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Seibæk L, Thaysen HV, Lomborg KE. Non-curative surgical oncology: postoperative needs and preferences. BMJ Support Palliat Care 2024; 14:208-214. [PMID: 33941572 DOI: 10.1136/bmjspcare-2020-002789] [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: 11/09/2020] [Revised: 03/18/2021] [Accepted: 04/01/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE When intended curative cancer surgery is not completed, the postoperative transition to palliative care represents a prognostic landmark to patients and their families. In patients referred for highly specialised surgery for peritoneal metastases from the intestinal tract and ovaries, surgery is not performed in approximately 25%. Still, little is known of their postoperative needs and preferences. METHODS We performed 14 qualitative research interviews with 12 patients (four men and eight women, aged 41-85 years) undergoing surgery for peritoneal metastases; five of these were together with a relative. Five of the participants had ovarian, and seven had colorectal cancer (four men and seven women). The interviews followed a semistructured interview guide, were audio recorded, transcribed verbatim and analysed using meaning condensation. RESULTS Patients accepted the surgeon's decision of refraining from the intended surgery. During the postoperative period, when realising the prognostic consequences, their needs changed rapidly, in some cases from day to day, and gradually they developed a reoriented focus on their lives. The findings were framed by two themes dealing with 'Change in treatment strategy' and 'Physical and psychosocial aspects of not undergoing curative surgery'. CONCLUSION When curative cancer surgery is not completed as intended, patient-centred communication is essential for patients' psychosocial reorientation and quality of life. Further, to support their well-being and action competences, patients have a need for basic supportive care and physical restitution. Finally, high-quality postoperative palliative care needs to be coordinated, which requires staff training and reorganisation of pathways.
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Affiliation(s)
- Lene Seibæk
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
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Senter M, Clifford AM, O'Callaghan M, McCormack M, Ni Bhriain O. Experiences of people living with Parkinson's disease and key stakeholders in dance-based programs: a systematic review and meta-ethnography. Disabil Rehabil 2024:1-14. [PMID: 38459897 DOI: 10.1080/09638288.2024.2327499] [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: 10/20/2023] [Accepted: 03/02/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE To identify and synthesize qualitative literature on the experiences of participants and key stakeholders in dance programs for people living with Parkinson's disease. Synthesizing the available literature can generate new insights into participant experience to inform current and future programs. MATERIALS AND METHODS Qualitative and mixed methods studies were identified via a systematic search of six databases: CINAHL, Web of Science, Scopus, SPORTDiscus, PsycInfo, and MEDLINE. Articles were synthesized using the meta-ethnographic method developed by Noblit and Hare (1988). Key concepts across studies were related via reciprocal translation, ultimately forming a line-of-argument synthesis. RESULTS 26 articles met the inclusion criteria. Four interrelated, overarching themes were developed: (1) dance communities provide peer support and insight into living with Parkinson's, (2) feeling safe, accepted, and included in the dance experience, (3) overcoming dance-based challenges contributes to sense of achievement, confidence, and connectedness, and (4) dance participation is an opportunity to re-imagine oneself. CONCLUSION Participant experience is shaped by the instructor-participant relationship, the social environment of classes, and class difficulty level. In order to support participant experience, classes should be safe, supportive, and have an appropriate challenge-skill balance. These qualities facilitate creative immersion and the potential for personal and collective change.
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Affiliation(s)
- Morgan Senter
- Irish World Academy of Music and Dance, Faculty of Arts, Humanities, and Social Sciences, University of Limerick, Co. Limerick, Ireland
| | - Amanda M Clifford
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Co. Limerick, Ireland
- Health Research Institute, University of Limerick, Co. Limerick, Ireland
- Ageing Research Centre, University of Limerick, Co. Limerick, Ireland
| | - Maureen O'Callaghan
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Co. Limerick, Ireland
| | - Megan McCormack
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Co. Limerick, Ireland
| | - Orfhlaith Ni Bhriain
- Irish World Academy of Music and Dance, Faculty of Arts, Humanities, and Social Sciences, University of Limerick, Co. Limerick, Ireland
- Health Research Institute, University of Limerick, Co. Limerick, Ireland
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Hayes C, Fitzgerald C, O'Shaughnessy Í, Condon B, Leahy A, O'Connor M, Manning M, Griffin A, Glynn L, Robinson K, Galvin R. Exploring stakeholders' experiences of comprehensive geriatric assessment in the community and out-patient settings: a qualitative evidence synthesis. BMC PRIMARY CARE 2023; 24:274. [PMID: 38093176 PMCID: PMC10717956 DOI: 10.1186/s12875-023-02222-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Comprehensive Geriatric Assessment (CGA) is a multidimensional interdisciplinary process that addresses an older adult's biopsychosocial capabilities to create an integrated and co-ordinated plan of care. While quantitative evidence that demonstrates the positive impacts of CGA on clinical and process outcomes has been synthesised, to date qualitative research reporting how older adults and service providers experience CGA has not been synthesised. This study aimed to systematically review and synthesise qualitative studies reporting community-dwelling older adults', caregivers' and healthcare professionals' (HCP) experiences of CGA in the primary care and out-patient (OPD) setting. METHOD We systematically searched five electronic databases including MEDLINE, CINAHL, PsycINFO, PsycARTICLES and Social Sciences Full Text targeting qualitative or mixed methods studies that reported qualitative findings on older adults', caregivers' and HCPs' experiences of CGA in primary care or out-patient settings. There were no language or date restrictions applied to the search. The protocol was registered with the PROSPERO database (Registration: CRD42021283167). The methodological quality of the included studies was appraised using the Critical Appraisal Skills Programme checklist for qualitative research. Results were synthesised according to Noblit and Hare's seven-step approach to meta-ethnography, which involves an iterative and inductive process of data synthesis. RESULTS Fourteen studies were included where CGA was completed in the home, general practice, out-patient setting in acute hospitals and in hybrid models across the community and hospital-based OPD settings. Synthesis generated four key themes: (1) CGA is experienced as a holistic process, (2) The home environment enhances CGA, (3) CGA in the community is enabled by a collaborative approach to care, and (4) Divergent experiences of the meaningful involvement of older adults, caregivers and family in the CGA process. CONCLUSION Findings demonstrate that CGA in a home-based or OPD setting allows for a holistic and integrated approach to care for community-dwelling older adults while increasing patient satisfaction and accessibility of healthcare. Healthcare professionals in the community should ensure meaningful involvement of older adults and their families or caregivers in the CGA process. Further robustly designed and well reported trials of different models of community-based CGA informed by the findings of this synthesis are warranted.
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Affiliation(s)
- Christina Hayes
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Christine Fitzgerald
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Íde O'Shaughnessy
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Brian Condon
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Aoife Leahy
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Margaret O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Limerick, Ireland
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Molly Manning
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anne Griffin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liam Glynn
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- HRB Primary Care Clinical Trials Network Ireland, Discipline of General Practice, School of Medicine, HRB Primary Care Clinical Trials Network Ireland, National University of Ireland Galway, Galway, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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González-Herrera A, Pujol-Ribera E, Esteva M, Ruiz-Marcos L, March S. Colorectal cancer: a qualitative study of coping strategies used by survivors, with associated social determinants. Arch Public Health 2023; 81:111. [PMID: 37331995 DOI: 10.1186/s13690-023-01104-4] [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: 08/12/2022] [Accepted: 05/06/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Colorectal cancer survivors have to develop coping strategies during the diagnosis and survivorship period. This study aims to identify coping strategies in patients with colorectal cancer, in particular the differences between coping strategies during the disease and throughout survival. It also aims to investigate the impact of some social determinants on coping strategies and critically reflect on the influence of positive psychology. METHODS Qualitative study with in-depth interviews of a purposive sample of 21 colorectal cancer survivors in Majorca (Spain), developed between 2017-2019. Data was analysed using interpretive thematic analysis. RESULTS We observed different coping strategies during the stages of disease and survival. However, striving toward acceptance and adaptation when facing difficulties and uncertainty, predominate in both stages. Confrontational attitudes are also considered important, as well as encouraging positive rather than negative feelings, which are considered unhelpful and to be avoided. CONCLUSIONS Although coping during illness and survival can be classified into common categories (problem and emotion-centred strategies), the challenges of these stages are faced differently. Age, gender and the cultural influence of positive psychology strongly influence both stages and strategies.
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Affiliation(s)
| | - Enriqueta Pujol-Ribera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Gerència Territorial de Barcelona, Institut Català de La Salut, Barcelona, Spain
| | - Magdalena Esteva
- Primary Care Research Unit, Majorca Department of Primary Care, Baleares Health Service (IbSalut), Palma, Majorca, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Majorca, Spain.
| | - Lorena Ruiz-Marcos
- Faculty of Political Sciences and Sociology, Complutense University of Madrid, Pozuelo de Alarcón, Madrid, Spain
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Raque TL, Ross KV, Hangge AR, Gaines RC. A Meta-Ethnography on the Impact of Cancer for Lesbian and Queer Women and Their Partners. QUALITATIVE HEALTH RESEARCH 2023; 33:371-387. [PMID: 36802915 DOI: 10.1177/10497323231155403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Lesbian and queer women face unique experiences navigating cancer care, including challenges in accessing services that incorporate their relational supports. Given the importance of social support for survivorship, this study examines the impact of cancer on lesbian/queer women in romantic relationships. We conducted the seven stages of Noblit and Hare's meta-ethnography. PubMed/MEDLINE, PsycINFO, SocINDEX, and Social Sciences Abstract databases were searched. Two hundred and ninety citations were initially identified, 179 abstracts were reviewed, and 20 articles were coded. Themes were (a) intersectionality of lesbian/queer identity in the cancer context; (b) institutional and systemic supports and barriers; (c) navigation of disclosure; (d) characteristics of affirmative cancer care; (e) survivors' critical reliance on their partner(s); and (f) shifts in connection after cancer. Findings indicate the importance of accounting for intrapersonal, interpersonal, institutional, and socio-cultural-political factors for understanding the impact of cancer for lesbian and queer women and their romantic partners. Affirmative cancer care for sexual minorities fully validates and integrates partners in care, removes heteronormative assumptions in services provided, and offers LGB+ patient and partner support services.
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Affiliation(s)
- Trisha L Raque
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Kaitlin V Ross
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Anna R Hangge
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Rebecca C Gaines
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
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Chou YJ, Wang YC, Lin BR, Shun SC. Resilience process in individuals with colorectal cancer: a qualitative study. Qual Life Res 2023; 32:681-690. [PMID: 36050622 DOI: 10.1007/s11136-022-03242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Resilience is a positive outcome in giving individuals strength to adapt to cancer and have better various aspects of health-related quality of life. However, research focusing on resilience in relation to colorectal cancer (CRC) is limited. Therefore, the aim of this study was to explore the process of resilience in individuals with CRC. METHOD Sixteen individuals diagnosed with stage Ι to III CRC within the last five years were recruited from a CRC surgical outpatient department in a medical center in Northern Taiwan. Semi-structured interviews were used to explore the resilience process of living with CRC. Recorded interviews were transcribed verbatim and were analyzed using modified grounded theory. FINDINGS Resilience is a dynamic three-phase process, including impact of CRC, adaptation or maladaptation following CRC, and growth from CRC experience. Resilience strategies (i.e., attitude adjustment, developing personal strategies to conquer CRC and side effects, setting new goals in life, and viewing death as a normal process), avoidance behaviors, and passive waiting strategy were shown across the resilience process. CONCLUSIONS All individuals showed negative impacts during CRC diagnosis and treatments, but some individuals used the resilience strategies in helping to promote positive adjustment and redirect to develop their resilience process. Furthermore, resilient and maladaptive individuals may change the situation depending on which strategies are used and on the progression of CRC because resilience is dynamic. Oncology clinicians should help individuals use resilience strategies to smoothly go through the resilience process.
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Affiliation(s)
- Yun-Jen Chou
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ya-Ching Wang
- School on Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Been-Ren Lin
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shiow-Ching Shun
- School of Nursing, Institute of Clinical Nursing, National Yang Ming Chiao Tung University, No.155, Sec.2, Li-Nong Street, Taipei, 112, Taiwan.
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Lognos B, Boulze-launay I, Élodie M, Bourrel G, Amouyal M, Gocko X, Bernard C, Ninot G, Oude Engberink A. The central role of peers facilitators in the empowerment of breast cancer patients: a qualitative study. BMC Womens Health 2022; 22:308. [PMID: 35871655 PMCID: PMC9310400 DOI: 10.1186/s12905-022-01892-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
Background In 2020, the number of new cancer cases was estimated at 20 490 862 worldwide up from 18.1 million in 2018 and 14.1 million in 2012. Since the 2000s, cancer treatments have significantly improved, allowing either a cure or control of the disease. Patients share their experience of the disease and use supportive care solutions through involvement in patient associations and online forums. All the associations were built on the principle of “peer support,” which is based on mutual aid between people who suffer or have suffered from the same somatic or psychological illness or had the same life experience. This experiential knowledge can be explored to understand the role of peers and associations in the appropriation of their cancer. Methods A qualitative phenomenological study was undertaken through semi-structured interviews with 12 participants. Interviews were audio-recorded, transcribed verbatim, then analyzed by means of triangulation up to the point of theoretical saturation by a semio-pragmatic method.
Results Four categories emerged: (1) “Transforms a painful experience into a positive one. It mobilizes the human values of sharing, love, and humility, which facilitates resilience”; (2) “The characteristics of the association, a non-medical place between people sharing a common destiny, resonates with patients’ needs and improves their well-being”; (3) “The association transforms the patients’ experiences by facilitating engagement that leads to a patient-expert (empowerment)”; and (4) “Understanding what is happening to them is soothing, reassuring, because patients’ concerns need to be heard and their care understood”.
Conclusions This study highlights patient associations can serve as the mediator of NPI and facilate the empowerment of breast cancer patients.
Practice implications Educating health professionals in initial and continuing education about non-pharmacological interventions will be a major issue. Teaching the patient-centred approach to health professionals is one of the priorities in initial and continuing medical education.
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Wan SW, Chng YJD, Lim SH, Chong CS, Pikkarainen M, He HG. A systematic review and meta-analysis on the effectiveness of web-based psychosocial interventions among patients with colorectal cancer. J Adv Nurs 2022; 78:1883-1896. [PMID: 35441711 DOI: 10.1111/jan.15258] [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: 09/05/2021] [Revised: 02/14/2022] [Accepted: 03/23/2022] [Indexed: 11/27/2022]
Abstract
AIMS To synthesize the effectiveness of web-based psychosocial interventions on self-efficacy, anxiety, depression, quality of life (QoL), non-specific psychological and cancer-specific distress among patients with colorectal cancer (CRC). DESIGN A systematic review and meta-analysis. DATA SOURCES Six databases (PubMed, PsycINFO, Embase, Scopus, CINAHL and CNKI) were searched from inception to December 2021. REVIEW METHODS Experimental/quasi-experimental studies involving patients with CRC for the improvement of aforementioned outcomes were included. Two reviewers screened and extracted the data, and assessed studies' methodological quality using risk of bias tools. Meta-analyses and narrative syntheses were performed. RESULTS Nineteen studies consisting of 1386 participants were identified. Cognitive-behavioural therapy delivered online was the most common trialled web-based psychosocial intervention. Meta-analyses revealed no positive effect for self-efficacy (standardized mean difference 0.93, 95% CI: 0.52 to 1.35, p < .01) and minimal benefit for QoL (mean difference [MD] 2.83, 95% CI: -0.31 to 5.98, p = .08) but significant positive effects for anxiety (MD -2.23, 95% CI: -3.31 to -1.14, p < .01) and depression (MD -2.84, 95% CI: -4.09 to -1.59, p < .01) among CRC survivors in the intervention group as compared with the control group. Narrative synthesis suggested possible benefits in reducing distress. CONCLUSION Web-based psychosocial interventions are promising alternatives to conventional delivery methods in reducing patients' anxiety, depression and distress. However, evidence on self-efficacy and QoL remains inconsistent. More adequately powered, well-designed trials with targeted and theory-based interventions are required to ascertain findings. IMPACT By highlighting the potential of web-based psychosocial interventions in reducing anxiety and depression among CRC survivors, this review has put forth beneficial information supporting the use and acceptance of web-based care delivery in light of COVID-19 restrictions and nationwide lockdowns. Meanwhile, the paucity of empirical support reflects the necessity of more extensive research to test and improve other health outcomes. PROSPERO registration number: CRD42021261396.
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Affiliation(s)
- Su Wei Wan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- National University Health System, Singapore
| | | | - Siew Hoon Lim
- Nursing Division (Research), Singapore General Hospital, Singapore
| | - Choon Seng Chong
- National University Health System, Singapore
- Division of Colorectal Surgery and Surgical Oncology, Department of Surgery, National University Cancer Institute, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Minna Pikkarainen
- Chalmers University of Technology, Goteborg, Sweden
- Oslomet, Oslo Metropolitan University, Oslo, Norway
- University of Oulu, Oulu, Finland
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- National University Health System, Singapore
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Renman D, Strigård K, Palmqvist R, Näsvall P, Gunnarsson U, Edin-Liljegren A. Attitudes to and Experiences of Physical Activity After Colon Cancer Diagnosis Amongst Physically Active Individuals - A Qualitative Study. Cancer Control 2022; 29:10732748221119352. [PMID: 36066380 PMCID: PMC9459499 DOI: 10.1177/10732748221119352] [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] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Physical activity improves survival, reduces postoperative complications, and reduces the risk of developing colon cancer. It is important to maintain physical activity after receiving a diagnosis of colon cancer to improve postoperative recovery. Individuals who are physically active and diagnosed with colon cancer presumably have different motivations to maintain physical activity compared to their sedentary counterparts. OBJECTIVE Enlighten how the diagnosis of colon cancer might affect physically active individuals in their attitude and experiences towards physical activity. METHODS A qualitative study using content analysis was conducted in northern Sweden based on semi-structured telephone interviews of twenty patients diagnosed with colon cancer. All participants met the recommendations for physical activity issued by the World Health Organization. RESULTS Participants were between 50 and 88 years and 50% were male. Three main categories were identified: I'll fight the cancer and come out stronger; The diagnosis makes no difference; and The diagnosis is an obstacle for physical activity. These main categories represent the ways the individuals reacted to the diagnosis of colon cancer regarding their physical activity. CONCLUSION Attitudes to and experience of physical activity after colon cancer diagnosis varied from a will to increase physical activity and fight the cancer, to the diagnosis putting a stop to physical activity. It is important that healthcare professionals recommend physical activity even in already physically active individuals, to encourage continued physical activity after diagnosis of colon cancer.
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Affiliation(s)
- David Renman
- Department of Surgical and Perioperative Sciences, Surgery, 206100Umeå University, Umeå, Sweden
| | - Karin Strigård
- Department of Surgical and Perioperative Sciences, Surgery, 206100Umeå University, Umeå, Sweden
| | - Richard Palmqvist
- Department of Medical Biosciences, Pathology, 377074Umeå University, Umeå, Sweden
| | - Pia Näsvall
- Department of Surgical and Perioperative Sciences, Surgery, 206100Umeå University, Umeå, Sweden
| | - Ulf Gunnarsson
- Department of Surgical and Perioperative Sciences, Surgery, 206100Umeå University, Umeå, Sweden
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Wan SW, Chong CS, Jee XP, Pikkarainen M, He HG. Perioperative experiences and needs of patients who undergo colorectal cancer surgery and their family caregivers: a qualitative study. Support Care Cancer 2022; 30:5401-5410. [PMID: 35298716 PMCID: PMC8929239 DOI: 10.1007/s00520-022-06963-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/07/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Colorectal cancer (CRC) surgeries are major, complex, and often associated with debilitating symptoms or significant deconditioning that may impair patients' quality of life. Little is known about how patients and family caregivers cope and their unmet needs during this daunting perioperative phase. This study aimed to explore the experiences and needs of CRC patients who undergo surgery and their family caregivers. METHODS An exploratory qualitative design was adopted. A total of 27 participants comprising fifteen outpatients who had undergone colorectal cancer surgery and twelve family caregivers were recruited through purposive sampling from a public tertiary hospital in Singapore between December 2019 and November 2020. Individual, audio-recorded, semi-structured interviews were conducted, transcribed verbatim, and analyzed using thematic analysis. RESULTS Four themes emerged: initial reactions to the diagnosis, impact of the illness and surgery, personal coping, and external support. The lack of apparent assessments on the psychological well-being of patients was found despite several participants exhibiting early signs of distress. Access to psychological support provided by healthcare professionals or peers was selective, and knowledge deficit was prevalent, especially in the preoperative stage. CONCLUSION Psychological priming and strengthening are important for CRC patients' and their caregivers' adaptive coping throughout the treatment continuum. Technology-based, dyadic psychoeducation should be offered preoperatively to ease CRC patients' acceptance of their diagnosis and adjustment to life after surgery while at the same time reduce the burden of family carers.
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Affiliation(s)
- Su Wei Wan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 1, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597 Singapore
| | - Choon Seng Chong
- Division of Colorectal Surgery and Surgical Oncology, Department of Surgery, National University Cancer Institute, National University Hospital, Singapore, Singapore ,Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Xin Pei Jee
- Division of Colorectal Surgery, Department of Nursing, National University Hospital, Singapore, Singapore ,National University Health System, Singapore, Singapore
| | - Minna Pikkarainen
- Martti Ahtisaari Institute, Oulu Business School, Oulu University, Oulu, Finland ,Oslomet, Oslo Metropolitan University, Oslo, Norway
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 1, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597 Singapore
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A Resilience Model for Patients With Colorectal Cancer: A Structural Equation Modeling Analysis. Cancer Nurs 2021; 45:E83-E90. [PMID: 34870940 DOI: 10.1097/ncc.0000000000000882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients with colorectal cancer (CRC) experience multiple symptoms. Resilience is a positive health outcome that can assist patients to face and adapt to their disease. OBJECTIVE The purpose of this study was to evaluate a proposed resilience model for patients with CRC. METHODS Patients (n = 416), who were given a diagnosis of stage Ι to III CRC within the past 5 years, were recruited from 2 medical centers in Northern Taiwan. Symptom Severity Scale, Fatigue Symptom Inventory, and Center for Epidemiological Studies Depression scale were used to assess the risk factors of symptom severity, fatigue, and depressive symptoms, respectively. Cancer Behavior Inventory and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale were used to assess the protective factors of self-efficacy for coping with cancer and spiritual well-being, respectively. Resilience was assessed using the Resilience Scale. Structural equation modeling was used to evaluate the proposed resilience model for patients with CRC. RESULTS The initial structural equation modeling fit indices did not support the proposed model. In the revised model, depressive symptoms was a partial mediator between protective factors and resilience with an acceptable model fit (comparative fit index, 0.968; root mean square error of approximation, 0.085; standardized root mean square residual, 0.034). CONCLUSIONS Patients with CRC who had higher levels of protective factors had higher levels of resilience. This study provides new information on the role of depressive symptoms as a partial mediator between protective factors and resilience. IMPLICATIONS FOR PRACTICE Oncology nurses need to evaluate for depressive symptoms as well as protective factors and resilience in patients with CRC.
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Wan SW, Chong CS, Toh EL, Lim SH, Loi CT, Lew YFH, Chua MCH, Jee XP, Liu G, Zhu L, Pikkarainen M, He HG. A Theory-Based, Multidisciplinary Approach to Cocreate a Patient-Centric Digital Solution to Enhance Perioperative Health Outcomes Among Colorectal Cancer Patients and Their Family Caregivers: Development and Evaluation Study. J Med Internet Res 2021; 23:e31917. [PMID: 34878991 PMCID: PMC8693179 DOI: 10.2196/31917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/10/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022] Open
Abstract
Background Elective colorectal cancer (CRC) surgeries offer enhanced surgical outcomes but demand high self-efficacy in prehabilitation and competency in self-care and disease management postsurgery. Conventional strategies to meet perioperative needs have not been pragmatic, and there remains a pressing need for novel technologies that could improve health outcomes. Objective The aim of this paper was to describe the development of a smartphone-based interactive CRC self-management enhancement psychosocial program (iCanManage) in order to improve health outcomes among patients who undergo elective CRC surgeries and their family caregivers. Methods A multidisciplinary international team comprising physicians, specialist nurses, a psychologist, software engineers, academic researchers, cancer survivors, patient ambassadors, and ostomy care medical equipment suppliers was formed to facilitate the development of this patient-centric digital solution. The process occurred in several stages: (1) review of current practice through clinic visits and on-site observations; (2) review of literature and findings from preliminary studies; (3) content development grounded in an underpinning theory; (4) integration of support services; and (5) optimizing user experience through improving interface aesthetics and customization. In our study, 5 participants with CRC performed preliminary assessments on the quality of the developed solution using the 20-item user version of the Mobile App Rating Scale (uMARS), which had good psychometric properties. Results Based on the collected uMARS data, the smartphone app was rated highly for functionality, aesthetics, information quality, and perceived impact, and moderately for engagement and subjective quality. Several limiting factors such as poor agility in the adoption of digital technology and low eHealth literacy were identified despite efforts to promote engagement and ensure ease of use of the mobile app. To overcome such barriers, additional app-training sessions, an instruction manual, and regular telephone calls will be incorporated into the iCanManage program during the trial period. Conclusions This form of multidisciplinary collaboration is advantageous as it can potentially streamline existing care paths and allow the delivery of more holistic care to the CRC population during the perioperative period. Should the program be found to be effective and sustainable, hospitals adopting this digital solution may achieve better resource allocation and reduce overall health care costs in the long run. Trial Registration ClinicalTrials.gov NCT04159363; https://clinicaltrials.gov/ct2/show/NCT04159363
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Affiliation(s)
- Su Wei Wan
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Choon Seng Chong
- National University Health System, Singapore, Singapore.,Division of Colorectal Surgery and Surgical Oncology, Department of Surgery, National University Cancer Institute, National University Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ee-Lin Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Colorectal Surgery, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Siew Hoon Lim
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
| | - Carol Tt Loi
- Centre of Psychosocial Support, Singapore Red Cross Academy, Singapore, Singapore
| | - Yuen Foong Henry Lew
- Department of Psychology, School of Humanities and Behavioural Science, Singapore University of Social Sciences, Singapore, Singapore
| | - Matthew Chin Heng Chua
- Medical and Cybernetics Systems, Institute of Systems Science, National University of Singapore, Singapore, Singapore
| | - Xin Pei Jee
- National University Health System, Singapore, Singapore.,Division of Colorectal Surgery, Department of Nursing, National University Hospital, Singapore, Singapore
| | - Guangyu Liu
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Lixia Zhu
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Minna Pikkarainen
- Faculty of Health Sciences and Faculty of Technology, Art and Design, Oslomet - Oslo Metropolitan University, Oslo, Norway.,Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Faculty of Medicine and Oulu Business School, University of Oulu, Oulu, Finland
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
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13
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Johansson A, Karlsson J, Fomichov V, Lindhoff Larsson A, Sandström P, Björnsson B, Drott J. Patient-reported recovery in upper abdominal cancer surgery care: A prospective study. Sci Prog 2021; 104:368504211016938. [PMID: 33979255 PMCID: PMC10454853 DOI: 10.1177/00368504211016938] [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] [Indexed: 11/16/2022]
Abstract
The study aimed to describe and analyse patient-reported recovery in patients after upper abdominal cancer surgery. This study had a quantitative design and patients were consecutively included in a university hospital in southern Sweden. Twenty-four patients answered the Postoperative Recovery Profile (PRP) questionnaire at three measurement points. All five dimensions were affected. In the physical symptoms dimension, the majority of patients reported a lack of energy upon discharge. High levels of anxiety were reported. Over 50% of patients reported some degree of depressed mood at all three measurement points. In the social dimension, the majority of patients reported some degree of being dependent on help from others in everyday life at 4 weeks after discharge. Few patients are fully recovered at 4 weeks after discharge. Individual patient-reported recovery estimates may be valuable in identifying and planning interventions tailored to each patient's needs throughout the care process.
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Affiliation(s)
- Anna Johansson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Jessica Karlsson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Victoria Fomichov
- Unit for Public Health and Statistics, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Anna Lindhoff Larsson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Per Sandström
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Bergthor Björnsson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Jenny Drott
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
- Division of Nursing Science, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Vena JA, Copel LC. A Meta-Ethnography of the Experiences of Adults with Lymphoma During Acute and Chronic Survivorship. Semin Oncol Nurs 2021; 37:151142. [PMID: 33773881 DOI: 10.1016/j.soncn.2021.151142] [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: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The acute and chronic phases of cancer survivorship are the periods of treatment, post-treatment, and early remission. During acute and chronic survivorship, adults with lymphoma have reported both positive and negative changes in health-related quality of life. This meta-ethnography aims to appraise the experiences of adults with lymphoma at the acute and chronic survivorship phases. DATA SOURCES This qualitative review used the established meta-ethnography framework from Noblit and Hare and is outlined following the meta-ethnography reporting guidance (eMERGe). A systematic literature search using four unique databases was completed, including the Cumulative Index to Nursing and Allied Health Literature, PubMed, Ovid Emcare, and Clarivate Web of Science. CONCLUSION In total, nine research studies were included in this review. Study characteristics and sample evidence were extracted from the included studies to produce the synthesis. The review and synthesis formed three main themes and six subthemes that reflect the challenges of cancer treatment and post-treatment, the communication and support from others, and how lymphoma patients reframe and reprioritize during and following treatment. IMPLICATIONS FOR NURSING PRACTICE This meta-ethnography provides a comprehensive analysis of adults' experiences with lymphoma at the acute and chronic survivorship phases. Several approaches for the management and care of lymphoma patients were found in this review, including integrating patient support groups from diagnosis through post-treatment, tailored psychological health care services, personalized care and delivery pathways at post-treatment, and the promotion of strategies to cope with cancer in remission. Additional research should examine younger and older adults to discover age-related issues in lymphoma populations in addition to disparities among minority patients with lymphoma and those from low socioeconomic backgrounds.
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Affiliation(s)
- Joseph A Vena
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA.
| | - Linda C Copel
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA
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15
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Kaiser M, Adami S, Lucius-Hoene G, Muller-Nordhorn J, Goerling U, Breuning M, Holmberg C. Learning-by-doing: the importance of experiential knowledge sharing for meeting the information needs of people with colorectal cancer in Germany-a qualitative study. BMJ Open 2021; 11:e038460. [PMID: 33622937 PMCID: PMC7907857 DOI: 10.1136/bmjopen-2020-038460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 01/14/2021] [Accepted: 01/30/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The aim of this article is to understand how, when and why the topics of information and information needs arise when people diagnosed with colorectal cancer (CRC) narrate their illness experiences. METHODS Guided by principles of grounded theory, a qualitative interview study was conducted that collected a wide variety of illness experiences with CRC in Germany using maximum variation sampling. Sampling criteria included place of residence, age at interview, age at diagnosis, treatment, disease course and sociodemographic factors such as varying family backgrounds and professions. SETTING AND PARTICIPANTS Men and women diagnosed with CRC in different parts of Germany were sought via physicians, social workers and psychologists in hospital settings, organisations offering psychosocial support for patients with cancer, self-help groups, rehabilitation centres, newspapers and personal contacts. The interviewees in the final sample (n=41) had been diagnosed with CRC between 4 weeks and 36 years prior to the interview. RESULTS Three inter-related categories of information needs emerged from the analysis: the need for non-medical information for daily life; the challenge of integrating the bodily changes that accompany CRC in everyday life; and sources of non-medical information concerning handling daily life. Learning to live with the bodily changes of CRC in everyday life was described as a long process of learning-by-doing. While sources for medical information were clear, finding practical information was often a challenge. The best source of such information was often seen to be other people living with the disease, who shared their experiential knowledge, as well as stoma and nutritional therapists. CONCLUSION Information needs are part of the process and struggle to normalise everyday life after a disruptive diagnosis and treatment. Providing access to practical knowledge and information from others with CRC experience may be an important resource for patient support.
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Affiliation(s)
- Maleen Kaiser
- Institute of Public Health, Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Sandra Adami
- Fachklinik für Psychosomatische Medizin und Psychotherapie, Celenus Fachklinik Freiburg, Freiburg, Germany
| | - Gabriele Lucius-Hoene
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Ute Goerling
- Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Martina Breuning
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg/Havel, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg/Havel, Germany
- Berlin School of Public Health, Charite Universitätsmedizin Berlin, Berlin, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany
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16
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Lo PS, Lin YP, Hsu HH, Chang SC, Yang SP, Huang WC, Wang TJ. Health self-management experiences of colorectal cancer patients in postoperative recovery: A qualitative study. Eur J Oncol Nurs 2021; 51:101906. [PMID: 33601194 DOI: 10.1016/j.ejon.2021.101906] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE Health self-management helps improve health-related quality of life and life satisfaction, as well as cancer survival. The study aim was to explore the essence of the health self-management experiences and support needs of colorectal cancer patients after surgeries. METHODS The study was based on phenomenology research methodology. Purposive sampling was used to obtain a heterogeneous sample to provide rich information regarding the research questions. Participants were recruited from colorectal surgery outpatient clinics in a hospital in Taiwan. Data were collected by semi-structured in-depth interviews and analyzed by thematic content analysis. Strategies adapted from Lincoln and Guba were used to enhance the trustworthiness of the study. RESULTS Ten participants, 5 males and 5 females, were interviewed. Their health self-management experience fell into 3 overarching themes and 9 related subthemes. Our results show that (1) seeking support when experiencing discomfort, (2) when life changes, re-adjust accordingly, and (3) staying positive and self-perseverance are the essences of the health self-management experiences and support needs of postoperative colorectal cancer patients. CONCLUSIONS Postoperative colorectal cancer patients experienced tremendous physical and psychosocial challenges after returning home from the hospital. Although burdened with multiple stressors, these patients were able to seek support, learning to practice self-care, facing cancer positively, and exhibit positive growth in life. Patients with colorectal cancer have to constantly adjust to the impacts of their diseases. The study results may provide as a reference for supporting postoperative adjustment and promoting health self-management among patients with colorectal cancer.
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Affiliation(s)
- Pei-Shan Lo
- Cultivation and Management Center, MacKay Memorial Hospital, New Taipei City, Taiwan, ROC.
| | - Yu-Ping Lin
- Nursing Department, Oriental Institution of Technology, New Taipei City, Taiwan.
| | - His-Hsien Hsu
- Department of Colorectal Surgery, MacKay Memorial Hospital, Taipei, Taiwan.
| | - Shih-Chang Chang
- Davison of Colorectal Surgery, Cathay General Hospital, Taipei, Taiwan.
| | - Shu-Ping Yang
- Nursing Department, Cathay General Hospital, Taipei, Taiwan.
| | - Wen-Chien Huang
- Department of Thoracic Surgery, Mackay Memorial Hospital, Taiwan.
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC.
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Kvåle K, Haugen DF, Synnes O. Patients' illness narratives-From being healthy to living with incurable cancer: Encounters with doctors through the disease trajectory. Cancer Rep (Hoboken) 2020; 3:e1227. [PMID: 32671998 PMCID: PMC7941441 DOI: 10.1002/cnr2.1227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Narrative medicine emphasizes how stories can increase the understanding of patients' experiences and give important insights into how patients interpret and strive to make meaning in the situation they find themselves in. AIM The aim of this study was to gain insight into the illness narratives of cancer patients, from the day they suspected that something was wrong until living with incurable cancer. METHODS AND RESULTS Six men and seven women, aged 47 to 79 years, diagnosed with metastatic cancer and undergoing chemotherapy with life-prolonging intent in an oncology outpatient clinic, were asked to tell their illness stories as freely as possible, without guiding questions. Stories were tape recorded, transcribed, and analyzed by a thematic narrative analysis. Encounters with doctors through the disease trajectory were highlighted by all narrators. Several informants described poor communication and consequences in the form of "doctors delay" and substandard psychosocial care. Continuity in follow-up and the physician's ability or inability to break bad news and adapt information to the patient's wishes and preferences were particularly emphasized. CONCLUSION A key finding was the importance of the doctor's role throughout the whole trajectory. A good doctor-patient relationship was characterized by continuity of care in follow-up, and trust acquired over time, based on the physician's thorough medical knowledge combined with sensitive communication and empathy.
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Affiliation(s)
- Kirsti Kvåle
- Department of Postgraduate StudiesVID Specialized UniversityBergenNorway
| | - Dagny Faksvåg Haugen
- Regional Centre of Excellence for Palliative Care, Western NorwayHaukeland University HospitalBergenNorway
- Department of Clinical Medicine K1University of BergenBergenNorway
| | - Oddgeir Synnes
- Centre of Diaconal and Professional PracticeVID Specialized UniversityOsloNorway
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18
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Drott J, Fomichov V, Börjeson S, Berterö C. Sense of coherence and health‐related quality of life in patients with neurotoxicity after cancer chemotherapy: Assessment from a real‐time mobile phone–based system. Psychooncology 2019; 29:107-113. [DOI: 10.1002/pon.5243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Jenny Drott
- Department of SurgeryLinköping University Linköping Sweden
- Division of Nursing Science, Department of Medical and Health SciencesLinköping University Linköping Sweden
| | - Victoria Fomichov
- Centre for Organisational Support and Development County Council of ÖstergötlandLinköping University Linköping Sweden
| | - Sussanne Börjeson
- Department of OncologyLinköping University Linköping Sweden
- Division of Nursing Science, Department of Medical and Health SciencesLinköping University Linköping Sweden
| | - Carina Berterö
- Division of Nursing Science, Department of Medical and Health SciencesLinköping University Linköping Sweden
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19
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Bootsma TI, Schellekens MPJ, van Woezik RAM, van der Lee ML, Slatman J. Experiencing and responding to chronic cancer-related fatigue: A meta-ethnography of qualitative research. Psychooncology 2019; 29:241-250. [PMID: 31442340 PMCID: PMC7027742 DOI: 10.1002/pon.5213] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 11/24/2022]
Abstract
Objective One of the most prevalent and disrupting symptoms experienced by cancer patients is chronic cancer‐related fatigue (CCRF). A better understanding of the chronic nature of CCRF can provide valuable insights for theory and practice. The purpose of this meta‐ethnography was to derive an overarching interpretative narrative on patients' experiences and responses to CCRF. Methods We conducted a comprehensive systematic literature search in five databases (05‐03‐2018). In addition, papers from reference lists were retrieved. Two researchers independently screened the papers for eligibility and appraised quality (CASP‐criteria). We followed the seven phases of meta‐ethnography to extract, translate, and synthesise first‐order constructs (ie, patients' views) and second‐order constructs (ie, authors' views) from the selected studies into third‐order constructs (ie, new interpretations). Results Of the 1178 collected articles, 16 articles were included. Through synthesis, a new figure of six interrelated third‐order constructs was developed: (1) embodied experience entails the dominating presence of the body; (2) (mis)recognition includes lack of recognition of CCRF by patients, relatives, and health providers; (3) small horizon describes a resultant narrowed world; (4) role change encompasses adopting other life roles; (5) loss of self refers to the impact on one's identity; and (6) regaining one's footing describes the struggle against CCRF, adaptation to CCRF and finally acceptance of a “new normal with CCRF.” Conclusion A new embodiment figure of CCRF with social (eg, (mis)recognition), spatial (eg, small horizon) and temporal dimensions (eg, regaining one's footing) was developed. This figure can help professionals to recognise CCRF, inform patients, and personalise treatment.
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Affiliation(s)
- Tom I Bootsma
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands.,Tilburg University, School of Humanities and Digital Sciences, Culture Studies Department, Tilburg, The Netherlands
| | - Melanie P J Schellekens
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
| | - Rosalie A M van Woezik
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
| | - Marije L van der Lee
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
| | - Jenny Slatman
- Tilburg University, School of Humanities and Digital Sciences, Culture Studies Department, Tilburg, The Netherlands
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