Browsing by Person "Blyth, Christine"

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25. Upper limb morbidity after treatment for breast cancer: A cross-sectional study of lymphedema and function
(2012-11) Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Jack, Wilma; Chetty, Udi; Tan, Chee-Wee; Barber, Matthew; Breast Cancer Institute
Introduction: This study explored the prevalence of impaired upper limb function (ULF) and lymphoedema (LO) after breast cancer treatment, their relationships with each other, quality of life, and with patient/treatment characteristics.
A Morbidity Screening Tool for identifying fatigue, pain, upper limb dysfunction and lymphedema after breast cancer treatment: A validity study
(Elsevier, 2013-11-15) Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Jack, Wilma; Chetty, Udi; Barber, Matthew; Tan, Chee-Wee
Purpose: This study aimed to investigate validity of a newly developed Morbidity Screening Tool (MST) to screen for fatigue, pain, swelling (lymphedema) and arm function after breast cancer treatment. Methods: A cross-sectional study included women attending reviews after completing treatment (surgery, chemotherapy and radiotherapy), without recurrence, who could read English. They completed the MST and comparator questionnaires: Disability of the Arm, Shoulder and Hand questionnaire (DASH), Chronic Pain Grade Questionnaire (CPGQ), Lymphedema and Breast Cancer Questionnaire (LBCQ) and Functional Assessment of Cancer Therapy questionnaire with subscales for fatigue (FACT F) and breast cancer (FACT B + 4). Bilateral combined shoulder ranges of motion were compared (upward reach; hand behind back) and percentage upper limb volume difference (%LVD =/>10% diagnosed as lymphedema) measured with the vertical perometer (400T). Results: 613 of 617 participants completed questionnaires (mean age 62.3 years, SD 10.0; mean time since treatment 63.0 months, SD 46.6) and 417 completed objective testing. Morbidity prevalence was estimated as 35.8%, 21.9%, 19.8% and 34.4% for fatigue, impaired upper limb function, lymphedema and pain respectively. Comparing those self-reporting the presence or absence of each type of morbidity, statistically significant differences in comparator variables supported validity of the MST. Statistically significant correlations resulted between MST scores focussing on impact of morbidity, and comparator variables that reflect function and quality of life. Conclusion: Analysis supports the validity of all four short-forms of the MST as providing indications of both presence of morbidity and impacts on participants' lives. This may facilitate early and appropriate referral for intervention. 2013 Elsevier Ltd. All rights reserved.
A study of the effect on accuracy of the introduction of a bellyboard as an immobilisation device to the radical radiotherapy treatment of prostate cancer patients
(2012-09) McIlwraith, K. A.; Blyth, Christine
Ensuring reproducibility in any radiotherapy technique is vital to ensure that a geometric miss does not occur. Patient position and comfort play a major part in the reproducibility of setups. Purpose: To study the effect on accuracy of the introduction of a bellyboard to the existing prone technique used for radical radiotherapy treatment of prostate cancer. Materials and Methods: Thirty patients were treated using the bellyboard in the standard method. Portal images were compared with those of a control group of patients who had treatment with no rigid immobilisation. Patients in both groups were males with prostate cancer, who underwent radical radiotherapy treatment. Images were analysed using anatomy matching, and deviations from the isocentre were noted. Results: Statistical analysis of the results showed no statistical significance between the groups, though within the control group there were more deviations over 0.5 cm from the isocentre position than in the bellyboard group. Conclusions: Introduction of the bellyboard was seen to be equivalent to the use of the control technique. When the deviations from isocentre position were evaluated for each group, the control group had more deviations over 0.5 cm than the bellyboard group. 2011 Cambridge University Press.
Assessment of set-up discrepancies using daily portal imaging during radiotherapy treatment for patients with spine and bone metastases
(Cambridge Journals, 2012-12) Young, L.; Blyth, Christine
It is well established that patients with bone metastases get good pain relief from radiotherapy. The aim of treatment is to achieve maximum pain relief with minimum morbidity. Accuracy and reproducibility of the patient's position are fundamental to the successful delivery of radiation therapy. It has been recognised for many years, that the accuracy of patient positioning will improve the success of radiation treatment. A previous study carried out in the department showed that the use of only a single tattoo for the set-up of palliative patients resulted in poor accuracy. The aim of this study was to assess if the addition of extra skin marks improved the set-up accuracy of palliative patients being treated for spine and bone metastases. A protocol was implemented detailing the extra skin marks to be used. Daily portal images were acquired and analysed retrospectively using anatomy matching. The results obtained were then compared with those of the previous study. The use of extra skin marks resulted in a total of 45% of images within 5 mm tolerance compared with 36% of images in patients treated with a single centre tattoo. Also, the number of images with deviations greater than 15 mm was reduced by more than 50% with the addition of extra skin marks. This study has shown that extra skin marks do increase the set-up accuracy in palliative patients treated for spine and bone metastases. Therefore, the practice of using extra skin marks has become standard protocol for all palliative patients within the department.
Comparison of breast cancer-related lymphedema (Upper Limb Swelling) prevalence estimated using objective and subjective criteria and relationship with quality of life
(Hindawi, 2013-05) Bulley, Catherine; Gaal, S.; Coutts, Fiona; Blyth, Christine; Jack, W.; Chetty, U.; Barber, M.; Tan, Chee-Wee
This study aimed to investigate lymphedema prevalence using three different measurement/diagnostic criterion combinations and explore the relationship between lymphedema and quality of life for each, to provide evaluation of rehabilitation. Cross-sectional data from 617 women attending review appointments after completing surgery, chemotherapy, and radiotherapy included the Morbidity Screening Tool (MST; criterion: yes to lymphedema); Lymphedema and Breast Cancer Questionnaire (LBCQ; criterion: yes to heaviness and/or swelling); percentage limb volume difference (perometer: %LVD; criterion: 10%+ difference); and the Functional Assessment of Cancer Therapy breast cancer-specific quality of life tool (FACT B+4). Perometry measurements were conducted in a clinic room. Between 341 and 577 participants provided sufficient data for each analysis, with mean age varying from 60 to 62 (SD 9.95-10.03) and median months after treatment from 49 to 51. Lymphedema prevalence varied from 26.2% for perometry %LVD to 20.5% for the MST and 23.9% for the LBCQ; differences were not significant. Limits of agreement analysis between %LVD and the subjective measures showed little consistency, while moderate consistency resulted between the subjective measures. Quality of life differed significantly for women with and without lymphedema only when subjective measurements were used. Results suggest that subjective and objective tools investigate different aspects of lymphedema. 2013 Catherine Bulley et al.
Covert observation to find if patient hospital clothing saves radiotherapy treatment room time, and the issue of a questionnaire to find if this is detrimental to patients' experience of radiotherapy
(Cambridge Journals, 2013-12) Farnan, M.; Blyth, Christine
Background Radiotherapy departments are having to work more efficiently to cope with increasing demand for radiotherapy resources. Radiotherapy treatment room efficiency may be increased by the introduction of hospital clothing as this negates the need for patient changing in the treatment room. However, studies have shown that hospital clothing can have a negative effect on patient dignity. It is therefore important to balance potential time saving with any detriment to patients. Purpose This study examined the effect that hospital clothing had on the time patients spend in the treatment room and aimed to identify patients' opinions of the clothing. Materials and methods Potential time saving was determined by covertly timing patients currently undergoing radiotherapy treatment as they entered and exited the treatment room. A total of 348 patients were timed in their own clothing and 341 were timed when they wore hospital clothing. The timings of these two groups were compared to determine whether hospital clothing saved treatment unit time. Patient opinions of the clothing were examined by issuing a short questionnaire, designed to gather ordinal data, at the end of their course of treatment. Questionnaires were issued only to patients who had worn hospital clothing in the radiotherapy department. Results Introducing hospital clothing saved a significant amount of treatment room time and patients were generally positive about wearing the clothing. Conclusion It is suggested that hospital clothing is a welcome addition to the radiotherapy department to increase efficiency without detriment to patients. Copyright Cambridge University Press 2013.
Diabetic peripheral neuropathy, is it an autoimmune disease?
(2015-09-16) Janahi, Noor M.; Santos, Derek; Blyth, Christine; Bakhiet, Moiz; Ellis, Mairghread JH
Background: Autoimmunity has been identified in a significant number of neuropathies, such as, proximal neuropathies, and autonomic neuropathies associated with diabetes mellitus. However, possible correlations between diabetic peripheral neuropathy and autoimmunity have not yet been fully investigated. Objectives: This study was conducted to investigate whether autoimmunity is associated with the pathogenesis of human diabetic peripheral neuropathy. Research design and methods: A case-control analysis included three groups: 30 patients with diabetic peripheral neuropathy, 30 diabetic control patients without neuropathy, and 30 healthy controls. Blood analysis was conducted to compare the percentages of positive antinuclear antibodies (ANA) between the three groups. Secondary analysis investigated the correlations between the presence of autoimmune antibodies and sample demographics and neurological manifestations. This research was considered as a pilot study encouraging further investigations to take place in the near future. Results: Antinuclear antibodies were significantly present in the blood serum of patients with diabetic peripheral neuropathy in comparison to the control groups (p<. 0.001). The odds of positive values of ANA in the neuropathy group were 50 times higher when compared to control groups. Secondary analysis showed a significant correlation between the presence of ANA and the neurological manifestation of neuropathy (Neuropathy symptom score, Neuropathy disability score and Vibration Perception Threshold). Conclusion: The study demonstrated for the first time that human peripheral diabetic neuropathy may have an autoimmune aetiology. The new pathogenic factors may lead to the consideration of new management plans involving new therapeutic approaches and disease markers. 2015 Elsevier B.V.
Enhancing student engagement and learning through programme redesign: experiences from undergraduate and post graduate radiography programmes at Queen Margaret University, Edinburgh
(TESEP, 2007) Meikle, D.; Blyth, Christine; Cockbain, Margaret; Morss, K.; Bovill, C.; Peacock, Susi
Patients' experiences of post radiotherapy skin reactions
(2009) Ellis, Mairghread JH; Blyth, Christine; Boyle, Louise; Dunphy, Michelle; Hornsby, C.; Fletcher, J.
Prevalence and impacts of upper limb morbidity after treatment for breast cancer: a cross-sectional study of lymphedema and function.
(2013) Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Jack, W.; Chetty, U.; Barber, M.; Tan, Chee-Wee; Breast Cancer Institute
A cross-sectional study screened lymphedema, impaired upper limb function (ULF) and quality of life (QOL) in women post-breast cancer. Women attending review appointments who had completed surgery, chemotherapy and radiotherapy, were without recurrence, and could complete questionnaires in English were invited. Medical records were reviewed and questionnaires completed: the Morbidity Screening Tool (MST), Disability of the Arm, Shoulder and Hand questionnaire (DASH), and Functional Assessment of Cancer Therapy for breast cancer QOL questionnaire (FACTB+4). The vertical perometer (400T) measured percentage upper limb volume difference (%LVD), with 10% or greater difference diagnosed as lymphedema. Of 617 participants (mean age 62.3y, SD 10.0; mean time since treatment 63.0 months, SD 46.6), sufficient questionnaire data were available for 613 and perometry data for 417. Using the MST, 21.9% self-reported impaired ULF, 19.8% lymphedema, and 9.2% both. Based on %LVD, 26.5% had lymphedema. Histogram analysis for individuals in the first eight twelve-month intervals after treatment found impaired ULF prevalence peaked at three to five years and lymphedema at three years. Significantly worse function (DASH) and QOL (FACT B+4) resulted for those with morbidity (p<0.000). This provides evidence that impaired ULF and lymphedema negatively affect QOL years after treatment and are not necessarily linked.
Screening for morbidity following breast cancer
(Wounds UK, 2012-12) Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Tan, Chee-Wee; Hamilton, L.; Jack, W.; Chetty, U.
Background: A screening tool was developed to identify morbidity emerging in the years after breast cancer treatment. Aims: This project aimed to investigate patient responses to a newly developed screening tool for lymphoedema, reduced arm function, fatigue and pain. Methods: Interviews were conducted following completion of the screening tool by 40 women attending review appointments post-treatment for breast cancer (86% response rate). Questions addressed ease of completion and administration. Results: On average, participants were 5.8 years post-treatment (1-28) and 64 years of age (38-79). It took eight to 20 minutes to complete the screening tool, with five participants needing assistance. Ninety-eight per cent of participants generally understood the instructions and 76% were able to answer all questions. There was some confusion about unfamiliar terminology (i.e. 'the axilla') and a question was raised relating to experiences of pain (people had difficulty differentiating pain relating to breast cancer and other conditions). Twenty per cent of respondents would prefer to receive the questionnaire by post, with 41% preferring paper to electronic completion. Conclusions: With minor modifications and further pilot testing of validity and reliability, this screening tool has the potential to enable rapid identification of morbidity, enabling appropriate action to be taken as well as facilitating service planning. Declaration of interest: None.