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Schöps AM, Skinner TC, Fosgerau CF. Tele-health coaches' responses to clients' emotional cues and concerns and engagement with the Bump to Baby and Me Intervention. PATIENT EDUCATION AND COUNSELING 2024; 127:108370. [PMID: 38996574 DOI: 10.1016/j.pec.2024.108370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 06/14/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE To explore the relationship between health coaches' responses to emotional cues/concerns and women's subsequent engagement with the health coaching mHealth platform. METHODS 24 face-to-face video-mediated initial conversations between participants and their health coaches were coded using the VR-CoDES-P method. Women with high risk of developing Gestational Diabetes Mellitus were selected from the study, based on their engagement with the smartphone health coaching platform. 12 women with very low engagement and 12 women with high engagement were identified. RESULTS In interactions with women with high goal engagement, coaches had significantly more counseling codes with prior other codes and no instances of non-explicit response codes that reduce space for further disclosure. Analysis showed that interactions with women with high goal engagement were more frequently met by the coach with affect-acknowledging and empathic responses prior to the counseling speech act. CONCLUSION High goal engagement among women with Gestational Diabetes Mellitus may appear to be associated with coaches facilitating the frequent use of empathy. PRACTICE IMPLICATIONS Findings can draw coaches' attention to the impact that their counseling has on goal engagement, increasing the opportunity for intervention to be person-centered and effective.
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Affiliation(s)
- Antje Maria Schöps
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark.
| | - Timothy Charles Skinner
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark; Department of Psychology, La Trobe University, Bendigo, Australia; Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia
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Haining Z, Xiaoli Z, Jiping Z, Beibei Z, Ping M, Yunfei G. Sexual experiences and information needs among patients with prostate cancer: a qualitative study. Sex Med 2024; 12:qfae019. [PMID: 38596664 PMCID: PMC11002319 DOI: 10.1093/sexmed/qfae019] [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: 09/14/2023] [Revised: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
Background Less is known about the sexual life and information seeking of Chinese patients with prostate cancer (PCa) after androgen deprivation therapy (ADT) treatment. Aim To identify the experiences of sex and information needs among Chinese patients with PCa after ADT treatment. Methods This qualitative study included 15 Chinese patients with PCa in urology inpatient wards, selected via a purposive sampling method. Semistructured interviews were conducted face-to-face or by telephone regarding sexual experiences and information needs after ADT treatment. Outcomes Themes and subthemes were assessed among patients with PCa. Results Two themes and 5 subthemes emerged from the interview data. The first theme was "altered sexual life and attitude" with 3 subthemes: (1) undesirable sexual function and altered sexuality, (2) sexual attitudes and sociocultural cognition, and (3) behavior adjustment and intimacy. The second theme was "scarce information sources" with 2 subthemes: (1) uncertainty and lack of information support and (2) barriers to access sexual information. Clinical Implications The present findings suggest that the following may help patients with PCa manage treatment and develop appropriate sexual attitudes: a tailored sexual health education program, well-equipped consultations rooms, and information delivery innovations. Strengths and Limitations Strengths of this study included adding unique evidence among patients with PCa within an Asian context to reveal the understudied topic of sexual health and information needs after ADT treatment. This study was limited in being representative of all Chinese patients with PCa, with different marital statuses, treatment therapies, sexual orientations, and barriers of information seeking. Conclusion Sexual life and attitude among patients with PCa were affected by their sociocultural cognition and ADT treatment, and most patients received insufficient information and sexual health education from health care providers.
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Affiliation(s)
- Zhou Haining
- Department of Urology, Henan Provincial People’s Hospital, Zhengzhou, 450000China
| | - Zhang Xiaoli
- Department of Urology, Henan Provincial People’s Hospital, Zhengzhou, 450000China
| | - Zhu Jiping
- Department of Urology, Henan Provincial People’s Hospital, Zhengzhou, 450000China
| | - Zhang Beibei
- Department of Urology, Henan Provincial People’s Hospital, Zhengzhou, 450000China
| | - Meng Ping
- Department of Andrology, Henan Provincial People’s Hospital, Zhengzhou, 450000China
| | - Guo Yunfei
- Emergency Medicine Department, Henan Provincial People’s Hospital, Zhengzhou, 450000China
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Bender JL, Scruton S, Wong G, Abdelmutti N, Berlin A, Easley J, Liu ZA, McGee S, Rodin D, Sussman J, Urquhart R. Virtual follow-up care among breast and prostate cancer patients during and beyond the COVID-19 pandemic: Association with distress. Cancer Med 2024; 13:e6948. [PMID: 38466233 PMCID: PMC10926960 DOI: 10.1002/cam4.6948] [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: 08/04/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate associations between self-reported distress (anxiety/depression) and satisfaction with and desire for virtual follow-up (VFU) care among cancer patients during and beyond the COVID-19 pandemic. METHODS Breast and prostate cancer patients receiving VFU at an urban cancer centre in Toronto, Canada completed an online survey on their sociodemographic, clinical, and technology, characteristics and experience with and views on VFU. EQ5D-5 L was used to assess distress. Statistical models adjusted for age, gender, education, income and Internet confidence. RESULTS Of 352 participants, average age was 65 years, 48% were women,79% were within 5 years of treatment completion, 84% had college/university education and 74% were confident Internet users. Nearly, all (98%) had a virtual visit via phone and 22% had a virtual visit via video. The majority of patients (86%) were satisfied with VFU and 70% agreed that they would like VFU options after the COVID-19 pandemic. Participants who reported distress and who were not confident using the Internet for health purposes were significantly less likely to be satisfied with VFU (OR = 0.4; 95% CI: 0.2-0.8 and OR = 0.19; 95% CI: 0.09-0.38, respectively) and were less likely to desire VFU option after the COVID-19 pandemic (OR = 0.49; 95% CI: 0.30-0.82 and OR = 0.41; 95% CI: 0.23-0.70, respectively). CONCLUSIONS The majority of respondents were satisfied with VFU and would like VFU options after the COVID-19 pandemic. Future research should determine how to optimize VFU options for cancer patients who are distressed and who are less confident using virtual care technology.
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Affiliation(s)
- Jacqueline L. Bender
- Cancer Rehabilitation and Survivorship, Department of Supportive CarePrincess Margaret Cancer CentreTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
| | - Sarah Scruton
- Cancer Rehabilitation and Survivorship, Department of Supportive CarePrincess Margaret Cancer CentreTorontoOntarioCanada
| | - Geoff Wong
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Nazek Abdelmutti
- Cancer Quality Lab (CQual)Princess Margaret Cancer CentreTorontoOntarioCanada
- Cancer Digital IntelligencePrincess Margaret Cancer CentreTorontoOntarioCanada
| | - Alejandro Berlin
- Department of Radiation OncologyUniversity of TorontoTorontoOntarioCanada
- Radiation Medicine ProgramPrincess Margaret Cancer CentreTorontoOntarioCanada
| | - Julie Easley
- Department of Medical EducationHorizon Health NetworkFrederictonNew BrunswickCanada
| | - Zhihui Amy Liu
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Biostatistics DepartmentUniversity Health NetworkTorontoOntarioCanada
| | - Sharon McGee
- Division of Medical Oncology, Department of MedicineThe Ottawa Hospital and the University of OttawaOttawaOntarioCanada
| | - Danielle Rodin
- Department of Radiation OncologyUniversity of TorontoTorontoOntarioCanada
- Radiation Medicine ProgramPrincess Margaret Cancer CentreTorontoOntarioCanada
| | | | - Robin Urquhart
- Department of Community Health and EpidemiologyDalhousie UniversityHalifaxNova ScotiaCanada
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Jiang J, Yan MH, Fan YY, Zhang JE. Psychosocial Adjustment Experiences Among Nasopharyngeal Carcinoma Survivors: A Qualitative Study. Cancer Nurs 2023:00002820-990000000-00199. [PMID: 38032215 DOI: 10.1097/ncc.0000000000001312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) has serious effects on the daily lives and psychosocial adjustment of survivors. In particular, psychosocial problems are a prominent concern. OBJECTIVE The aim of this study was to understand the lived experiences of NPC survivors regarding psychosocial adjustment. METHODS A qualitative design using individual semistructured interviews was conducted with 20 NPC survivors. Each participant was asked open-ended questions about their lived experience with psychosocial adjustment. The data were then subjected to thematic analysis. RESULTS The following 4 themes, which had subthemes, were identified from the data: (1) grappling with discomforts (symptoms distress of late toxicities, impaired body image, and returning-to-work restrictions), (2) struggling with uncertainty (disease attribution with self-blame, contradictory rehabilitation information, fear of cancer recurrence, and distance from medical staff), (3) changing social patterns (special favors, social isolation, and social discrimination), and (4) cultivating positive change (healthy lifestyle and positive mindset). CONCLUSIONS Nasopharyngeal carcinoma survivors experience many obstacles, as well as positive changes, during psychosocial adjustment. This study highlights the pressing need to consider NPC survivors' concerns about their psychosocial adjustment. IMPLICATIONS FOR PRACTICE Medical staff should provide NPC survivors with sufficient rehabilitation information to help them deal with possible late toxicities and mitigate their uncertainty and misunderstanding. Effective public education measures are needed to address misunderstandings about cancer in Chinese cultural settings.
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Affiliation(s)
- Jie Jiang
- Author Affiliations: School of Nursing (Ms Jiang and Dr Zhang); Hospital of Stomatology (Mr Yan); and Department of Nasopharyngeal Carcinoma, Cancer Centre, (Ms Fan), Sun Yat-sen University, Guangzhou, China
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Hult A, Lundgren E, Fröjd C, Lindam A, Jangland E. Patient complaints about communication in cancer care settings: Hidden between the lines. PATIENT EDUCATION AND COUNSELING 2023; 114:107838. [PMID: 37295042 DOI: 10.1016/j.pec.2023.107838] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/16/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To investigate patient complaints in cancer care settings reported to patient advisory committees (PACs) and describe the frequency and content of communication failures across all reports. METHODS Content analysis, with a summative approach, was applied to cancer care complaints (2016-2020) by 692 patients to PACs in one Swedish healthcare region. RESULTS More than half the patients reported communication failures. Patients reported not receiving proper information, not being listened to, and being treated disrespectfully or impersonally. Communication failures occurred in different stages of the patients' cancer care, from diagnostic workup to end-of-life. Compared with the results of the PACs, communication failures were underreported, and were often combined with complaints in other categories. CONCLUSIONS Communication failures are hidden "between the lines" and do not appear clearly in existing reporting systems. Healthcare must utilize the knowledge conveyed by patient complaints and create conditions and environments that support healthcare providers in delivering person-centered care. PRACTICE IMPLICATION A summary picture of patients' complaints in Swedish cancer care is provided. These results could be used to further improve the patient complaint system. Above all, the results could serve as a "wake-up call" about the importance of communication and a valuable resource in improving cancer care.
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Affiliation(s)
- Anna Hult
- Department of Surgical Sciences (EL), Nursing Research (AH, CL, EJ), Uppsala University, Uppsala, Sweden.
| | - Ewa Lundgren
- Department of Surgical Sciences (EL), Nursing Research (AH, CL, EJ), Uppsala University, Uppsala, Sweden
| | - Camilla Fröjd
- Department of Surgical Sciences (EL), Nursing Research (AH, CL, EJ), Uppsala University, Uppsala, Sweden
| | - Anna Lindam
- Department of Public Health and Clinical Medicine, Unit of Research, Education and Development, Östersund Hospital, Umeå University, Umeå, Sweden
| | - Eva Jangland
- Department of Surgical Sciences (EL), Nursing Research (AH, CL, EJ), Uppsala University, Uppsala, Sweden
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Wollersheim BM, van der Poel HG, van Asselt KM, Pos FJ, Tillier CN, Akdemir E, Vis AN, Lampe MI, van den Bergh R, Somford DM, Knipscheer B, Cauberg ECC, Noordzij A, Aaronson NK, Boekhout AH, van de Poll-Franse LV. Quality of early prostate cancer follow-up care from the patients’ perspective. Support Care Cancer 2022; 30:10077-10087. [DOI: 10.1007/s00520-022-07396-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/04/2022] [Indexed: 11/24/2022]
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Specialist versus Primary Care Prostate Cancer Follow-Up: A Process Evaluation of a Randomized Controlled Trial. Cancers (Basel) 2022; 14:cancers14133166. [PMID: 35804937 PMCID: PMC9264897 DOI: 10.3390/cancers14133166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Worldwide, there is an increased focus on reorganizing prostate cancer survivorship care. In this study, we describe for the first time a process evaluation as part of a randomized controlled trial that is currently comparing the effectiveness of specialist- versus primary care-based prostate cancer follow-up. We found that within an RCT context, 67% patients and their GPs were willing to receive/provide primary care-based follow-up. Patients who received primary care-based follow-up care experienced this to be more personal, efficient, and sustainable. However, patients, GPs, and specialists also indicated several challenges that are described in this study and should be addressed to enable a smooth transition of prostate cancer follow-up to primary care. Abstract Background: A randomized controlled trial (RCT) is currently comparing the effectiveness of specialist- versus primary care-based prostate cancer follow-up. This process evaluation assesses the reach and identified constructs for the implementation of primary care-based follow-up. Methods: A mixed-methods approach is used to assess the reach and the implementation through the Consolidated Framework for Implementation Research. We use quantitative data to evaluate the reach of the RCT and qualitative data (interviews) to indicate the perspectives of patients (n = 15), general practitioners (GPs) (n = 10), and specialists (n = 8). Thematic analysis is used to analyze the interview transcripts. Results: In total, we reached 402 (67%) patients from 12 hospitals and randomized them to specialist- (n = 201) or to primary care-based (n = 201) follow-up. From the interviews, we identify several advantages of primary care- versus specialist-based follow-up: it is closer to home, more accessible, and the relationship is more personal. Nevertheless, participants also identified challenges: guidelines should be implemented, communication and collaboration between primary and secondary care should be improved, quality indicators should be collected, and GPs should be compensated. Conclusion: Within an RCT context, 402 (67%) patients and their GPs were willing to receive/provide primary care-based follow-up. If the RCT shows that primary care is equally as effective as specialist-based follow-up, the challenges identified in this study need to be addressed to enable a smooth transition of prostate cancer follow-up to primary care.
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Addressing colon cancer patients' needs during follow-up consultations at the outpatient clinic: a multicenter qualitative observational study. Support Care Cancer 2022; 30:7893-7901. [PMID: 35726108 PMCID: PMC9512715 DOI: 10.1007/s00520-022-07222-z] [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: 10/22/2021] [Accepted: 06/11/2022] [Indexed: 11/13/2022]
Abstract
Purpose To describe colon cancer patients’ needs and how healthcare providers respond to these needs during routine follow-up consultations in hospital. Methods A multicenter qualitative observational study, consisting of follow-up consultations by surgeons and specialized oncology nurses. Consultations were analyzed according to Verona Coding Definitions of Emotional Sequences. Patients’ questions, cues, and concerns were derived from the data and categorized into supportive care domains. Responses of healthcare providers were defined as providing or reducing space for disclosure. Patient satisfaction with care was measured with a short questionnaire. Results Consultations with 30 patients were observed. Questions typically centered around the health system and information domain (i.e., follow-up schedule and test results; 92%). Cues and concerns were mostly associated with the physical and daily living domain (i.e., experiencing symptoms and difficulties resuming daily routine; 43%), followed by health system and information (i.e., miscommunication or lack of clarity about follow-up; 28%), and psychological domain (i.e., fear of recurrence and complications; 28%). Problems in the sexuality domain hardly ever arose (0%). Healthcare providers provided space to talk about half of the cues and concerns (54%). Responses to cancer-related versus unrelated problems were similar. Overall, the patients were satisfied with the information and communication received. Conclusions Colon cancer patients express various needs during consultations. Healthcare providers respond to different types of needs in a similar fashion. We encourage clinicians to discuss all supportive care domains, including sexuality, and provide space for further disclosure. General practitioners are trained to provide holistic care and could play a greater role. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-07222-z.
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