1
|
Aker FZ, Karazeybek E. Relationship between perceived social support and stoma self-efficacy in permanent colostomy patients: A correlational study. J Eval Clin Pract 2024. [PMID: 39099203 DOI: 10.1111/jep.14117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024]
Abstract
AIM In the context of adjusting to life with a permanent colostomy, this study explored how perceived social support from family, friends and others influences patients' self-efficacy in managing their stoma and engaging with their social lives. METHODS The study employed a descriptive, correlational design to investigate the relationship between social support and self-efficacy in 94 colostomy patients between April 2021 and August 2022. Participants completed the Descriptive Characteristics Form, Multidimensional Scale of Perceived Social Support (MSPSS), and stoma self-efficacy scale (SSES). Descriptive statistics were used to summarise the data, and one-way ANOVA with Tukey HSD post-hoc test examined group differences. Pearson correlation assessed the relationship between age, social support and self-efficacy, while multiple linear regression identified factors independently associated with self-efficacy level. RESULTS The participants had a mean age of 56.9 ± 14.34 years, and 37.2% had been suffering from stoma complications for a duration ranging from 13 months to 5 years. The mean total score on the MSPSS was 64.3 ± 13.5, whereas the mean total score on the SSES stood at 71.22 ± 20.21. A moderate positive correlation (r = 0.419, p < 0.001) was observed between the total scores from the MSPSS and SSES. The increase in the total score on the MSPSS was a significant predictor (β = 0.293, p = 0.001) of the level of stoma self-efficacy, explaining 48.9% of the variance. CONCLUSION Stronger perceived social support was linked to higher stoma self-efficacy in permanent colostomy patients.
Collapse
|
2
|
Brissette V, Monton O, Demian M, Al Busaidi N, Moon J, Sabboobeh S, Vasilevsky CA, Rajabiyazdi F, Boutros M. Exploring patients' needs and expectations for information on sexual dysfunction after rectal cancer treatment: A qualitative study. Colorectal Dis 2024; 26:1535-1543. [PMID: 38890007 DOI: 10.1111/codi.17048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/25/2024] [Accepted: 05/15/2024] [Indexed: 06/20/2024]
Abstract
AIM Sexual dysfunction is an important, and often overlooked, sequela of rectal cancer treatment with significant implications for patients' quality of life. The aim of this study was to explore patients' information needs regarding sexual health after rectal cancer treatment and their experiences accessing information on sexual dysfunction throughout the cancer care continuum. The secondary aim was to explore surgeons' perspectives on patients' information needs and gain insight into their experiences providing information on sexual health following rectal cancer surgery. METHOD A qualitative study was conducted using semistructured interviews with 10 rectal cancer survivors and six colorectal surgeons from a Canadian tertiary care institution. Transcribed interviews were coded independently by two researchers and thematic analysis was performed. RESULTS Analysis of patient interviews revealed that patients had limited knowledge of sexual dysfunction symptoms following rectal cancer treatment and received inadequate information on sexual dysfunction from their treating medical team. Patients expressed the desire to receive information on sexual dysfunction in different formats, especially before the start of treatment. The surgeon interviews revealed that colorectal surgeons faced challenges when informing patients about sexual dysfunction. Surgeons did not routinely provide information on sexual dysfunction to all patients; however, they felt that patients should receive high-quality information on sexual dysfunction, both before and after treatment. CONCLUSION Patients' information needs related to sexual dysfunction after rectal cancer treatment were inadequately met. High-quality informational resources are needed to facilitate communication between patients and physicians and improve patients' understanding of sexual dysfunction.
Collapse
Affiliation(s)
- Vincent Brissette
- Department of Medicine (Neurology), University of Ottawa, Ottawa, Ontario, Canada
| | - Olivia Monton
- Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Marie Demian
- Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Nasra Al Busaidi
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeongyoon Moon
- Department of Surgery, Division of General Surgery, McGill University, Montreal, Quebec, Canada
| | - Sarah Sabboobeh
- Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Fateme Rajabiyazdi
- Department of Systems and Computer Engineering, Carleton University, Ottawa, Ontario, Canada
| | - Marylise Boutros
- Department of Surgery, McGill University, Montreal, Quebec, Canada
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
| |
Collapse
|
3
|
Bozkul G, Senol Celik S, Nur Arslan H. Nursing interventions for the self-efficacy of ostomy patients: A systematic review. J Tissue Viability 2024; 33:165-173. [PMID: 38627154 DOI: 10.1016/j.jtv.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/01/2024] [Accepted: 04/04/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Self-efficacy interventions, which include the acquisition of skills that enable patients to manage their health on a daily basis, play a key role in ostomy patients, which leads to significant changes in the quality of life of patients. In this context, nursing interventions to increase self-efficacy of ostomy patients are very important. In this context, nursing interventions are crucial to increase the self-efficacy of ostomy patients. OBJECTIVES The aim of this systematic review is to describe nursing interventions for ostomy patients' self-efficacy (primary outcome) and the impact of these interventions on patient outcomes (complications, quality of life, satisfaction, psychological resilience, stoma adaptation) (secondary outcomes). METHOD As a systematic review, this study included articles published in PUBMED, Web of Science, Science-Direct, TUBITAK-ULAKBIM, and TRDizin databases between January 2013 and January 2023 that included nursing interventions for self-efficacy ostomy patients. This systematic review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The risk of bias was assessed using the RoB2 tool developed by Cochrane. RESULTS A total of 1211 articles were retrieved from the databases using Turkish and English keywords. Fifteen studies met the study criteria. These studies found that various interventions, such as training, telephone follow-up, psychosocial support groups, or mobile applications provided to intervention groups, increased self-efficacy, decreased stoma-related complications, improved stoma adaptation, and improved quality of life by increasing patients' knowledge and awareness of stoma. CONCLUSION Nursing interventions to improve the self-efficacy and adaptation of ostomy patients are critical. This improvement leads to a reduction in adverse patient outcomes and ostomy complications, shorter hospital stays, and increased patient and nurse satisfaction.
Collapse
Affiliation(s)
- Gamze Bozkul
- Tarsus University, Faculty of Health Sciences, Nursing Department, Turkey.
| | | | | |
Collapse
|
4
|
Xavier SSDM, de Medeiros LP, de Lima Neto AV, da Silva IP, Lucena SKP, Oliveira ACDS, Araújo RDO, Costa IKF. Sociodemographic and clinical characteristics of people with ostomy and the adaptive domains of Roy's theory: A cross-sectional study. PLoS One 2024; 19:e0302036. [PMID: 38635597 PMCID: PMC11025736 DOI: 10.1371/journal.pone.0302036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/27/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION The adaptation of people with ostomies may be associated with and affected by sociodemographic and clinical factors. The present study aimed to investigate the association between the sociodemographic and clinical characteristics and the adaptation of people with an intestinal stoma. METHOD An analytical study, carried out through an interview with 200 patients with ostomy for five months. For that, it was applied to scale for the level of adaptation of ostomy patients to measure the physiological domains, self-concept, role function and interdependence and a questionnaire was used in which sociodemographic and clinical information. Descriptive and multivariate analyses were performed to test the study hypothesis. RESULTS The study pointed out statistically significant associations with male sex, age group below 60, low education level, Stoma time less than one year, below one minimum wage, temporary permanence criteria and presence of complications relation to low scores of adaptation. CONCLUSIONS The association of sociodemographic and clinical factors with the measured adaptive modes provides important information for the planning of nursing care and other care providers, since it directs actions to the aspects that give greater adaptive difficulty to people with stomas and which are the focus of care nursing to this clientele.
Collapse
|
5
|
Krouse RS, Zhang S, Wendel CS, Sun V, Grant M, Ercolano E, Hornbrook MC, Cidav Z, Nehemiah A, Rock M, Appel S, Hibbard JH, Holcomb MJ. A randomized prospective trial of an ostomy telehealth intervention for cancer survivors. Cancer 2024; 130:618-635. [PMID: 37905783 DOI: 10.1002/cncr.35091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Cancer survivors with ostomies face complex challenges. This study compared the Ostomy Self-Management Telehealth program (OSMT) versus attention control usual care (UC). METHODS Three academic centers randomized participants. OSMT group sessions were led by ostomy nurses and peer ostomates (three for ostomates-only, one for support persons, and one review session for both). Surveys at baseline, OSMT completion, and 6 months were primary outcome patient activation (PAM), self-efficacy (SE), City of Hope quality of life-Ostomy (COH-O), and Hospital Anxiety and Depression Scale (HADS). Surveys were scored per guidelines for those completing at least two surveys. Linear mixed effects models were used to select potential covariates for the final model and to test the impact of OSMT within each timeframe. RESULTS A total of 90 OSMT and 101 UC fulfilled analysis criteria. Arms were well-matched but types of tumors were unevenly distributed (p = .023). The OSMT arm had a nonsignificant improvement in PAM (confidence interval [CI], -3.65 to 5.3]; 4.0 vs. 2.9) at 6 months. There were no significant differences in other surveys. There was a significant OSMT benefit for urinary tumors (four SE domains). Higher OSMT session attendance was associated with post-session improvements in five SE domains (p < .05), two COH-O domains (p < .05), and HADS anxiety (p = .01). At 6 months, there remained improvements in one SE domain (p < .05), one COH-O domain (p < .05), and HADS anxiety (p < .01). CONCLUSIONS No clear benefit was seen for the OSMT intervention, although there may be an advantage based on type of tumor. Benefit with greater session attendance was also encouraging. PLAIN LANGUAGE SUMMARY Cancer patients with ostomies have many challenges. We tested a telehealth curriculum compared to usual care. There are indications of benefit for the program for those that attend more sessions and those with urostomies.
Collapse
Affiliation(s)
- Robert S Krouse
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Siqi Zhang
- Biostatistics Analysis Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA
| | - Marcia Grant
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA
| | | | - Mark C Hornbrook
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | - Zuleyha Cidav
- Center for Mental Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ariel Nehemiah
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Matthew Rock
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Scott Appel
- Biostatistics Analysis Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Judith H Hibbard
- Department of Planning, Public Policy & Management, University of Oregon, Eugene, Oregon, USA
| | - Michael J Holcomb
- Arizona Telemedicine Program, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
6
|
Lazenby BS, Guidry A, Donovan EE, Dailey R, Ivatury SJ. 'That gave me a lot of comfort, that he would ask my opinion about how we wanted to talk about this': A qualitative analysis of clinical communication experiences of ostomy patients. BMJ Open 2024; 14:e079362. [PMID: 38326256 PMCID: PMC10859983 DOI: 10.1136/bmjopen-2023-079362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES The purpose of this study was to investigate the communication challenges and successes that people with ostomies experienced during their healthcare encounters. DESIGN We conducted semistructured interviews of people with ostomies. Interviews focused on important social situations and health communication strategies for managing these situations. We transcribed interviews and coded them to create themes. PARTICIPANTS Participants were eligible to participate if they were above the age of 18 and have had an ostomy for at least a year. 27 people participated in the study. SETTING The study was conducted in a university setting. RESULTS Interviews with ostomates surfaced several themes related to ostomate needs. Participants benefited from communication that was open, thorough and had a positive outlook on ostomies. Participants found patient-clinician communication to be challenging when there was a lack of knowledge surrounding ostomy care, communication was unclear or inadequate, and when clinicians had a negative outlook on ostomies. CONCLUSIONS Findings from this project are intended to amplify existing patient and clinician education materials and to inform the creation of a communication guide specifically for the ostomy context.
Collapse
Affiliation(s)
- Braidyn S Lazenby
- Department of Communication Studies, The University of Texas at Austin, Austin, Texas, USA
| | - Ashley Guidry
- Department of Communication Studies, The University of Texas at Austin, Austin, Texas, USA
| | - Erin E Donovan
- Department of Communication Studies, The University of Texas at Austin, Austin, Texas, USA
| | - René Dailey
- Department of Communication Studies, The University of Texas at Austin, Austin, Texas, USA
| | - Srinivas Joga Ivatury
- Department of Surgery and Perioperative Care, The University of Texas at Austin, Austin, Texas, USA
| |
Collapse
|
7
|
Xu J, Hoover RL, Woodard N, Leeman J, Hirschey R. A Systematic Review of Dietary Interventions for Cancer Survivors and Their Families or Caregivers. Nutrients 2023; 16:56. [PMID: 38201886 PMCID: PMC10780967 DOI: 10.3390/nu16010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Family or caregiver engagement has the potential to support healthy dietary changes among cancer survivors. However, little is known about these family- or caregiver-involved dietary interventions and their effects. This systematic review aimed to identify the behavior change techniques (BCTs) used in dietary interventions for cancer survivors and their families or caregivers and to synthesize intervention effects on dietary and health outcomes. Following the PRISMA guidelines, we conducted systematic searches in three databases and identified 12 trials (16 peer-reviewed manuscripts) for inclusion in this review. Data were extracted from these manuscripts and the BCT taxonomy was used to identify the BCTs. A total of 38 BCTs were identified from 12 trials, 13 of which were used in at least half of the 12 trials. Ten studies reported significant intervention effects on health outcomes (e.g., adiposity) and six suggested significant improvements in dietary behaviors (e.g., fruit and vegetable intake). Overall, this review found that family- or caregiver-involved interventions for cancer survivors significantly improved dietary and health outcomes. Future research should identify BCTs particularly for dietary changes and develop effective dyadic strategies to facilitate diet-related interactions between survivors and their families or caregivers to enhance their engagement in healthy diets.
Collapse
Affiliation(s)
- Jingle Xu
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
| | - Rebecca L. Hoover
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
| | - Nathaniel Woodard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
| | - Jennifer Leeman
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
| |
Collapse
|
8
|
Rimmer B, Brown MC, Sotire T, Beyer F, Bolnykh I, Balla M, Richmond C, Dutton L, Williams S, Araújo-Soares V, Finch T, Gallagher P, Lewis J, Burns R, Sharp L. Characteristics and Components of Self-Management Interventions for Improving Quality of Life in Cancer Survivors: A Systematic Review. Cancers (Basel) 2023; 16:14. [PMID: 38201442 PMCID: PMC10777971 DOI: 10.3390/cancers16010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024] Open
Abstract
Self-management can improve clinical and psychosocial outcomes in cancer survivors. Which intervention characteristics and components are beneficial is unclear, hindering implementation into practice. We systematically searched six databases from inception to 17 November 2021 for studies evaluating self-management interventions for adult cancer survivors post-treatment. Independent reviewers screened for eligibility. Data extraction included population and study characteristics, intervention characteristics (TIDieR) and components (PRISMS), (associations with) quality of life (QoL), self-efficacy, and economic outcomes. Study quality was appraised, and narrative synthesis was conducted. We identified 53 papers reporting 32 interventions. Studies had varying quality. They were most often randomised controlled trials (n = 20), targeted at survivors of breast (n = 10), prostate (n = 7), or mixed cancers (n = 11). Intervention characteristics (e.g., provider, location) varied considerably. On average, five (range 1-10) self-management components were delivered, mostly "Information about condition and its management" (n = 26). Twenty-two studies reported significant QoL improvements (6 also reported significant self-efficacy improvements); these were associated most consistently with combined individual and group delivery. Economic evaluations were limited and inconclusive. Self-management interventions showed promise for improving QoL, but study quality was variable, with substantial heterogeneity in intervention characteristics and components. By identifying what to adapt from existing interventions, these findings can inform development and implementation of self-management interventions in cancer.
Collapse
Affiliation(s)
- Ben Rimmer
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Morven C. Brown
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Tumi Sotire
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Fiona Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Iakov Bolnykh
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Catherine Richmond
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Lizzie Dutton
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Sophie Williams
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
| | - Vera Araújo-Soares
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
- Centre for Preventive Medicine and Digital Health, Department for Prevention, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Pamela Gallagher
- School of Psychology, Dublin City University, D09 N920 Dublin, Ireland
| | - Joanne Lewis
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, F91 YW50 Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, F91 YW50 Sligo, Ireland
| | - Linda Sharp
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| |
Collapse
|
9
|
Ercolano E, Grant M, Sun V, Tallman N, Mo J, Pitcher P, Hornbrook MC, Yonsetto P, Bojorquez O, Raza S, McCorkle R, Krouse RS. Self-management goals of cancer survivors with an ostomy. J Cancer Surviv 2023; 17:1480-1487. [PMID: 35522352 DOI: 10.1007/s11764-022-01164-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 01/07/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Ostomies due to cancer surgery impose complex and enduring care challenges that necessitate cancer survivors" self-management. The objective of this analysis is to evaluate ostomates' self- management goals using a qualitative approach. METHODS A multi-site randomized controlled trial testing the Ostomy Self-Management Training program (OSMT) was delivered via telehealth to a group of cancer survivors with an ostomy randomized to either the OSMT program with goal setting or usual care (UC), without goal setting. Goals were classified by type and frequency according to a modified City of Hope Health-Related Quality of Life framework (physical, psychological, social, spiritual, ostomy-specific, and healthcare quality domains), using a directed and systematic content analysis approach. RESULTS The 524 self-management goals analyzed by domain frequencies physical (29.4%), ostomy specific (29.0%) and social well-being (25.0%) were predominant. Managing other health issues (7.6%), psychological issues (6.0%), and spiritual well-being issues (3.0%) were next. Common self-management themes were ostomy care independence (87.5%), handling cancer-related issues (62.5%), achieving acceptance (56.2%), resuming physical activity (43.0%), and maintaining fluid/diet balance (43.0%). DISCUSSION/CONCLUSION Goal-setting offers insights into self-management concerns of cancer survivors with ostomies. Results demonstrate the broad aspects of self-management ostomates face. PRACTICE IMPLICATIONS Self-management training with patient goal-setting may be used to help ostomates with cancer and their health care providers identify areas for needed education and support.
Collapse
Affiliation(s)
| | - Marcia Grant
- Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Virginia Sun
- Department of Population Sciences, City of Hope, Duarte, CA, USA
- Department of Surgery, City of Hope, Duarte, CA, USA
| | - Nancy Tallman
- Unaffiliated, Wound, Ostomy, and Continence Nurse, Tucson, AZ, USA
| | - Julia Mo
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Peter Yonsetto
- Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA
| | | | - Sabreen Raza
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | |
Collapse
|
10
|
Olivia M, Allister S, Jeongyoon M, Marie D, Richard G, Carol-Ann V, Fateme R, Marylise B. An online educational and supportive care application for rectal cancer survivors with low anterior resection syndrome: A mixed methods pilot study. Colorectal Dis 2023; 25:1812-1820. [PMID: 37501348 DOI: 10.1111/codi.16665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/19/2023] [Accepted: 04/30/2023] [Indexed: 07/29/2023]
Abstract
AIM Restorative proctectomy is commonly associated with significant bowel dysfunction, known as low anterior resection syndrome (LARS), which has a negative impact on patients' quality of life. We developed an online patient-centred application on LARS (eLARS) for rectal cancer survivors. The primary objective of this study was to assess the feasibility of eLARS for rectal cancer survivors with LARS following restorative proctectomy. The secondary objective was to explore participants' experiences with LARS and the eLARS application. METHODS This was a mixed methods study, which included a feasibility and qualitative analysis. Participants were rectal cancer survivors who underwent restorative proctectomy for rectal cancer within 3 years, completed all adjuvant treatment, and suffered from bowel dysfunction postoperatively. Participants were given access to the application over a 2-month study period. Feasibility was defined as 75% of study participants using the application ≥4 times per month. Semi-structured interviews were conducted with participants after the study period and were analysed using thematic analysis. RESULTS Our sample included eight rectal cancer survivors, five women and three men. The median age was 58.5 years (56.5-64.5). Most participants (75%) were >1-year post-restorative proctectomy. 75% of study participants used the application ≥4 times per month for 2 months. Our thematic analysis revealed that participants felt that they lacked access to credible information and emotional support around the time of ileostomy closure, and found that eLARS addressed these challenges. CONCLUSION eLARS is a feasible educational and supportive care intervention for patients with LARS and has the potential to improve patients' quality of life.
Collapse
Affiliation(s)
- Monton Olivia
- Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Smith Allister
- Department of Emergency Medicine, Western University, London, Ontario, Canada
| | - Moon Jeongyoon
- Department of Surgery, Division of General Surgery, McGill University, Montreal, Quebec, Canada
| | - Demian Marie
- Department of Surgery, Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Garfinkle Richard
- Department of Surgery, Division of General Surgery, McGill University, Montreal, Quebec, Canada
| | - Vasilevsky Carol-Ann
- Department of Surgery, Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Rajabiyazdi Fateme
- Department of Systems and Computer Engineering, Carleton University, Ottawa, Ontario, Canada
| | - Boutros Marylise
- Department of Surgery, Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| |
Collapse
|
11
|
Xu S, Tan X, Ma C, McElyea RS, Shieh K, Stover AM, Smith A, Stitzenberg K, Basch E, Song L. An eHealth symptom and complication management program for cancer patients with newly created ostomies and their caregivers (Alliance): a pilot feasibility randomized trial. BMC Cancer 2023; 23:532. [PMID: 37301841 PMCID: PMC10257159 DOI: 10.1186/s12885-023-10919-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/04/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Cancer patients with newly created ostomies face complications that reduce quality of life (QOL) and increase morbidity and mortality. This proof-of-concept study examined the feasibility, usability, acceptability, and initial efficacy of an eHealth program titled the "Patient Reported Outcomes-Informed Symptom Management System" (PRISMS) during post-ostomy creation care transition. METHODS We conducted a 2-arm pilot randomized controlled trial among 23 patients who received surgical treatment with curative intent for bladder and colorectal cancer and their caregivers. After assessing QOL, general symptoms, and caregiver burden at baseline, participants were randomly assigned to PRISMS (n = 16 dyads) or usual care (UC) (n = 7 dyads). After a 60-day intervention period, participants completed a follow-up survey and post-exit interview. We used descriptive statistics and t-tests to analyze the data. RESULTS We achieved an 86.21% recruitment rate and a 73.91% retention rate. Among the PRISMS participants who used the system and biometric devices (n = 14, 87.50%), 46.43% used the devices for ≥ 50 days during the study period. Participants reported PRISMS as useful and acceptable. Compared to their UC counterparts, PRISMS patient social well-being scores decreased over time and had an increased trend of physical and emotional well-being; PRISMS caregivers experienced a greater decrease in caregiver burden. CONCLUSIONS PRISMS recruitment and retention rates were comparable to existing family-based intervention studies. PRISMS is a useful and acceptable multilevel intervention with the potential to improve the health outcomes of cancer patients needing ostomy care and their caregivers during post-surgery care transition. A sufficiently powered RCT is needed to test its effects. TRIAL REGISTRATION ClinicalTrial.gov ID: NCT04492007. Registration date: 30/07/2020.
Collapse
Affiliation(s)
- Shenmeng Xu
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Xianming Tan
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Chunxuan Ma
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rebecca S McElyea
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Karl Shieh
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Angela M Stover
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA
| | - Angela Smith
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- School of Medicine, UNC-CH, Chapel Hill, NC, USA
| | - Karyn Stitzenberg
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- School of Medicine, UNC-CH, Chapel Hill, NC, USA
| | - Ethan Basch
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- School of Medicine, UNC-CH, Chapel Hill, NC, USA
| | - Lixin Song
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA.
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
| |
Collapse
|
12
|
Kovoor JG, Jacobsen JHW, Stretton B, Bacchi S, Gupta AK, Claridge B, Steen MV, Bhanushali A, Bartholomeusz L, Edwards S, Asokan GP, Asokan G, McGee A, Ovenden CD, Hewitt JN, Trochsler MI, Padbury RT, Perry SW, Wong ML, Licinio J, Maddern GJ, Hewett PJ. Depression after stoma surgery: a systematic review and meta-analysis. BMC Psychiatry 2023; 23:352. [PMID: 37217917 DOI: 10.1186/s12888-023-04871-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/15/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Depression is the leading cause of global disability and can develop following the change in body image and functional capacity associated with stoma surgery. However, reported prevalence across the literature is unknown. Accordingly, we performed a systematic review and meta-analysis aiming to characterise depressive symptoms after stoma surgery and potential predictive factors. METHODS PubMed/MEDLINE, Embase, CINAHL and Cochrane Library were searched from respective database inception to 6 March 2023 for studies reporting rates of depressive symptoms after stoma surgery. Risk of bias was assessed using the Downs and Black checklist for non-randomised studies of interventions (NRSIs), and Cochrane RoB2 tool for randomised controlled trials (RCTs). Meta-analysis incorporated meta-regressions and a random-effects model. REGISTRATION PROSPERO, CRD42021262345. RESULTS From 5,742 records, 68 studies were included. According to Downs and Black checklist, the 65 NRSIs were of low to moderate methodological quality. According to Cochrane RoB2, the three RCTs ranged from low risk of bias to some concerns of bias. Thirty-eight studies reported rates of depressive symptoms after stoma surgery as a proportion of the respective study populations, and from these, the median rate across all timepoints was 42.9% 42.9% (IQR: 24.2-58.9%). Pooled scores for respective validated depression measures (Hospital Anxiety and Depression Score (HADS), Beck Depression Inventory (BDI), and Patient Health Questionnaire-9 (PHQ-9)) across studies reporting those scores were below clinical thresholds for major depressive disorder according to severity criteria of the respective scores. In the three studies that used the HADS to compare non-stoma versus stoma surgical populations, depressive symptoms were 58% less frequent in non-stoma populations. Region (Asia-Pacific; Europe; Middle East/Africa; North America) was significantly associated with postoperative depressive symptoms (p = 0.002), whereas age (p = 0.592) and sex (p = 0.069) were not. CONCLUSIONS Depressive symptoms occur in almost half of stoma surgery patients, which is higher than the general population, and many inflammatory bowel disease and colorectal cancer populations outlined in the literature. However, validated measures suggest this is mostly at a level of clinical severity below major depressive disorder. Stoma patient outcomes and postoperative psychosocial adjustment may be enhanced by increased psychological evaluation and care in the perioperative period.
Collapse
Affiliation(s)
- Joshua G Kovoor
- University of Adelaide, Adelaide, South Australia, Australia.
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
- Royal Adelaide Hospital, Adelaide, South Australia, Australia.
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia.
- Health and Information, Adelaide, South Australia, Australia.
| | | | - Brandon Stretton
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Stephen Bacchi
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Aashray K Gupta
- University of Adelaide, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
- Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Brayden Claridge
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Matthew V Steen
- Glenside Health Services, Adelaide, South Australia, Australia
| | - Ameya Bhanushali
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Lorenz Bartholomeusz
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Suzanne Edwards
- University of Adelaide, Adelaide, South Australia, Australia
| | - Gayatri P Asokan
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Gopika Asokan
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Amanda McGee
- Stoma Care Services, Adelaide, South Australia, Australia
| | - Christopher D Ovenden
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Joseph N Hewitt
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Markus I Trochsler
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Robert T Padbury
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Seth W Perry
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Ma-Li Wong
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Julio Licinio
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Guy J Maddern
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
| | - Peter J Hewett
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| |
Collapse
|
13
|
Scientific and Clinical Abstracts From WOCNext® 2023: Las Vegas, Nevada ♦ June 4-7, 2023. J Wound Ostomy Continence Nurs 2023; 50:S1-S78. [PMID: 37632270 DOI: 10.1097/won.0000000000000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
14
|
Indrebø KL, Aasprang A, Olsen TE, Andersen JR. Experiences and results from using a novel clinical feedback system in routine stoma care nurse follow-up of patients with an ostomy: a longitudinal study. J Patient Rep Outcomes 2023; 7:27. [PMID: 36913078 PMCID: PMC10010226 DOI: 10.1186/s41687-023-00573-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/04/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND A faecal or urinary ostomy may be lifesaving. However, it involves significant bodily change, and the adjustment process to life with an ostomy includes a broad spectre of physical and psychosocial challenges. Thus, new interventions are needed to improve adaptation to living with an ostomy. This study aimed to examine experiences and outcomes using a new clinical feedback system with patient-reported outcome measures in ostomy care. METHODS In this longitudinal explorative study, 69 ostomy patients were followed by a stoma care nurse in an outpatient clinic, using a clinical feedback system postoperatively at 3, 6 and 12 months. The patients responded electronically to the questionnaires before each consultation. The Generic Short Patient Experiences Questionnaire was used to measure patient experiences and satisfaction with follow-up. The Ostomy Adjustment Scale (OAS) measured adjustment to life with an ostomy, and the Short Form-36 (SF-36) assessed the patient's health-related quality of life. Longitudinal regression models with time as an explanatory (categorical) variable were used to analyse changes. The STROBE guideline was applied. RESULTS The patients were satisfied with their follow-up (96%). Especially, they felt they received sufficient and individualised information, were involved in treatment decisions, and benefited from the consultations. The OAS subscale scores for 'daily activities', 'knowledge and skills' and 'health' improved over time (all p < 0.05), as did the physical and mental component summary scores of the SF-36 (all p < 0.05). Effect sizes of changes were small (0.20-0.40). Sexuality was the most challenging factor reported. CONCLUSIONS The clinical feedback system could be helpful because outpatient follow-ups for ostomy patients may be more tailored when clinicians use clinical feedback systems. However, further development and testing are needed.
Collapse
Affiliation(s)
- Kirsten Lerum Indrebø
- Department of Surgery, Førde Central Hospital, Svanehaugvegen 2, 6812, Førde, Norway.
- Western Norway University of Applied Sciences, Førde, Norway.
| | - Anny Aasprang
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
- Western Norway University of Applied Sciences, Førde, Norway
| | - Torill Elin Olsen
- Western Norway University of Applied Sciences, Bergen, Norway
- Department of Surgery, Haukeland University Hospital, Bergen, Norway
| | - John Roger Andersen
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
- Western Norway University of Applied Sciences, Førde, Norway
| |
Collapse
|
15
|
Diniz IV, Pereira da Silva I, Silva RA, Garcia Lira Neto JC, do Nascimento JA, Costa IKF, Mendonça AEOD, Oliveira SHDS, Soares MJGO. Effects of the Quality of Life on the Adaptation of People With An Intestinal Stoma. Clin Nurs Res 2023; 32:527-538. [PMID: 35075912 DOI: 10.1177/10547738211067006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study aimed to examine the effects of the quality of life on the adaptation of people with an intestinal stoma. Cross-sectional study with 152 people with an ostomy. Three instruments were used: the sociodemographic and clinical characterization, Scale for the Level of Adaptation of Ostomy Patients, and City of Hope Quality of Life - Ostomy Questionnaire. The multiple linear regression model, multivariate technique, and cluster were used. The determination coefficient showed that 94.1% of the variability of the Adaptation scores is explained by the dimensions of quality of life. It can be seen that the highest standardized coefficients are the psychological dimension (β = .386) and the social dimension (β = .365), in which they produce the greatest changes in the average adaptation scores. The psychological and social well-being dimensions are the ones that most contribute to raising the levels of adaptation.
Collapse
|
16
|
Vohra Y, Brown CM, Moczygemba LR, Wilfong L. Evaluating the relationship between patient activation and health-related quality of life (HRQOL) in patients with pancreatic cancer (PwPC). Support Care Cancer 2023; 31:191. [PMID: 36847972 DOI: 10.1007/s00520-023-07632-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/06/2023] [Indexed: 02/28/2023]
Abstract
PURPOSE Advanced pancreatic cancer is synonymous with a high mortality rate, debilitating symptom profile, and minimal prolongation in overall survival. Therefore, health-related quality of life (HRQOL) is important in patients with pancreatic cancer (PwPC). In chronic conditions, patient activation is positively associated and higher HRQOL. However, no known study has evaluated patient activation, HRQOL, and their association in PwPC. METHODS A 43-item cross-sectional survey assessed patient activation and HRQOL of patients with locally advanced and metastatic pancreatic cancer undergoing chemotherapy. Variables were analyzed descriptively, and relationships were assessed using bivariate statistics (sig p < 0.05). RESULTS Fifty-six patients participating in the study had an average age of 69.5 ± 11.1 years, and the majority were females (51.8%), Caucasians (61.8%), married/partnered (64.3%), and had at least a college degree (59%). Almost half were at stage 4 (48.2%), and most were newly diagnosed (66.1%). Mean patient activation score was 63.5 ± 17.2 (scale range: 0-100), with most at higher activation levels of 3 or 4 (66.7%). Mean HRQOL score of 41.0 ± 12.7 (scale range: 0-72) was low. Patient activation levels, age, education level, and gender explained 21% of variation in overall HRQOL scores. Patients at activation level 4 had significantly higher overall HRQOL versus those at lower activation (level 1 or 2). Higher patient activation was significantly associated with having either private insurance only or multiple insurances and being partnered. CONCLUSION Patient activation significantly predicted HRQOL in PwPC despite the low sample size. Initiatives to increase patient activation should focus on patients of low socioeconomic status and those without partner support.
Collapse
Affiliation(s)
- Yogesh Vohra
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA.
| | - Carolyn M Brown
- College of Pharmacy, University of Texas at Austin, Austin, TX, USA
| | | | | |
Collapse
|
17
|
Bonetti L, Barello S, Franzoso-Sartorio C, Rinaldi MC, Cattaneo A, Tolotti A, Liptrott S, Sari D. Protocol for a pilot and feasibility study evaluating a complex nurse-led patient education intervention to promote cancer patient engagement in healthy lifestyle (O-PHE programme). BMJ Open 2022; 12:e066163. [PMID: 36564120 PMCID: PMC9791443 DOI: 10.1136/bmjopen-2022-066163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Literature suggests that patient engagement in healthy lifestyle is of crucial importance in ensuring a more effective management of side effects of cancer therapies and better quality of life for patients. While many studies describe educational interventions to promote healthy lifestyles, few are focused on promoting active patient engagement in this field. This protocol paper outlines a study to determine the feasibility of a complex nurse-led patient education intervention aimed to promote cancer patient engagement in a healthy lifestyle. METHOD AND ANALYSIS This is a randomised pilot and feasibility study. Research nurses will recruit 40 adult patients newly diagnosed with cancer. Consenting participants will be randomised to undergo the patient engagement in healthy lifestyle intervention or the control group by means of a four-block randomisation procedure. The intervention will be delivered by a clinical nurse trained in patient engagement strategies. The primary outcome will be a description of study feasibility (recruitment and retention rates, protocol adherence and stakeholder acceptability). Secondary outcomes include changes between and within groups in healthy lifestyle behaviours (ie, increase in healthy diet, smoke cessation or reduction, increase in physical activity), in quality-of-life rates after the intervention, in patient engagement levels, in the perception of the quality of care, in nutritional status; the number of recurrences or the onset of new cancer diagnosis; the number of hospitalization. ETHICS AND DISSEMINATION The study protocol has been approved by the Canton Ticino Ethical Committee (Protocol ID: 2020-02477 TI). The results will be published in peer-reviewed journals and will be presented at national and international congresses. Finally, patients' organisations, such as the Swiss Cancer League, will be involved in the dissemination process. This study will inform the decision to proceed with a randomised controlled trial to assess the effect of this intervention.
Collapse
Affiliation(s)
- Loris Bonetti
- Nursing Research Competence Centre, Department of Nursing, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Serena Barello
- EngageMinds Hub Research Center - Faculty of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Cristina Franzoso-Sartorio
- Mendrisio Outpatient Clinic, Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), Mendrisio, Switzerland
| | - Maria Claudia Rinaldi
- Mendrisio Outpatient Clinic, Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), Mendrisio, Switzerland
| | - Andrea Cattaneo
- Mendrisio Outpatient Clinic, Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), Mendrisio, Switzerland
| | - Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Sarah Liptrott
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| |
Collapse
|
18
|
Nurse's Roles in Colorectal Cancer Prevention: A Narrative Review. JOURNAL OF PREVENTION (2022) 2022; 43:759-782. [PMID: 36001253 DOI: 10.1007/s10935-022-00694-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 02/07/2023]
Abstract
The objective of this paper is to investigate the different roles of nurses as members of healthcare teams at the primary, secondary, and tertiary levels of colorectal cancer prevention. The research team conducted a narrative review of studies involving the role of nurses at different levels of colorectal cancer prevention, which included a variety of quantitative, qualitative, and mixed-method studies. We searched PubMed, Scopus, Web of Science, Cochrane Reviews, Magiran, the Scientific Information Database (SID), Noormags, and the Islamic Science Citation (ISC) databases from ab initio until 2021. A total of 117 studies were reviewed. Nurses' roles were classified into three levels of prevention. At the primary level, the most important role related to educating people to prevent cancer and reduce risk factors. At the secondary level, the roles consisted of genetic counseling, stool testing, sigmoidoscopy and colonoscopy, biopsy and screening test follow-ups, and chemotherapy intervention, while at the tertiary level, their roles were made up of pre-and post-operative care to prevent further complications, rehabilitation, and palliative care. Nurses at various levels of prevention care also act as educators, coordinators, performers of screening tests, follow-up, and provision of palliative and end-of-life care. If these roles are not fulfilled at some levels of colorectal cancer, it is generally due to the lack of knowledge and competence of nurses or the lack of instruction and legal support for them. Nurses need sufficient clinical knowledge and experience to perform these roles at all levels.
Collapse
|
19
|
Tolotti A, Barello S, Vignaduzzo C, Liptrott SJ, Valcarenghi D, Nania T, Sari D, Bonetti L. Patient Engagement in Oncology Practice: A Qualitative Study on Patients' and Nurses' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11644. [PMID: 36141919 PMCID: PMC9517681 DOI: 10.3390/ijerph191811644] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Patient engagement has gained increasing attention in cancer care as it is widely acknowledged as an essential element of high-quality care. There are limited data on how oncology nurses might apply techniques that encourage patient engagement. Therefore, this study aims to understand which nursing strategies can favour patient engagement in oncological care from patients' and nurses' perspectives. We conducted a qualitative study involving oncology patients and oncology nurses. Patients were interviewed, while nurses were involved in focus groups (FGs). Both interviews and FGs were analysed by the means of thematic analysis. We interviewed six patients and conducted two FGs, involving 17 nurses. Five themes were identified from patients' interviews: effective information, having the opportunity to choose, being considered a person, trusted relationship with nurses, and receiving support and advice. Additionally, five themes were identified from the FGs: the nurse-patient relationship, personalisation of care, information style, engagement strategies, and the team. The participants highlighted the importance of comprehensive information in order for patients to feel more involved. Great importance was given to the nurse-patient relationship, which must be based on trust and mutual respect. Both nurses and patients emphasised the importance of person-centred care. A more systematic implementation of suggestions from the participants in this study is desirable for the future.
Collapse
Affiliation(s)
- Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Serena Barello
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Camilla Vignaduzzo
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Sarah Jayne Liptrott
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
- Nursing Development and Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale (EOC), Via Ospedale 12, 6500 Bellinzona, Switzerland
| | - Dario Valcarenghi
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Tiziana Nania
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato Milanese, 20097 Milan, Italy
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland
| | - Loris Bonetti
- Nursing Research Competence Centre, Department of Nursing, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland or
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Via Violino, 11, 6928 Manno, Switzerland
| |
Collapse
|
20
|
Al-Husban RY, Abu Shosha G. The Lived Experience of Jordanian Persons With a Stoma: A Qualitative Study. Gastroenterol Nurs 2022; 45:300-309. [PMID: 36112077 DOI: 10.1097/sga.0000000000000696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 01/27/2022] [Indexed: 11/26/2022] Open
Abstract
Individuals may live with an intestinal stoma either temporarily or for the rest of their lives. The purpose of this study was to understand the lived experience of Jordanian persons living with a stoma. Qualitative design was employed via semistructured interviews with 22 Muslim participants who had an intestinal stoma. Thematic analysis of the transcripts resulted in 3 main themes. The first core theme was stoma burden, which represented difficulties and challenges resulting from the creation of a stoma. This theme was divided into 4 subthemes: physical, self-care, social, and psychological burdens. The second theme was the adaptation to a stoma, whereas the third theme was suggestions for healthcare providers to decrease stoma burden. Conclusively, these themes conveyed that the presence of supportive family members and qualified healthcare providers can decrease the burden of a stoma. Generally, persons with a stoma (ostomates) experienced stoma-related physical, social, psychological, and financial burdens. Therefore, ostomates were in need of training, psychosocial therapy, and more follow-ups to prevent and treat stoma complications and adapt to living easily with the stoma.
Collapse
Affiliation(s)
- Raya Yousef Al-Husban
- Raya Yousef Al-Husban, PhD, RN, CNS, is Assistant Professor, Faculty of Nursing, Zarqa University, Zarqa, Jordan
- Ghada Abu Shosha, PhD, RN, CNS, is Associate Professor, Faculty of Nursing, Zarqa University, Zarqa, Jordan
| | - Ghada Abu Shosha
- Raya Yousef Al-Husban, PhD, RN, CNS, is Assistant Professor, Faculty of Nursing, Zarqa University, Zarqa, Jordan
- Ghada Abu Shosha, PhD, RN, CNS, is Associate Professor, Faculty of Nursing, Zarqa University, Zarqa, Jordan
| |
Collapse
|
21
|
Fernández-Gálvez A, Rivera S, Durán Ventura MDC, de la Osa RMR. Nutritional and Educational Intervention to Recover a Healthy Eating Pattern Reducing Clinical Ileostomy-Related Complications. Nutrients 2022; 14:nu14163431. [PMID: 36014936 PMCID: PMC9416208 DOI: 10.3390/nu14163431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/01/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to evaluate a diet intervention implemented by our hospital in order to determinate its capacity to improve the eating pattern of patients with an ileostomy, facilitating the implementation new eating-related behaviors, reducing doubt and dissatisfaction and other complications. The study was conducted with a quasi-experimental design in a tertiary level hospital. The elaboration and implementation of a nutritional intervention consisting of a Mediterranean-diet-based set of menus duly modified that was reinforced by specific counseling at the reintroduction of oral diet, hospital discharge and first follow-up appointment. Descriptive, bivariate and multivariate analyses were performed. The protocol was approved by the competent Ethics Committee. The patients of the intervention group considered that the diet facilitated eating five or more meals a day and diminished doubt and concerns related to eating pattern. Most patients (86%) had a favorable experience regarding weight recovery and a significant reduction of all-cause readmissions and readmission with dehydration (p = 0.015 and p < 0.001, respectively). The intervention helped an effective self-management of eating pattern by patients who had a physical improvement related to hydration status, which, together with an improvement in weight regain, decreased the probability of readmissions.
Collapse
Affiliation(s)
- Antonio Fernández-Gálvez
- General and Digestive Surgery Department, University Hospital Virgen del Rocio, 410013 Seville, Spain
| | - Sebastián Rivera
- General and Digestive Surgery Department, University Hospital Virgen del Rocio, 410013 Seville, Spain
| | | | - Rubén Morilla Romero de la Osa
- Department Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 410013 Seville, Spain
- Institute of Biomedicine of Seville, University Hospital Virgen del Rocio, CSIC, University of Seville, 410013 Seville, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-635-991-295
| |
Collapse
|
22
|
Li J, Zhang Q, Wu X, Pang D. The Quality and Clinical Applicability of Recommendations in Ostomy Guidelines: A Systematic Review. Risk Manag Healthc Policy 2022; 15:1517-1529. [PMID: 35971434 PMCID: PMC9375557 DOI: 10.2147/rmhp.s378684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022] Open
Abstract
Aim To systematically search ostomy clinical practice guidelines, critically assess their quality and clinical applicability of recommendations, and summarize the recommendations. Design Systematic review. Data Sources The PubMed, ProQuest and CINAHL databases, eight guideline databases, and three ostomy institution websites were searched on September 3, 2021. Review Methods Appraisal of Guidelines for Research and Evaluation II (AGREE II) and AGREE Recommendation EXcellence (AGREE-REX) were used to assess the guideline. Results The initial search identified 1475 documents. Of these, 27 full-text documents were reviewed. Finally, 10 guidelines were included. Among these, the 2019 Registered Nurses’ Association of Ontario (RNAO) guidelines had the highest total scores using AGREE II and AGREE-REX. The 2019 National Institute for Health and Care Excellence (NICE) and 2018 European Hernia Society (EHS) were also ranked as high-quality and evaluated as “recommended.” The median of the “applicability” domain was the lowest (45%) among the six AGREE II domains. The median of the “values and preferences” domain was the lowest (38%) among the three AGREE-REX domains. In total, 172 recommendations were summarized and parastomal hernia received the most attention among the recommendations. Conclusion The quality of the 10 clinical practice guidelines varied widely. The three identified high-quality guidelines might be appropriate first choices in daily ostomy care and management practice and can be tailored to the local context. Ostomy guidelines require further improvement in the “applicability” and “values and preferences” domains. No Patient or Public Contribution This review only searched and evaluated relevant documents, so such details do not apply to this review.
Collapse
Affiliation(s)
- Jiamin Li
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Qiuwen Zhang
- School of Nursing, Health Science Center for Evidence-Based Nursing, Peking University, Beijing, People's Republic of China
| | - Xinjuan Wu
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Dong Pang
- School of Nursing, Health Science Center for Evidence-Based Nursing, Peking University, Beijing, People's Republic of China
| |
Collapse
|
23
|
Bonetti L, Tolotti A, Anderson G, Nania T, Vignaduzzo C, Sari D, Barello S. Nursing interventions to promote patient engagement in cancer care: A systematic review. Int J Nurs Stud 2022; 133:104289. [PMID: 35751947 DOI: 10.1016/j.ijnurstu.2022.104289] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Patient engagement is becoming increasingly relevant in cancer care. Nurses have been recognized as crucial in promoting active engagement of people with carcer. Despite the growing interest on this topic and the relevance of patient engagement interventions to improve patient' conditions, to the best of our knowledge there is no synthesis of the literature on the characteristics and impact of nurse-led patient engagement intervention for adults with cancer. OBJECTIVE This review aims to systematically summarize nurse-led patient engagement interventions for adult patients diagnosed with cancer and to describe the state of the art on the impact of these interventions on patients' outcomes. DESIGN Systematic review. SETTING(S) Hospital and outpatient care. PARTICIPANTS Adults with cancer. METHODS We searched PubMed, CINAHL, Embase, Scopus, Web of Science and Cochrane library from 2005 to 2021. We included randomized clinical trials, quasi-experimental studies and single-arm, pre-test/post-test studies written in English, Spanish, French and Italian. All the included articles reported nurse-led patient engagement interventions designed to improve patient engagement in the management of their own disease and to assess outcomes related to patient engagement. We appraised the methodological quality of the included articles with the Joanna Briggs Institute appraisal tools. RESULTS Twenty-four articles met the inclusion criteria. Four distinct types of nurse-led engagement interventions, showing different degrees of complexity, were classified: (i) generic health information delivery, (ii) patient-specific information delivery, (iii) personalized decision support and (iv) motivational support. These interventions were effective in supporting behavioral changes and reducing symptoms burden of adults with cancer. In addition, many of the retrieved studies showed significant increase in patients' knowledge, informed decisions making, perceived quality of nurse-patient interaction and quality of life after the engagement intervention. CONCLUSIONS This systematic review summarized a wide variety of nurse-led patient engagement interventions with different degrees of complexity. In addition, a significant positive effect of these interventions was found on outcomes such as patient activation, self-efficacy, health literacy and quality of life. Among those identified, nurse-led motivational interventions appear to be the most effective ones for improving engagement outcomes in adults with cancer. REGISTRATION NUMBER PROSPERO Nr: CRD42020146189.
Collapse
Affiliation(s)
- Loris Bonetti
- Nursing Research Competence Centre, Department of Nursing, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland; University of Applied Sciences and Arts of Southern Switzerland, Department of Business Economics, Health and Social Care, Via Violino, 11, Manno 6928, Switzerland.
| | - Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, Bellinzona, Switzerland.
| | - Gloria Anderson
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Tiziana Nania
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
| | - Camilla Vignaduzzo
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Phychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy.
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, Bellinzona, Switzerland.
| | - Serena Barello
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Department of Phychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy.
| |
Collapse
|
24
|
Scientific and Clinical Abstracts From WOCNext® 2022: Fort Worth, Texas ♦ June 5-8, 2022. J Wound Ostomy Continence Nurs 2022; 49:S1-S99. [PMID: 35639023 DOI: 10.1097/won.0000000000000882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
25
|
Pate K, Powers K, Coffman MJ, Morton S. Improving Self-Efficacy of Patients With a New Ostomy With Written Education Materials: A Quality Improvement Project. J Perianesth Nurs 2022; 37:620-625. [DOI: 10.1016/j.jopan.2021.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 11/15/2022]
|
26
|
Pinto Pinto IS, Queirós S, Alves P, Sousa Carvalho TM, Santos C, Brito A. Nursing Interventions to Promote Self-Care in a Candidate for a Bowel Elimination Ostomy: Scoping Review. AQUICHAN 2022. [DOI: 10.5294/aqui.2022.22.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: To identify nursing interventions, their characteristics, and outcomes for promoting self-care in candidates for a bowel elimination ostomy.
Materials and methods: A scoping review was carried out based on the Joanna Briggs Institute’s recommendations. For this, studies published in Portuguese, English, and Spanish on the Web of Science, CINAHL, and Scopus databases and without a time limit were selected on November 9, 2020.
Results: Of 2248 articles identified, 41 were included in this review. We identified 20 nursing interventions associated with the self-care of patients with an ostomy; most of them have gaps in their content, method, and frequency or dosing. More than 30 indicators were identified to assess the impact of nursing interventions; however, most of them were indirect assessments.
Conclusion: There is scarce evidence regarding the different aspects that must be involved in nursing interventions for patients with a stoma. Moreover, there is no standardization in methods, frequency, or dosing of intervention. It is urgent to define the content, method, and frequency of nursing interventions necessary to promote self-care in patients with a bowel elimination ostomy and to use assessment tools that directly measure stoma self-care competence.
Collapse
|
27
|
Pozebom NV, Viégas K. DIGITAL HEALTH AND SELF-CARE IN PEOPLE WITH INTESTINAL OSTOMIES: AN INTEGRATIVE REVIEW. ESTIMA 2021. [DOI: 10.30886/estima.v19.1127_in] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: synthesize the scientific production related to digital health in ostomies to promote self-care. Method: integrative review with research in online databases, seeking to answer the following guiding question: What are the digital approaches used to teach self-care to patients with ostomy identified in the publications? Results: six different ways of using digital health to promote self-care in people living with intestinal ostomies were identified. Five were published in the National Library of Medicine (MEDLINE) database and one published in the databases Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Base de Dados de Enfermagem da Biblioteca Virtual em Saúde (BDENF),in the period from 2017 to 2020. Conclusion: the six approaches studied can be used simultaneously in individuals with ostomies and can be considered complementary, as they act in different aspects of the individual’s routine, with the ultimate goal being to improve the quality of life of the person with an intestinal ostomy.
Collapse
Affiliation(s)
| | - Karin Viégas
- Universidade Federal de Ciências da Saúde de Porto Alegre
| |
Collapse
|
28
|
Pozebom NV, Viégas K. SAÚDE DIGITAL E AUTOCUIDADO EM PESSOAS COM ESTOMIAS INTESTINAIS: REVISÃO INTEGRATIVA. ESTIMA 2021. [DOI: 10.30886/estima.v19.1127_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo:sintetizar a produção científica relacionada à saúde digital em estomias para a promoção do autocuidado. Método: revisão integrativa com pesquisa em bases de dados on-line, buscando responder a seguinte questão norteadora: Quais são as abordagens digitais utilizadas para o ensino do autocuidado de pacientes com estomia identificadas nas publicações? Resultados: foram identificadas seis diferentes maneiras de empregar a saúde digital para promover o autocuidado em pessoas vivendo com estomias intestinais. Cinco foram publicadas na base de dados da National Library of Medicine (MEDLINE) e uma publicada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Base de Dados de Enfermagem da Biblioteca Virtual em Saúde (BDENF), no período de 2017 a 2020. Conclusão: as seis abordagens estudadas podem ser utilizadas simultaneamente em indivíduos com estomias e podem ser consideradas complementares, pois têm ação em diferentes aspectos da rotina do indivíduo, sendo o objetivo final a melhoria da qualidade de vida da pessoa com estomia intestinal.
Collapse
Affiliation(s)
| | - Karin Viégas
- Universidade Federal de Ciências da Saúde de Porto Alegre
| |
Collapse
|
29
|
Mungai MW, Abere MN, Avula EK. Quality of life of ostomates at a teaching and referral hospital in Kenya. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:S24-S32. [PMID: 34889671 DOI: 10.12968/bjon.2021.30.22.s24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Ostomy surgery is performed to maintain gastrointestinal function. However, there is a lack of knowledge and experience about ostomies among patients and clinicians in public hospitals in Kenya. The issue is compounded by the social isolation and stigma ostomates face in the wards and in the community after discharge. Although it is not easy to identify the exact number of ostomates in Kenya and other African countries, there is need to shift the focus from curing symptoms in ostomates to maximising patients' quality of life (QoL) and integrating services for ostomates in mainstream public hospitals. AIM To understand the effects of ostomies on patients' QoL, with a focus on nutrition, psychosocial aspects and challenges around sexuality after ostomy creation. METHOD A descriptive study was undertaken using an interviewer-administered QoL questionnaire with 81 patients. RESULTS Most patients were male (54%); the largest age group was 35-44 years (24.7%). Colorectal carcinoma, intestinal obstruction and traumatic injuries were the main indications for ostomy. Ostomates resumed sexual activity, but did not find it fulfilling (P=0.002). Most reported feeling depressed, with suicidal attempts that negatively correlated with QoL. Ostomates adjusted their diets regardless of whether their level of QoL was poor, fair, good or excellent after ostomy creation (P=0.564). CONCLUSION Ostomates experience low QoL. Patients' lives can be improved by focusing on providing individualised ostomy care services after discharge. Enhancing stoma therapy training for nurses and running ostomy clinics alongside mainstream services, as well as support for ostomates towards enrolment into the country's National Hospital Insurance Fund, will also improve patients' QoL.
Collapse
Affiliation(s)
- Margaret Wanjiru Mungai
- Deputy Director Nursing/Wound Care Nurse Specialist, Moi Teaching and Referral Hospital, Directorate of Nursing, Eldoret, Kenya
| | - Mercy Nyanchama Abere
- Senior Principal Nursing Officer, Quality Assurance Officer, Moi Teaching and Referral Hospital, Directorate of Nursing, Eldoret, Kenya
| | - Edward Kilamonda Avula
- Perioperative and Stoma Therapy Nurse, Moi Teaching and Referral Hospital, Directorate of Nursing, Eldoret, Kenya
| |
Collapse
|
30
|
Patient activation and treatment decision-making in the context of cancer: examining the contribution of informal caregivers' involvement. J Cancer Surviv 2021; 16:929-939. [PMID: 34510365 DOI: 10.1007/s11764-021-01085-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/02/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE The present work investigated the relationship between patient activation, treatment decision-making, and adherence to the prescribed treatment regimen. Given the role of informal caregivers in patient-reported outcomes, it was additionally assessed whether caregiver involvement acted as a moderator of this relationship. METHODS Survey data collected from 504 cancer survivors were utilized. Structural equation modeling (SEM) controlling for covariates was used to examine the relationship between patient activation measure (PAM), caregiver involvement, and the identified outcomes. Moderator analysis was conducted using multiple group SEM. RESULTS Patient activation was significantly associated with treatment planning being reflective of survivors' goals and values (p < 0.001); adherence to treatment (p = 0.011); and satisfaction (p < 0.001). Caregiver's involvement significantly moderated the association between activation and adherence to treatment. CONCLUSIONS Patient activation was positively associated with all three selected outcomes. However, for cancer survivors reporting low rates of caregiver's involvement, patient activation was not associated with treatment adherence. Research is needed to test and deliver self-management interventions inclusive of informal caregivers. IMPLICATIONS FOR CANCER SURVIVORS Findings supported the need not only to monitor and sustain patient activation across the cancer continuum, but also to assume a dyadic perspective when designing self-management interventions in cancer survivorship.
Collapse
|
31
|
Cidav Z, Marcus S, Mandell D, Hornbrook MC, Mo JJ, Sun V, Ercolano E, Wendel CS, Weinstein RS, Holcomb MJ, Grant M, Rock M, Krouse RS. Programmatic Costs of the Telehealth Ostomy Self-Management Training: An Application of Time-Driven Activity-Based Costing. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1245-1253. [PMID: 34452703 DOI: 10.1016/j.jval.2021.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 02/19/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Programmatic cost assessment of novel clinical interventions can inform their widespread dissemination and implementation. This study aimed to determine the programmatic costs of a telehealth Ostomy Self-Management Training (OSMT) intervention for cancer survivors using Time-Driven Activity-Based Costing (TDABC) methodology. METHODS We demonstrated a step-by-step application of TDABC based on a process map with core OSMT intervention activities and associated procedures and determined resource use and costs, per unit procedure. We also assessed per-patient costs from a payer perspective and provided estimates of total hours and costs by personnel, activity, and procedure. RESULTS The per-patient cost of the OSMT was $1758. Personnel time accounted for 91% of the total cost. Site supervisor and information technology technician time were the most expensive personnel resources. Telehealth technical and communication equipment accounted for 8% of the total cost. Intervention coordination and monitoring efforts represented most of the total time cost (62%), followed by the intervention delivery (35%). The procedures with the highest cost were communication via phone or virtual meetings (24%), email exchanges (18%), and telehealth session delivery (18%). CONCLUSIONS Future efforts to replicate, disseminate, and implement the OSMT intervention should anticipate funding for nonclinical components of the intervention, including coordination and monitoring, and consider how these activities can be performed most efficiently. For institutions without established telemedicine programs, selection of videoconferencing platforms and adequate staffing for participant technical support should be considered. Our step-by-step application of TDABC serves as a case study demonstrating how interventionists can gather data on resource use and costs of intervention activities concurrently with their collection of trial data.
Collapse
Affiliation(s)
- Zuleyha Cidav
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Steven Marcus
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David Mandell
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Julia J Mo
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Virginia Sun
- Division of Nursing Research and Education, City of Hope Medical Center, Duarte, CA, USA
| | | | | | | | | | - Marcia Grant
- Division of Nursing Research and Education, City of Hope Medical Center, Duarte, CA, USA
| | - Matthew Rock
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert S Krouse
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
32
|
Grant M, Sun V, Tallman NJ, Wendel CS, McCorkle R, Ercolano E, Simons C, Mo J, Raza S, Donahue D, Passero F, Henson J, MacDougall L, Friedlaender J, Pitcher P, Fry D, Yonsetto P, Holcomb MJ, Hornbrook MC, Weinstein RS, Krouse RS. Cancer survivors' greatest challenges of living with an ostomy: findings from the Ostomy Self-Management Telehealth (OSMT) randomized trial. Support Care Cancer 2021; 30:1139-1147. [PMID: 34435212 DOI: 10.1007/s00520-021-06449-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/18/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES An ostomy results in lifelong quality of life changes for a cancer survivor. We describe the greatest challenges reported from a randomized trial of cancer survivors with stomas (ostomies). METHODS Cancer survivors with ostomies participating in a multi-site randomized prospective trial of an Ostomy Self-Management Telehealth (OSMT) program versus usual care (UC) were surveyed at six months post accrual. An open-ended question requested greatest challenges after ostomy surgery. Quantitative descriptive and qualitative analyses were used to examine greatest challenges reported. RESULTS A total of 118 trial participants identified greatest challenges with 55 in the OSMT and 63 in the UC. Six conceptual domains were used to code comments-physical, psychological, social, and spiritual quality of life; ostomy-specific issues, and healthcare issues. The OSMT contributed 187 comments, and UC contributed 235 comments. Ostomy specific issues and social well-being had the most comments overall with UC contributing more comments in all domains except physical well-being. Word Clouds revealed post-operative and treatment-related issues and going out in public as the most common challenges in both groups. Word Clouds compared types of ostomies revealing bowel function challenges (colostomy group), difficulties going out in public (ileostomy group), and positive support (urostomy group). CONCLUSIONS Fewer challenges submitted by the OSMT group provide the beginning evidence of the OSMT program impact. Dominant challenges across both groups were social well-being and ostomy care. Challenges varied by type of ostomy. Findings support long-term care and support for all cancer survivors with ostomies. TRIAL REGISTRATION NCT02974634.
Collapse
Affiliation(s)
- Marcia Grant
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA.
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Nancy J Tallman
- Unaffilated, Wound, Ostomy, and Continence Nurse, Tucson, AZ, USA
| | | | - Ruth McCorkle
- School of Nursing and School of Public Health, Yale University, New Haven, CT, USA
| | - Elizabeth Ercolano
- School of Nursing and School of Public Health, Yale University, New Haven, CT, USA
| | | | - Julia Mo
- University of Pennsylvania, Philadelphia, PA, USA
| | - Sabreen Raza
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | - Dan Fry
- , Patient Stakeholder, Philadelphia, PA, USA
| | - Pete Yonsetto
- Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA
| | - Michael J Holcomb
- Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA
| | | | | | - Robert S Krouse
- Perelman School of Medicine, University of Pennsylvania and the Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| |
Collapse
|
33
|
Corvese F, Giordano V, Alvaro R, Vellone E, Villa G. Sociodemographic characteristics and self-care management knowledge of patients with an ostomy. ACTA ACUST UNITED AC 2021; 29:S20-S26. [PMID: 33325299 DOI: 10.12968/bjon.2020.29.22.s20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND An increasing number of patients worldwide are living with an ostomy. Among them, self-care management skills and stoma self-care abilities are associated with better quality of life. AIMS To identify the sociodemographic and clinical characteristics of Italian ostomy patients and investigate their knowledge of stoma management. METHODS A questionnaire was used to gather the sociodemographic and clinical data of 433 adult patients. Participants responded to a nine-item survey assessing their knowledge of stoma management. FINDINGS Respondents reported having received extensive or adequate information in 64.4% of cases, and the remaining 35.6% reported receiving little or no information at any time. The health professional who imparted at least adequate information was a stoma nurse specialist in 32.1% of cases, usually during admission (24.0%) or before and during admission (19.6%). CONCLUSION This study demonstrated that most patients received adequate information regarding the ostomy.
Collapse
Affiliation(s)
- Francesco Corvese
- PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Vittoria Giordano
- PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Full Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Associate Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Villa
- Nurse, Health Professions Research and Development Unit, IRCCS San Raffaele Institute, Milan, Italy
| |
Collapse
|
34
|
Effects of a Self-Management Program for Patients With Colorectal Cancer and a Colostomy: A Nonrandomized Clinical Trial. J Wound Ostomy Continence Nurs 2021; 48:311-317. [PMID: 34186549 DOI: 10.1097/won.0000000000000779] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE We constructed a self-management program for rectal cancer survivors with colostomies and evaluated the effect of the program on self-efficacy, self-management ability, and incidence of stomal and peristomal complications. DESIGN A prospective, nonrandomized clinical trial. SUBJECTS AND SETTING Participants were recruited from 4 proctology departments in a tertiary hospital in northeast China. Fifty-five were assigned to the intervention group and 56 were assigned to the control group; 26 were lost to follow-up. Therefore, data analysis was based on 43 participants in the intervention group and 42 in the control group. METHODS Control group patients received the standard care where guidance and stoma care manuals were given the day before hospital discharge, and regular telephone follow-up twice a month for 3 months. Participants in the experimental group received, in addition to standard care, a self-management program delivered via a multimedia messaging app initiated after discharge available over a 6-week period. Primary outcomes were self-efficacy and self-management ability; we also analyzed the incidence of stomal and peristomal complications as a secondary outcome. Between-groups outcomes were analyzed via a repeated-measures analysis of variance. RESULTS Analysis indicated intervention group participants had higher levels of self-efficacy and self-management of their colostomies than did control group participants. Analysis also revealed intervention group participants had a lower incidence of peristomal complications; no differences in the incidence of stomal complications were found. CONCLUSIONS Study findings suggest that use of the multimedia messaging app-based self-management program enhanced self-efficacy and self-management, while reducing the incidence of peristomal complications in rectal cancer survivors with colostomies.
Collapse
|
35
|
Effects of Evidence-Based Continuing Care Bundle on Health Outcomes in Rectal Cancer Patients With Temporary Stomas: A Multicenter Randomized Controlled Trial. Cancer Nurs 2021; 44:223-234. [PMID: 31833919 DOI: 10.1097/ncc.0000000000000762] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The patients with temporary stomas after anterior resection for rectal cancer may experience significant impact on their health outcomes, and hence continuing care is necessary and important for these patients. However, the effects of some single continuing care interventions remain unclear. Continuing care bundle may be an effective approach to address this uncertainty. OBJECTIVE The aim of this study was to investigate the effects of an evidence-based continuing care bundle on selected health outcomes in patients with temporary stomas after anterior resection for rectal cancer. METHODS This was a multicenter randomized controlled trial. A total of 124 patients with temporary stomas after anterior resection for rectal cancer were recruited from 4 general tertiary hospitals in Guangzhou, China, and were randomly assigned to a control group or an intervention group. Both groups received usual care, whereas the intervention group additionally received evidence-based continuing care bundle. Self-efficacy, quality of life, and stoma-related complications were collected at baseline and 4 and 12 weeks after surgery. Satisfaction and outcomes of stoma reversal were collected at the end of the observation. RESULTS The intervention group had significantly improved the self-efficacy (F = 11.88, P = .001), quality of life (F = 17.99, P < .001) over time, satisfaction (t = 4.08, P < .001), and outcomes of stoma reversal (χ2 = 5.93, P = .015) and reduced the incidence of complications (P < .05). CONCLUSIONS Evidence-based continuing care bundle can be an effective method to improve the health outcomes among these patients. IMPLICATION FOR PRACTICE By using the evidence-based continuing care bundle, nurses can help these patients improve their health outcomes in stoma-specific nursing.
Collapse
|
36
|
Giordano V, Iovino P, Corvese F, Vellone E, Alvaro R, Villa G. Caregiver contribution to self-care and its associated variables among caregivers of ostomy patients: Results of a cross-sectional study. J Clin Nurs 2021; 31:99-110. [PMID: 34121255 DOI: 10.1111/jocn.15851] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/02/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe caregiver contribution (CC) to ostomy self-care and identify its associated variables among caregivers of ostomy patients. BACKGROUND Self-care is essential for ostomy patients, but it can be difficult to perform. In these cases, caregivers play a key role in promoting self-care behaviours. So far, the CC to ostomy self-care has not been investigated thoroughly. DESIGN This is a cross-sectional and multicentre study conducted at seven outpatient clinics of two Italian regions. METHODS We recruited 252 caregivers between February 2017-May 2018. The Caregiver Contribution to Ostomy Self-Care Index (CC-OSCI) was used to measure CC to ostomy self-care. Three multivariable linear regression models were fitted to identify variables associated with CC dimensions (maintenance, monitoring and management). The STROBE checklist was used to report the present study. RESULTS The sample (mean age = 58.73, SD = 13.98) was mostly female (80.60%), unemployed (58.70%) and resided with the patient (81.00%). Caregivers being employed and those declaring more hours of contribution per week were associated with a significantly lower contribution to self-care maintenance. Caregivers with lower levels of education and those residing with the patient were less likely to contribute to CC to self-care monitoring. Spousal caregivers and those with higher preparedness contributed significantly lower to CC to self-care management. CONCLUSIONS We found a variety of sociodemographic factors associated with CC to ostomy self-care. RELEVANCE TO CLINICAL PRACTICE Sociodemographic variables associated with CC to ostomy self-care can help clinicians develop more tailored educational interventions for caregivers who find their contribution challenging.
Collapse
Affiliation(s)
- Vittoria Giordano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Francesco Corvese
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
37
|
Queirós SMM, Pinto IES, de Brito MAC, Santos CSVDB. Nursing interventions for the promotion of tracheostomy self-care: A scoping review. J Clin Nurs 2021; 30:3055-3071. [PMID: 34101275 DOI: 10.1111/jocn.15823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To map nursing interventions, their characteristics, and outcomes, in promoting self-care of the person with a tracheostomy. BACKGROUND The development of competencies in self-care of a person with a tracheostomy is recognised as one of the most significant nursing intervention areas for the promotion of autonomy, prevention of complications and adaptation. Identifying nursing interventions for the promotion of self-care of the person with a tracheostomy enables enhanced clinical practice knowledge within different care contexts and the identification of gaps in the available evidence. DESIGN The Joanna Briggs Institute (JBI) methodology was used to perform this scoping review. METHOD A search was conducted on the CINAHL, Scopus, Web of Science, PubMed, JBI Database of Systematic Reviews and Implementation Reports, and Cochrane Database of Systematic Reviews. The search for grey literature included Portugal´s Open Access Scientific Repository, OpenGrey, and ProQuest Dissertations and Theses. Studies published in Portuguese, English, Spanish and French were included. The PRISMA-ScR checklist was used. RESULTS From a total of 4,224 identified articles, 31 were included in this review. Multiple nursing interventions were identified and grouped into four types of action: informing, managing, determining and attending. Although most interventions are implemented with the face-to-face method, there is a growing interest in using technologies for this purpose. The dose is the characteristic most poorly described in interventions. Various results were obtained; however, valid assessment tools were not always used. CONCLUSIONS Designing and testing intervention programmes for the promotion of self-care of the person with a tracheostomy is necessary, based on available and robust evidence to guide clinical practice. RELEVANCE TO CLINICAL PRACTICE This review allowed to systematise nursing interventions to promote self-care of the person with a tracheostomy. The use of combined interventions and methodologies is likely to be more effective in care delivery.
Collapse
Affiliation(s)
- Sílvia Maria Moreira Queirós
- Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal.,Hospital Epidemiology Center, Centro Hospitalar Universitário de S. João, Porto, Portugal
| | - Igor Emanuel Soares Pinto
- Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal.,Surgery Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Portugal.,Nursing School of Porto, Porto, Portugal
| | | | | |
Collapse
|
38
|
Alenezi A, McGrath I, Kimpton A, Livesay K. Quality of life among ostomy patients: A narrative literature review. J Clin Nurs 2021; 30:3111-3123. [PMID: 33982291 DOI: 10.1111/jocn.15840] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVE This study aims to identify and summarise factors related to ostomy patients' experiences and how these impact the perceived quality of life for those patients. BACKGROUND Ostomy formation is a common therapeutic technique used to treat different colorectal diseases such as colorectal cancer. Although surgical intervention and ostomy formation may prolong a patient's life, it may cause many problems in their daily lifestyle and affect their quality of life. The surgical creation of an ostomy has a significant impacts on a patient's quality of life from multiple perspectives, including physical, psychological, social and spiritual aspects. DESIGN A narrative literature review, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline). METHODS This review analysis of search filters was conducted in the following databases: PubMed (MEDLINE), CINAHL, Embase, ProQuest, Science Direct, Scopus, and PsycINFO. A validation data set of 283 research articles between January 2000 and December 2019 were used to identify the impact of stoma surgery on patients' quality of life. RESULT Thirty-seven studies were identified as suitable for inclusion in this literature review. The results of the review indicate that quality of life (QoL) in patients who have an ostomy is influenced by many modifiable factors. Exercise, preoperative stoma site identification, family support, maintenance of social networks, education, spirituality and financial stability are all potentially modifiable factors that can improve the QOL for ostomy patients. CONCLUSION This review has identified multiple challenges that ostomy patients experience, which were clustered according to physical, psychological, social and spiritual challenges. RELEVANCE TO CLINICAL PRACTICE This study identifies issues associated with stoma creation and can help in planning and providing the required nursing care which may assist in the reduction of predictable challenges. Recommendations for future research related to nursing practice are stated.
Collapse
Affiliation(s)
- Aishah Alenezi
- Discipline of Nursing, RMIT University, Melbourne, VIC, Australia
| | - Ian McGrath
- Discipline of Nursing, RMIT University, Melbourne, VIC, Australia
| | - Amanda Kimpton
- Chiropractic and Exercise Sciences Department, RMIT University, Melbourne, VIC, Australia
| | - Karen Livesay
- Discipline of Nursing, RMIT University, Melbourne, VIC, Australia
| |
Collapse
|
39
|
Weinstein RS, Holcomb MJ, Mo J, Yonsetto P, Bojorquez O, Grant M, Wendel CS, Tallman NJ, Ercolano E, Cidav Z, Hornbrook MC, Sun V, McCorkle R, Krouse RS. Ostomy Self-Management Training Intervention for Cancer Survivors: Technology-Related Findings from a Randomized Trial. J Med Internet Res 2021; 23:e26545. [PMID: 34086595 PMCID: PMC8506262 DOI: 10.2196/26545] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/05/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ostomy Self-Management Telehealth (OSMT) intervention by nurse-educators and peer-ostomates can equip new ostomates with critical knowledge regarding ostomy care. A telehealth technology assessment aim was to measure telehealth engineer support requirements for telehealth technology related (TTR) incidents encountered during OSMT intervention sessions held via a secure cloud videoconferencing service, "Zoom for Healthcare". OBJECTIVE This paper examines technology challenges, issues, and opportunities encountered in the use of telehealth in the setting of an intervention RCT for cancer survivors living with a permanent ostomy. METHODS The Arizona Telemedicine Program (ATP) provided telehealth engineering support for 105 scheduled 90-120-minute OSMT sessions over a two-year period. OSMT groups included up to 15 participants, comprised of four to six ostomates, four to six peer-ostomates, two nurse educators, and one telehealth engineer. OSMT session TTR incidents were recorded contemporaneously in detailed notes by research study staff. TTRs were categorized and tallied. RESULTS 102 of 105 (97%) OSMT sessions were completed as scheduled. Three OSMT sessions were not held due to non-technology related reasons. Of the 93 ostomates who participated in OSMT sessions, 80 (86%) completed their OSMT curriculum. TTR incidents occurred in 35.3% of completed sessions with varying disruptive impact. Zero sessions were cancelled or rescheduled due to TTR incidents. Disruptions resulting from TTR incidents were minimized by following TTR incident prevention and incident response plans. CONCLUSIONS Telehealth videoconferencing technology can enable ostomates to participate in ostomy self-management education by incorporating dedicated telehealth engineering support. OSMT potentially greatly expands availability of ostomy self-management education to new ostomates. CLINICALTRIAL Ostomy Telehealth For Cancer Survivors (PCORI) NCT02974634.
Collapse
Affiliation(s)
- Ronald S Weinstein
- Arizona Telemedicine Program, The University of Arizona Health Sciences, 1501 N Campbell AHSL 1156, Tucson, US
| | - Michael J Holcomb
- Arizona Telemedicine Program, The University of Arizona Health Sciences, 1501 N Campbell AHSL 1156, Tucson, US
| | - Julia Mo
- Hospital of the University of Pennsylvania, Philadelphia, US
| | - Peter Yonsetto
- Arizona Telemedicine Program, The University of Arizona Health Sciences, 1501 N Campbell AHSL 1156, Tucson, US
| | | | - Marcia Grant
- Nursing Research and Education, City of Hope National Medical Center, Duarte, US
| | | | | | | | | | - Mark C Hornbrook
- Center for Health Research, Kaiser Permanente, Northwest Region, Portland, US
| | - Virginia Sun
- Nursing Research and Education, City of Hope National Medical Center, Duarte, US
| | | | - Robert S Krouse
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
| |
Collapse
|
40
|
Wulff-Burchfield EM, Potts M, Glavin K, Mirza M. A qualitative evaluation of a nurse-led pre-operative stoma education program for bladder cancer patients. Support Care Cancer 2021; 29:5711-5719. [PMID: 33661368 PMCID: PMC7930519 DOI: 10.1007/s00520-021-06093-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Abstract
Introduction Radical cystectomy remains the standard of care for muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer. Postoperative ostomy education is common, but patients struggle to maintain self-management practices. A preoperative ostomy education program was developed to meet this need, and we conducted a qualitative study with participating patient-caregiver dyads to evaluate the educational and psychosocial impacts of the program and examine alignment with program objectives. Materials and methods A qualitative descriptive study was conducted utilizing a thematic analysis approach. Sixteen patients, eighteen caregivers, and three program educators completed semi-structured interviews from 3 to 18 months post the program. Interviews were audio-recorded and transcribed. Thirteen end-of-course surveys from the initial educational program cohort were transcribed, coded, analyzed; this data was triangulated with patient, caregiver, and educator interviews. Results Analysis uncovered three themes: (1) Patient and caregiver motivation to attend the program, (2) attitudes toward this life-changing event, and (3) education. For theme 1, patients and caregivers cited lack of knowledge, fear, and concern about ostomy surgery and care as motivation. For theme 2, there were a variety of attitudes toward the ostomy, ranging from avoidance to acceptance, and a similar breadth of attitudes toward caregiving, with some patients and caregivers describing ongoing dependence and other patients seeking complete independence. For theme 3, the interactive curriculum was determined to be effective, and the patient advocate was cited as the most memorable program component. Conclusions A formal preoperative ostomy education program employing an interactive educational approach and featuring a patient advocate can prepare bladder cancer patients and caregivers for ostomy self-management and post-ostomy life.
Collapse
Affiliation(s)
| | - Maryellen Potts
- University of Kansas School of Nursing, Kansas City, KS, USA
| | - Katherine Glavin
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Moben Mirza
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| |
Collapse
|
41
|
Luo X, Li J, Chen M, Gong J, Xu Y, Li Q. A literature review of post-treatment survivorship interventions for colorectal cancer survivors and/or their caregivers. Psychooncology 2021; 30:807-817. [PMID: 33656767 DOI: 10.1002/pon.5657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/05/2021] [Accepted: 02/11/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Colorectal cancer (CRC) survivors have reported a number of concerns and unmet needs after treatment completion. This paper aims to explore existing survivorship interventions after CRC treatment according to the American Cancer Society CRC Survivorship Care Guidelines, to identify study gaps, and provide valuable evidence directing future research. METHODS Five electronic databases, including CINAHL, PsycINFO, Embase, PubMed, and Cochrane Library databases from 2005 to October 2020, were systematically searched to identify English or Chinese literature on CRC post-treatment survivorship interventions. Manual searching through the articles' references lists was also conducted. RESULTS Thirty studies met the criteria, and focused on addressing issues in four CRC Survivorship Care Guidelines domains. Several issues for CRC surveillance programmes remain to be explored. Regarding the long-term physical and psychosocial effects of CRC treatment, we found mounting evidence for various interventions to solve ostomy issues and improve distress/depression/anxiety, strong evidence for exercise to improve fatigue, and limited evidence in addressing CRC patient sexual concerns. For health promotion, high-quality evidence was found for exercises to improve cardiopulmonary fitness, metabolism, tumour-related biomarkers, and short-term improvement in physical fitness and QOL. Emerging evidence was found for a survivorship care plan to improve patient perceptions of care coordination. CONCLUSIONS Further refinements based on the existing evidence, and the development of comprehensive CRC survivorship care comprising multiple essential survivorship components, are required. Furthermore, considering both survivor and caregiver cancer survivorship needs, future research may optimise the care delivered, and help survivors and their families live better with cancer.
Collapse
Affiliation(s)
- Xingjuan Luo
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Jieyu Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Meizhen Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Jiali Gong
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Yongyong Xu
- School of Medicine, Northwest University, Xian, Shaanxi, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| |
Collapse
|
42
|
Son H, Kang Y. Coping Processes of Patients with Ostomies in South Korea: A Focus Group Study. Healthcare (Basel) 2020; 9:healthcare9010021. [PMID: 33375414 PMCID: PMC7824537 DOI: 10.3390/healthcare9010021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022] Open
Abstract
Despite the adverse effects of negative coping after receiving a stoma, there is a lack of information on how patients cope with ostomies and on their families' experiences throughout the coping process. We aimed to explore the coping experiences of individuals with ostomies throughout their illness, applying the Corbin and Strauss Chronic Illness Trajectory Framework, using exploratory qualitative methods involving focus group interviews. Purposive sampling was utilized to recruit 19 participants (split across three groups) through an ostomy association in South Korea. Two focus group interviews were separately conducted from March through to May 2017 until data saturation was achieved. Using qualitative content analysis, we analyzed the transcribed interviews and identified words and themes to interpret the results. The coping experiences of patients with ostomies were expressed through three interrelated themes: struggling and suffering, learning how to live with ostomy, and living with ostomy. We found gender differences in spousal support and a struggle among older patients regarding social coping. The themes identified suggest that gender should be considered when designing interventions to help patients cope with ostomies.
Collapse
Affiliation(s)
- Heesook Son
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea;
| | - Youngmi Kang
- East-West Nursing Research Institute, College of Nursing Science, Kyung Hee University, Seoul 02447, Korea
- Correspondence: ; Tel.: +82-2-961-9175
| |
Collapse
|
43
|
Biddell CB, Spees LP, Mayer DK, Wheeler SB, Trogdon JG, Rotter J, Birken SA. Developing personalized survivorship care pathways in the United States: Existing resources and remaining challenges. Cancer 2020; 127:997-1004. [PMID: 33259060 DOI: 10.1002/cncr.33355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/27/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Caitlin B Biddell
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Lisa P Spees
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Deborah K Mayer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.,School of Nursing, University of North Carolina, Chapel Hill, North Carolina
| | - Stephanie B Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Justin G Trogdon
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | | | - Sarah A Birken
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| |
Collapse
|
44
|
Maculotti D, Melis V, Roveron G, Spena PR, Villa G. Patient flow for the management of ostomy patients. MINERVA CHIR 2020; 75:365-372. [PMID: 33210529 DOI: 10.23736/s0026-4733.20.08472-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Subjects undergoing ostomy are increasing and share a reduced quality of life. The patient flow (PF) is the pathway of a patient from hospital admission to discharge and should provide care appropriateness to the patient himself. In the recent literature no paper exists regarding the PF of the patient undergoing (intestinal or urinary) ostomy, which is the objective of the present article. This paper stems from the work done during the Educational Camp entitled "The Patient Flow in Stoma Care," which took place on three separate days (27<sup>th</sup> May, 18<sup>th</sup> September, and 21<sup>st</sup> November 2019) at B. Braun Milano S.p.A. and regarded 33 stomatherapy nurses from all over Italy supervised by the authors. The participants, divided into heterogeneous groups, developed the PF by means of three specific work methodologies: mental maps, timeline and appreciative inquiry. The elaborated PF was inspired to the International Charter of the Ostomates' Rights. The efficacious and empathic communication and the role of the patient and/or the caregiver as the main characters are transversal to every step and must be always pursued. The PF is developed in eight macro-areas: diagnosis; pre-admission; admission and preoperative phase; surgical operation; awakening; postoperative phase; discharge; follow-up. In agreement with the recent literature, this systematic approach will give benefits to the patients in terms of outcome and perception of taking charge before, during and after the ostomy. At the same time the performances, the therapeutic appropriateness, the optimization of technology and healthcare resources and the staff satisfaction will equally be guaranteed.
Collapse
Affiliation(s)
- Danila Maculotti
- Fondazione Poliambulanza Istituto Europeo Multispecialistico, Brescia, Italy
| | | | - Gabriele Roveron
- Associazione Tecnico-Scientifica di Stomaterapia e Riabilitazione del Pavimento Pelvico (AIOSS), Padua, Italy
| | - Pier R Spena
- Federazione Associazioni Incontinenti e Stomizzati (FAIS), Milan, Italy
| | | | | |
Collapse
|
45
|
Abstract
Background: Minimal research focuses on interactions between providers and new ostomy patients. Studies show that provider communication is important for patient health outcomes. Objective: The purpose of this study was to investigate ostomy patients’ perceptions of provider communication following surgery and whether interactions adequately prepare ostomy patients to care for their new appliance. Method: Using a nonprobability national sample of 381 ostomy patients, we conducted a retrospective quantitative study. We measured adequacy of provider communication from self-reports from ostomy patients. Results: The results show that almost half of the sample (49%) reported receiving inadequate communication from providers. We also found a relationship between ostomy patients’ educational level and their perceptions of receiving adequate communication. Notably, patients with lower educational attainment reported receiving adequate communication up to 4 times more than patients with higher educational attainment. Conclusion: Our results suggest that not only do ostomy patients need better communication from providers following their surgery but also patients with higher educational attainment appear to expect more information from providers than patients with lower educational attainment.
Collapse
Affiliation(s)
| | - B Mitchell Peck
- Department of Sociology, University of Oklahoma, Norman, OK, USA
| |
Collapse
|
46
|
Mo J, Thomson CA, Sun V, Wendel CS, Hornbrook MC, Weinstein RS, Ercolano E, Grant M, Cidav Z, McCorkle RC, Krouse RS. Healthy behaviors are associated with positive outcomes for cancer survivors with ostomies: a cross-sectional study. J Cancer Surviv 2020; 15:461-469. [PMID: 32940890 PMCID: PMC7965775 DOI: 10.1007/s11764-020-00940-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/05/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cancer survivors (CS) with ostomies may face challenges in sustaining physical activity (PA) levels and maintaining healthy diets. This analysis describes lifestyle behaviors and their relationships with health-related quality of life (HRQOL) in CS with ostomies. METHODS This is a cross-sectional, secondary analysis of a multisite randomized self-management education trial for CS with ostomies. The baseline self-reported measures were queried on aerobic PA and diet using the City of Hope Quality of Life Ostomy measure, and the Self-Efficacy to Perform Self-Management Behaviors questionnaire (SE). PA was compared against the American Cancer Society PA guidelines for CS. Relationships between PA and HRQOL were evaluated using multiple linear regression, stratified by BMI. RESULTS Among 200 responders, fewer than 20% met or exceeded the PA guideline for cancer survivors; overall, confidence in the ability to perform gentle or aerobic PA was moderate (6/10 on the SE). Overall HRQOL (p = 0.038), psychological well-being (p = 0.017), and physical strength (p = 0.025) were associated with increased PA. Almost half (48.7%) of CS reported a special diet. CS with urostomies were less likely to report diet adjustments after their ostomy surgeries (OR: 0.16, 95% CI [0.08-0.38]) than CS with fecal ostomies. CONCLUSIONS Better HRQOL is associated with PA guideline achievement among CS with ostomies. Additionally, diet adjustments were reported more frequently in CS with fecal ostomies. Our findings bear clinical relevance for designing ostomy self-management and lifestyle recommendations for CS with ostomies. IMPLICATIONS FOR CANCER SURVIVORS The evaluation of lifestyle behaviors may be an especially important focus for CS with ostomies.
Collapse
Affiliation(s)
- Julia Mo
- Department of Surgery, University of Pennsylvania, 3400 Spruce St., 4 Silverstein, Philadelphia, PA, 19104, USA
| | - Cynthia A Thomson
- Mel & Enid Zuckerman College of Public Health and University of Arizona Cancer Center, Tucson, AZ, USA
| | - Virginia Sun
- Division of Nursing Research and Education, City of Hope, Duarte, CA, USA
| | | | - Mark C Hornbrook
- Center for Health Research, Kaiser Permanente, Portland, OR, USA
| | | | | | - Marcia Grant
- Division of Nursing Research and Education, City of Hope, Duarte, CA, USA
| | - Zuleyha Cidav
- Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Robert S Krouse
- Department of Surgery, University of Pennsylvania, 3400 Spruce St., 4 Silverstein, Philadelphia, PA, 19104, USA.
| |
Collapse
|
47
|
Giordano V, Nicolotti M, Corvese F, Vellone E, Alvaro R, Villa G. Describing self‐care and its associated variables in ostomy patients. J Adv Nurs 2020; 76:2982-2992. [DOI: 10.1111/jan.14499] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/15/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Vittoria Giordano
- Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy
| | | | - Francesco Corvese
- Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy
| | - Giulia Villa
- Urology Unit IRCCS San Raffaele Institute Milan Italy
| |
Collapse
|
48
|
Rimmer B, Dutton L, Lewis J, Burns R, Gallagher P, Williams S, Araujo-Soares V, Finch T, Sharp L. Ways Ahead: developing a supported self-management programme for people living with low- and intermediate-grade gliomas - a protocol for a multi-method study. BMJ Open 2020; 10:e041465. [PMID: 32727741 PMCID: PMC7394298 DOI: 10.1136/bmjopen-2020-041465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Living with and beyond a diagnosis of a low- and intermediate-grade glioma (LIGG) can adversely impact many aspects of people's lives and their quality of life (QoL). In people with chronic conditions, self-management can improve QoL. This is especially true if people are supported to self-manage. Supported self-management programmes have been developed for several cancers, but the unique challenges experienced by LIGG survivors mean these programmes may not be readily transferable to this group. The Ways Ahead study aims to address this gap by exploring the needs of LIGG survivors to develop a prototype for a supported self-management programme tailored to this group. METHODS AND ANALYSIS Ways Ahead will follow three sequential phases, underpinned by a systematic review of self-management interventions in cancer. In phase 1, qualitative methods will be used to explore and understand the issues faced by LIGG survivors, as well as the barriers and facilitators to self-management. Three sets of interviews will be conducted with LIGG survivors, their informal carers and professionals. Thematic analysis will be conducted with reference to the Theoretical Domains Framework and Normalisation Process Theory. Phase 2 will involve co-production workshops to generate ideas for the design of a supported self-management programme. Workshop outputs will be translated into a design specification for a prototype programme. Finally, phase 3 will involve a health economic assessment to examine the feasibility and benefits of incorporating the proposed programme into the current survivorship care pathway. This prototype will then be ready for testing in a subsequent trial. ETHICS AND DISSEMINATION The study has been reviewed and approved by an National Health Service Research Ethics Committee (REC ref: 20/WA/0118). The findings will be disseminated through peer-reviewed journals, conference presentations, broadcast media, the study website, The Brain Tumour Charity and stakeholder engagement activities.
Collapse
Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Joanne Lewis
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | | | - Sophie Williams
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Vera Araujo-Soares
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
49
|
Jin Y, Ma H, Jiménez‐Herrera M. Self‐disgust and stigma both mediate the relationship between stoma acceptance and stoma care self‐efficacy. J Adv Nurs 2020; 76:2547-2558. [DOI: 10.1111/jan.14457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/22/2020] [Accepted: 06/15/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Yanfei Jin
- Rovira i Virgili University Tarragona Spain
| | | | | |
Collapse
|
50
|
Abstract
BACKGROUND Patient engagement (PE) is a key factor for early-stage breast cancer survivors during survivorship, yet little is known about what factors may contribute to PE. OBJECTIVES The aims of this study were to describe the relationship between sociodemographic factors, survivorship variables, and PE and explore how variations in these variables might contribute to PE in breast cancer survivors. METHODS A cross-sectional, web-based self-report national survey was conducted to assess sociodemographic factors and survivorship variables: health-related quality of life (HRQOL) as measured by 7-item Functional Assessment of Cancer Therapy-General, fear of cancer recurrence, cancer health literacy, and 2 measures of PE (Patient Activation and Knowing Participation in Change) in breast cancer survivors. One open-ended question assessed additional survivorship concerns. Data were analyzed via bivariate associations and backward linear regression modeling in SPSS. RESULTS The sample (N = 303), equally dispersed across the United States, was predominantly middle-aged (mean, 50.70 [SD, 14.01]), white, non-Hispanic women. Knowing Participation in Change and Patient Activation regression models indicate HRQOL was significantly associated with PE (P ≤ .001), whereas findings related to fear of cancer recurrence lacked significance. In the Knowing Participation in Change regression model, HRQOL, social support, and level of education were all significantly associated with PE (P ≤ .001). CONCLUSIONS Breast cancer survivors with higher HRQOL, greater social support, and higher levels of education were more likely to have higher levels of PE. IMPLICATIONS FOR PRACTICE Findings may provide insight as to which survivors may be ready to engage in SC and those who may need more specific tailoring of resources and support.
Collapse
|