Sophia Smith

Overview:

Dr. Sophia Smith is an Associate Professor at the Duke School of Nursing and earned her PhD and MSW degrees at UNC-Chapel Hill School of Social Work. Her research explores ways to improve the quality of cancer care including post-treatment survivorship and palliative care with a primary focus on leveraging technology in delivering behavioral health interventions to the community. She is leading efforts to integrate clinical cancer care and research as a means to build the body of scientific evidence that forms the foundation of evidence-based practice through her leadership as Association of Oncology Social Work (AOSW) Research Director and membership on the National Comprehensive Cancer Network (NCCN) Survivorship Guidelines Panel and American Society of Clinical Oncology (ASCO) Survivorship Committee. Dr. Smith’s research has been funded by the National Institutes of Health, the American Cancer Society, NCCN, and Pfizer Grants for Independent Learning and Change.

Positions:

Associate Professor in the School of Nursing, with tenure

School of Nursing
School of Nursing

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Member in the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Education:

M.S.W. 2001

University of North Carolina - Chapel Hill

Ph.D. 2007

University of North Carolina - Chapel Hill

Grants:

Symptom Burden and Quality of Life in Multiple Myeloma Patients

Administered By
School of Nursing
Awarded By
American Cancer Society, Inc.
Role
Principal Investigator
Start Date
End Date

Pillars4Life: An Online Self-Management Curriculum for Cancer Survivors

Administered By
School of Nursing
Awarded By
Pfizer, Inc.
Role
Principal Investigator
Start Date
End Date

Advanced symptom burden and quality of life in multiple myeloma patients

Administered By
School of Nursing
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Advanced symptom burden and quality of life in multiple myeloma patients

Administered By
School of Nursing
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

Quality of Life and Impact of Cancer: Differences in Rural and Nonrural Non-Hodgkin's Lymphoma Survivors.

PURPOSE:People living in rural areas experience greater health disparities than their nonrural counterparts, but little is known about the association between rural status and quality of life (QOL) in non-Hodgkin's lymphoma (NHL) survivors. We compared self-reported quality of life and impact of cancer in rural and nonrural NHL survivors. METHODS:This study is a secondary analysis of 566 NHL cancer survivors recruited from cancer registries at 2 large academic medical centers in 1 state. Standardized measures collected information on demographics and clinical characteristics, quality of life (QOL; SF-36), and the Impact of Cancer (IOCv2). Rural residence was determined by Rural-Urban Commuting Area (RUCA) codes designated as nonmetropolitan. Multiple linear regression analysis, adjusted for demographic and clinical covariates, was used to evaluate the relationship between rural residence and QOL and impact of cancer. FINDINGS:Among the 566 participants (83% response rate), rural residence was independently associated with lower SF-36 physical component summary scores and the physical function subscale (all P < .05). Rural residence was also associated with higher IOCv2 positive impact scores and the subscales of altruism/empathy and meaning of cancer scores in the adjusted models (all P < .05). CONCLUSIONS:Given documented rural cancer disparities and the lack of resources in rural communities, study findings support the continued need to provide supportive care to rural cancer survivors to improve their QOL. Consistent with previous research, rural residence status is associated with increased positive impact following cancer diagnosis.
Authors
Noonan, D; LeBlanc, M; Conley, C; Benecha, H; Leak-Bryant, A; Peter, K; Zimmerman, S; Mayer, D; Smith, S
MLA Citation
Noonan, Devon, et al. “Quality of Life and Impact of Cancer: Differences in Rural and Nonrural Non-Hodgkin's Lymphoma Survivors.The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association, May 2020. Epmc, doi:10.1111/jrh.12420.
URI
https://scholars.duke.edu/individual/pub1444195
PMID
32472708
Source
epmc
Published In
The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
Published Date
DOI
10.1111/jrh.12420

Four Conversations: A Randomized Controlled Trial of an Online, Personalized Coping and Decision Aid for Metastatic Breast Cancer Patients.

Background: Anticipating and making health care decisions about appropriate or preferred treatment around end-of-life care are intellectually challenging and emotionally distressing for metastatic breast cancer (MBC) patients, new interventions are needed. Objective: This study examined the effect of Four Conversations, an online and personalized coping and decision aid curriculum, on the completion of advance care directives and shared decision making among patients and their loved ones, clinicians, and spirit. Design: Participants were randomized 1:1 to Four Conversations or wait-listed usual care conditions. Setting: Adult breast cancer survivors with metastatic disease were recruited nationally. Measurements: Electronic surveys collected self-reported demographic, clinical, and outcome data at baseline and four weeks postintervention. Results: Participants (N = 252) were mean age 53.6 ± 11.0 years; 100% female; 88% Caucasian; 67% married; and 33% employed. Over half (54%) of treatment arm participants without an advance directive completed one by study end, most (62%) felt that Four Conversations helped them quite a bit or a great deal in making a better decision, and 90% would recommend to others. Difference in the change in decisional conflict scores for treatment and control conditions was not significant (p = 0.07). Conclusions: These results suggest that Four Conversations facilitated the completion of advance care directives. Given that reductions in decisional conflict scores between the treatment and control arms were not significant, we cannot conclude that program use was associated with improved decisional conflict among MBC survivors. Online programs can be a feasible and effective alternative to in-person support.
Authors
Smith, SK; Westbrook, K; MacDermott, K; Amarasekara, S; LeBlanc, M; Pan, W
MLA Citation
Smith, Sophia K., et al. “Four Conversations: A Randomized Controlled Trial of an Online, Personalized Coping and Decision Aid for Metastatic Breast Cancer Patients.Journal of Palliative Medicine, vol. 23, no. 3, Mar. 2020, pp. 353–58. Epmc, doi:10.1089/jpm.2019.0234.
URI
https://scholars.duke.edu/individual/pub1416989
PMID
31638448
Source
epmc
Published In
Journal of Palliative Medicine
Volume
23
Published Date
Start Page
353
End Page
358
DOI
10.1089/jpm.2019.0234

How are patient-reported outcomes and symptoms being measured in adults with relapsed/refractory multiple myeloma? A systematic review.

PURPOSE: Patients with relapsed and/or refractory multiple myeloma (RRMM) are living longer due in part to changing treatment patterns. It is important to understand how changing treatment patterns affect patients' lives beyond extending survival. Research suggests that direct patient report is the best way to capture information on how patients feel and function in response to their disease and its treatment. Therefore, the purpose of this review is to summarize evidence of patients' experience collected through patient-reported outcomes (PRO) in RRMM patients, and to explore PRO reporting quality. METHODS: We conducted a systematic search to identify manuscripts reporting PROs in RRMM and summarized available evidence. We assessed PRO reporting quality using the Consolidated Standards of Reporting Trials (CONSORT) PRO Extension checklist. RESULTS: Our search resulted in 30 manuscripts. Thirteen unique PRO measures were used to assess 18 distinct PRO domains. Pain, fatigue, and emotional function were commonly assessed domains though reporting formats limited our ability to understand prevalence and severity of PRO challenges in RRMM. Evaluation of PRO reporting quality revealed significant reporting deficiencies. Several reporting criteria were included in less than 25% of manuscripts. CONCLUSIONS: Existing evidence provides a limited window for understanding the patient experience of RRMM and is further limited by suboptimal reporting quality. Observational studies are needed to describe prevalence, severity and patterns of PROs in RRMM overtime. Future studies that incorporate PROs would benefit from following existing guidelines to ensure that study evidence and conclusions can be fully assessed by readers, clinicians and policy makers.
Authors
MLA Citation
LeBlanc, Matthew R., et al. “How are patient-reported outcomes and symptoms being measured in adults with relapsed/refractory multiple myeloma? A systematic review.Qual Life Res, vol. 29, no. 6, June 2020, pp. 1419–31. Pubmed, doi:10.1007/s11136-019-02392-6.
URI
https://scholars.duke.edu/individual/pub1424091
PMID
31848847
Source
pubmed
Published In
Qual Life Res
Volume
29
Published Date
Start Page
1419
End Page
1431
DOI
10.1007/s11136-019-02392-6

Health-related quality of life among non-muscle-invasive bladder cancer survivors: a population-based study.

OBJECTIVE:To examine the effect of non-muscle-invasive bladder cancer (NMIBC) diagnosis and treatment on survivors' quality of life (QoL). PATIENTS AND METHODS:Of the 5979 patients with NMIBC diagnosed between 2010 and 2014 in North Carolina, 2000 patients were randomly selected to be invited to enroll in this cross-sectional study. Data were collected by postal mail survey. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core (QLQ-C30) and the NMIBC-specific module were included in the survey to measure QoL. Descriptive statistics, t-tests, anova, and Pearson's correlation were used to describe demographics and to assess how QoL varied by sex, cancer stage, time since diagnosis, and treatment. RESULTS:A total of 398 survivors returned questionnaires (response rate: 23.6%). The mean QoL score for QLQ-C30 (range 0-100, higher = better QoL in all domains but symptoms) for global health status was 73.6, function domain scores ranged from 83.9 to 86.5, and scores for the top five symptoms (insomnia, fatigue, dyspnoea, pain, and financial difficulties) ranged from 14.1 to 24.3. The lowest NMIBC-specific QoL domain was sexual issues including sexual function, enjoyment, problems, and intimacy. Women had worse bowel problems, sexual function, and sexual enjoyment than men but better sexual intimacy and fewer concerns about contaminating their partner. Stage Ta had the highest global health status, followed by T1 and Tis. QoL did not vary by time since diagnosis except for sexual function. The cystectomy group (n = 21) had worse QoL in sexual function, discomfort with sexual intimacy, sexual enjoyment, and male sexual problems than the non-cystectomy group (n = 336). CONCLUSION:Survivors of NMIBC face a unique burden associated with their diagnosis and the often-lifelong surveillance and treatment regimens. The finding has important implications for the design of tailored supportive care interventions to improve QoL for NMIBC survivors.
Authors
Jung, A; Nielsen, ME; Crandell, JL; Palmer, MH; Smith, SK; Bryant, AL; Mayer, DK
MLA Citation
Jung, Ahrang, et al. “Health-related quality of life among non-muscle-invasive bladder cancer survivors: a population-based study.Bju International, vol. 125, no. 1, Jan. 2020, pp. 38–48. Epmc, doi:10.1111/bju.14888.
URI
https://scholars.duke.edu/individual/pub1402591
PMID
31381249
Source
epmc
Published In
Bju International
Volume
125
Published Date
Start Page
38
End Page
48
DOI
10.1111/bju.14888

NCCN Guidelines Insights: Survivorship, Version 2.2019.

The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for consequences of cancer and cancer treatment to aid healthcare professionals who work with survivors of adult-onset cancer. Guidance is also provided to help promote physical activity, weight management, and proper immunizations in survivors and to facilitate care coordination to ensure that all needs are addressed. These NCCN Insights summarize some of the topics discussed by the NCCN Survivorship Panel during the 2019 update of the guidelines, including the survivorship population addressed, ways to improve care coordination, and pain management.
Authors
Sanft, T; Denlinger, CS; Armenian, S; Baker, KS; Broderick, G; Demark-Wahnefried, W; Friedman, DL; Goldman, M; Hudson, M; Khakpour, N; Koura, D; Lally, RM; Langbaum, TS; McDonough, AL; Melisko, M; Mooney, K; Moore, HCF; Moslehi, JJ; O'Connor, T; Overholser, L; Paskett, ED; Peterson, L; Pirl, W; Rodriguez, MA; Ruddy, KJ; Smith, S; Syrjala, KL; Tevaarwerk, A; Urba, SG; Zee, P; McMillian, NR; Freedman-Cass, DA
MLA Citation
Sanft, Tara, et al. “NCCN Guidelines Insights: Survivorship, Version 2.2019.Journal of the National Comprehensive Cancer Network : Jnccn, vol. 17, no. 7, July 2019, pp. 784–94. Epmc, doi:10.6004/jnccn.2019.0034.
URI
https://scholars.duke.edu/individual/pub1398212
PMID
31319383
Source
epmc
Published In
Jnccn Journal of the National Comprehensive Cancer Network
Volume
17
Published Date
Start Page
784
End Page
794
DOI
10.6004/jnccn.2019.0034

Research Areas:

Cancer
Cancer Survivors
Cancer--Patients
Palliative Care
Palliative treatment
Social Work
Technology--Information services
Telemedicine