients with metastatic breast cancer newly prescribed an oral chemotherapy or targeted therapy agent. The intervention group received the patient-centred medication self-management support programme conducted by trained nurses. Primary outcome was adherence to medication at three months after the commencement of treatment, calculated by medication possession ratio (MPR). Secondary outcomes included self-efficacy, functional assessment, psychological distress, symptom severity and symptom interference, and patient satisfaction. After the completion of the intervention study, focus group interviews were conducted among intervention nurses. Results: Both intervention and control groups maintained more than 90% of MPR and no significant difference was observed in the primary outcome. Regarding secondary outcomes, only general self-efficacy was significantly different in the two groups. In the qualitative study, the intervention nurses perceived improvement in the patients’ self-efficacy, ability to anticipate the impact of treatment and adjust to life, and avoidance of loneliness. Conclusions: A significant effect of the programme was not found in the program because the adherence rate was high in both groups. Improvement in the patients’ self-efficacy was observed both quantitatively and qualitatively. Trial Registration: UMIN Clinical Trials Registry (UMIN-CTR), Japan, UMIN000016597. (27 February 2015).

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Evaluation of the Japanese Version of the Cancer Survivors' Unmet Needs Scale

Komatsu H., Yagasaki K., Sato Y., Arao H., Yamamoto S., Hayashida T.

Asia-Pacific Journal of Oncology Nursing (Asia-Pacific Journal of Oncology Nursing) 7 ( 2 ) 167 - 173 2020.04

ISSN 23475625

This study aimed to evaluate the psychometric properties of the Japanese version of the Cancer Survivors' Unmet Needs (CaSUN-J) scale among cancer survivors in Japan. Methods: The CaSUN-J was developed using standardized translation methodology. Content validity was evaluated by a group of experts, and a pilot test was conducted with a convenience sample of 10 cancer patients. A total of 183 Japanese cancer survivors completed the CaSUN-J. The internal consistency of the scale was examined with Cronbach's . Construct validity was analyzed using correlations with the physical effects, quality of life (QoL), and age. To assess the factorial validity of the CaSUN-J, confirmatory factor analysis (CFA) was performed. Results: The CaSUN-J indicated good readability and high content validity for use as an assessment tool among Japanese cancer survivors. All Cronbach's coefficients were above the minimum acceptable criterion of ≥0.70. For construct validity, higher physical effect scores, as well as poorer QoL scores and younger patients, were significantly positively associated with higher levels of needs. CFA indicated that the five-factor structure of the CaSUN-J was a good fit to the data. Conclusions: The CaSUN-J can serve as a valid and reliable tool to evaluate unmet needs among Japanese cancer survivors.

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Patient voice on management of facial dermatological adverse events with targeted therapies: a qualitative study

Yagasaki K., Takahashi H., Ouchi T., Yamagami J., Hamamoto Y., Amagai M., Komatsu H.

Journal of Patient-Reported Outcomes (Journal of Patient-Reported Outcomes) 3 ( 1 ) 2019.12

Background: With the increased use of targeted therapies in oncology, dermatological adverse events (dAEs) have drawn attention. Because the face is crucial for human identity and social interactions, facial dAEs have significant impact on a patient’s quality of life. This study aimed to explore patients’ experience with regard to the management of targeted oncological therapy-induced facial dAEs. Methods: In this qualitative study, 20 patients at a university hospital in Japan with advanced/metastatic cancer and targeted therapy-induced facial dAEs were individually interviewed to collect data. Thematic analysis was used to analyze the data. Results: Patients with cancer and targeted oncological therapy-induced facial dAEs who were referred to the Department of Dermatology had certain expectations from specialist services. Three key themes were identified: professional input and advice, empathetic commitment to individual management, and integrated care across specialties. Conclusions: The referred patients with cancer and facial dAEs needed more in-depth information and advice from dermatological services and were reassured by the empathetic commitment to individual management in integrated care across specialties. These findings suggest that attention to the patient’s perspective with a “sick person first” attitude and a collaborative effort across different specialties is important to minimize the effects of facial dAEs on the quality of life of patients with cancer.

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Falls and Functional Impairments in Breast Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy

Komatsu H., Yagasaki K., Komatsu Y., Yamauchi H., Yamauchi T., Shimokawa T., Doorenbos A.

Asia-Pacific Journal of Oncology Nursing (Asia-Pacific Journal of Oncology Nursing) 6 ( 3 ) 253 - 260 2019.07

ISSN 23475625

Objective: We investigated the incidence of falls and functional impairments in breast cancer patients with chemotherapy-induced peripheral neuropathy (CIPN). Additionally, we examined whether taxane-induced peripheral neuropathy was associated with the patients' falls and functional impairments. Methods: We conducted a cross-sectional study including 88 patients with breast cancer who received taxane-based chemotherapy and were recognized as having peripheral neuropathy symptoms (Common Terminology Criteria for Adverse Events Grade ≥1). Patients completed the Functional Assessment of Cancer Therapy-Gynecologic Oncology Group-Neurotoxicity questionnaire for neuropathy and described falls from the onset of the taxane-based chemotherapy to the time of the survey. Functional impairments were defined using the Activities of Daily Living subsection of the Vulnerable Elder's Scale. Data were analyzed using descriptive statistics and logistic regression. Results: Of the participants, 40.9% experienced falls and 38.4% reported functional impairments. Most falls occurred on flat ground. Bone fracture due to falls was observed in 11.4% of the participants. Logistic regression revealed that CIPN was not significantly associated with the reported incidence of falls. However, it was significantly associated with functional impairments (odds ratio, 6.415; 95% confidence interval: 1.271-32.379; P = 0.024). Conclusions: CIPN was associated with functional impairments, but not with the incidence of falls. Patients should be informed prior to the onset of anticancer therapy that CIPN is a risk factor for functional impairments.

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Unmet needs of cancer patients with chemotherapy-related hand-foot syndrome and targeted therapy-related hand-foot skin reaction: A qualitative study

Komatsu H., Yagasaki K., Hirata K., Hamamoto Y.

European Journal of Oncology Nursing (European Journal of Oncology Nursing) 38 65 - 69 2019.02

ISSN 14623889

Purpose: The objective of this qualitative study was to understand the perceived needs of advanced-stage cancer patients with chemotherapy-related hand-foot syndrome (HFS) and/or targeted therapy-related hand-foot skin reaction (HFSR). Method: Face-to-face interviews were conducted with 20 outpatients with advanced/recurrent cancer and chemotherapy-related HFS and/or targeted therapy-related HFSR using a semi-structured interview guide at Keio University Hospital, Tokyo, Japan. Thematic analysis was used to analyse the data. Results: The unmet needs of cancer patients with chemotherapy-related HFS and/or targeted therapy-related HFSR was identified through four themes: a sense of helplessness with persistent symptoms, noticeable appearance as a barrier to social participation, decreased willingness to work and continue treatment, and need of individual coping strategies. Conclusion: This study revealed unmet needs of cancer patients with chemotherapy-related HFS and/or targeted therapy-related HFSR that are not often voiced. Health care providers should provide full information in advance and find the best coping strategy for individual patients.

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Falls and Physical Inactivity in Patients with Gastrointestinal Cancer and Hand-Foot Syndrome

Komatsu Hiroko, Yagasaki Kaori, Hamamoto Yasuo, Takebayashi Toru

Asia-Pacific Journal of Oncology Nursing (Asia-Pacific Journal of Oncology Nursing) 5 ( 3 ) 307 - 313 2018.07

ISSN 2347-5625

<p>Objective: This study aims to ascertain the incidence and association of falls and physical inactivity in patients with gastrointestinal cancer and hand-foot syndrome (HFS) after receiving chemotherapy or targeted therapy. Methods: The present cross-sectional study was conducted on 50 outpatients with HFS of Grade 1 or above, according to the National Cancer Institute Common Terminology Criteria for Adverse Events, following the receipt of chemotherapy or targeted therapy for gastrointestinal cancer in Japan between November 2016 and February 2017. For measurement, Dermatology Life Quality Index (DLQI) and the International Physical Activity Questionnaire were used. Data were analyzed by logistic regression analysis. Results: Of the participants, 18% experienced falls and 60% reported physical inactivity. Multivariate logistic regression revealed that the DLQI treatment domain score was the only factor associated with falls (odds ratio [OR] =8.01, 95% confidence interval [CI] =1.27-50.63, P = 0.027). Physical inactivity was associated with DLQI symptom and feeling domain scores (OR = 5.54, 95% CI = 1.26-24.33, P = 0.023) and the with-oxaliplatin or paclitaxel regimen (OR = 3.71, 95% CI = 1.06-13.03, P = 0.041). Conclusions: The results of the present study suggest patients should be informed that HFS is a risk factor for physical inactivity and falls.</p>

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Targeted Therapy-induced Facial Skin Toxicities: Impact on Quality of Life in Cancer Patients

Yagasaki K., Komatsu H., Soejima K., Naoki K., Kawada I., Yasuda H., Hamamoto Y.

Asia-Pacific Journal of Oncology Nursing (Asia-Pacific Journal of Oncology Nursing) 5 ( 2 ) 172 - 177 2018.04

ISSN 23475625

Objective: Targeted therapy-induced facial skin toxicities may reduce overall quality of life (QoL) in cancer patients. We investigated whether facial skin toxicities affect QoL and attempted to identify factors related to QoL in patients with advanced/recurrent cancer. Methods: We performed a cross-sectional study in 34 outpatients with advanced/recurrent cancer showing targeted therapy-induced facial skin toxicities in Japan between November 2016 and February 2017. For measurement, we used the Kessler Psychological Distress Scale (K6), Mental Adjustment to Cancer (MAC) Scale, and Dermatology Life Quality Index (DLQI). Data were analyzed using Spearman's rank correlation coefficient. Results: Mean DLQI score in 34 patients was 4.59 (standard deviation ± 4.70), which was interpreted as a small effect on a patient's life. Acneiform rash was the most common skin condition noted, followed by xerosis, pruritus, and erythema. Analysis of DLQI scores revealed that symptoms and feelings was the domain most commonly affected among different domains constituting the DLQI. MAC analysis revealed that the fighting spirit score was the highest among MAC scales. We found that age, K6, and fatalism construct in MAC were significantly correlated with total DLQI scores (age: Spearman's ρ= -0.48, P = 0.004; K6: ρ= 0.58, P < 0.001; fatalism; ρ= -0.39, P = 0.025). Conclusions: This is the first study investigating targeted therapy-induced facial skin toxicities in cancer patients. Our results suggest potential negative effects of facial skin toxicities on overall QoL in patients with advanced/recurrent cancer in middle and early old age.

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Fertility decision-making under certainty and uncertainty in cancer patients

Komatsu H., Yagasaki K., Yamauchi H.

Sexual and Reproductive Healthcare (Sexual and Reproductive Healthcare) 15 40 - 45 2018.03

ISSN 18775756

Objective The objective of this study was to understand how reproductive-age women with breast cancer make fertility-related decisions. Methods Using grounded theory methodology, we collected data from 11 reproductive-age women with breast cancer between March and August 2016. Verbatim transcriptions were analyzed using constant comparative analysis and open, axial, and selective coding. Results “Fertility Decision-Making under Certainty and Uncertainty” emerged as a core category. Fertility decision-making started with the participants’ “values and preferences” about having a child. In making a decision, there were certainty (“Information” and “Emotional support”) and uncertainty (“Time constraints,” “Recurrent risk,” “Labeling,” and “Unmet needs”) factors. Participants had more uncertainty factors than certainty factors, and healthcare professionals’ services accounted for one of the uncertainty factors. Conclusions After fertility preservation counseling, women with cancer made difficult decisions in stressful situations without sufficient healthcare information and support. Tailored information should be provided to individual women in collaboration between oncology and reproductive health professionals.

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Preparing for a paradigm shift in aging populations: listen to the oldest old

Komatsu H., Yagasaki K., Kida H., Eguchi Y., Niimura H.

International Journal of Qualitative Studies on Health and Well-being (International Journal of Qualitative Studies on Health and Well-being) 13 ( 1 ) 2018.01

ISSN 17482623

Purpose: Current healthcare systems are not suitable for serving future societies in which the oldest old are commonplace. The objective of this study was to understand what the oldest old care most about in their daily lives. Methods: Semi-structured in-depth interviews and thematic analysis were used. Face-to-face interviews were conducted in 17 elderly residents (≥ 95 years) of Arakawa-ku, Tokyo, Japan from July to November 2017. Results: Three themes emerged from the interview responses: “unshakable beliefs and social ties,” “natural acceptance,” and “my day-to-day life with precious moments.” The oldest old strongly believe in diligence and compassion and maintain strong relationships with people around them. Despite their small social networks, they are concerned about future society. They accept their selves and their lives, including their impending deaths. Despite their functional decline, they control their lives by making very small decisions. They live on a moment-to-moment basis, cherishing simple events. Conclusion: Maintaining autonomy through making small decisions and enjoying small pleasures are important to the oldest old. Understanding the needs of the oldest old is the first step towards developing optimal geriatric care for an aging population.

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Regular group exercise contributes to balanced health in older adults in Japan:A Qualitative study.

Komatsu Hiroko, Yagasaki Kaori, Saito Yoshinobu, Oguma Yuko

BMC Geriatrics 17 ( 1 ) 190 2017.08

ISSN 1471-2318

<p>Background: While community-wide interventions to promote physical activity have been encouraged in older adults, evidence of their effectiveness remains limited. We conducted a qualitative study among older adults participating in regular group exercise to understand their perceptions of the physical, mental, and social changes they underwent as a result of the physical activity. Methods: We conducted a qualitative study with purposeful sampling to explore the experiences of older adults who participated in regular group exercise as part of a community-wide physical activity intervention. Four focus group interviews were conducted between April and June of 2016 at community halls in Fujisawa City. The participants in the focus group interviews were 26 older adults with a mean age of 74.69 years (range: 66-86). The interviews were analysed using the constant comparative method in the grounded theory approach. We used qualitative research software NVivo10® to track the coding and manage the data. Results: The finding 'regular group exercise contributes to balanced health in older adults' emerged as an overarching theme with seven categories (regular group exercise, functional health, active mind, enjoyment, social connectedness, mutual support, and expanding communities). Although the participants perceived that they were aging physically and cognitively, the regular group exercise helped them to improve or maintain their functional health and enjoy their lives. They felt socially connected and experienced a sense of security in the community through caring for others and supporting each other. As the older adults began to seek value beyond individuals, they gradually expanded their communities beyond geographical and generational boundaries. Conclusions: The participants achieved balanced health in the physical, mental, and social domains through regular group exercise as part of a community-wide physical activity intervention and contributed to expanding communities through social connectedness and mutual support. Health promotion through physical activity is being increasingly emphasized. The study results can help to develop effective physical activity programs for older adults in the community.</p>

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