1
|
Hu J, Zhang X, Sun J, Hu H, Tang C, Ba L, Xu Q. Supportive Care Needs of Patients With Temporary Ostomy in Enhanced Recovery After Surgery: A Mixed-Methods Study. J Nurs Res 2024; 32:e329. [PMID: 38727228 DOI: 10.1097/jnr.0000000000000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Enhanced recovery after surgery (ERAS), a global surgical quality improvement initiative, reduces the length of stay in the hospital. Temporary stoma care for rectal cancer is complex, and patients require prolonged care services to adjust to the stoma. The shorter stay durations in the new model challenge the conventional care pathways and create new patient needs. PURPOSE This study was designed to explore the supportive care needs of patients under the new surgical model to provide a reference for the design of ERAS nursing care plans. METHODS A convergent parallel mixed-methods design was used in this study. Patients with temporary stomas for rectal cancer were recruited using a convenience sampling method in gastrointestinal surgery wards and wound & stoma clinics in two public tertiary care hospitals in China. Standardized questionnaires were administered to 140 patients to collect quantitative data, and semistructured interviews were conducted individually with 13 patients to collect qualitative data. The questionnaire data were analyzed using descriptive statistics, and the interview data were analyzed using thematic analysis. RESULTS "Health system and information needs" and "care and support needs" were identified in both the qualitative and quantitative analyses as the most significant unmet needs of the participants. In addition, the qualitative analysis identified receiving focused stoma care instructions and easily understandable information as essential to fulfilling health system and information needs. Care and support needs included access to continued postdischarge services and attention from medical professionals. CONCLUSION/IMPLICATIONS FOR PRACTICE The participants in this study experienced a variety of unmet supportive care needs under the ERAS protocol, with gaps particularly notable in two categories: "health system and information needs" and "care and support needs." Increased perioperative care and shorter hospital stays under the ERAS protocol reduce opportunities for patients to receive targeted instruction and shift much of the ostomy education and care workload out of the hospital, requiring greater attention from clinical nurses to ensure quality of care.
Collapse
Affiliation(s)
- Jieman Hu
- PhD, RN, Lecturer, School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xiuling Zhang
- BSN, RN, Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jianan Sun
- MS, RN, Department of Gastrointestinal Colorectal and Anal Surgery, The First Hospital of Jilin University, Changchun, China
| | - Haiyan Hu
- BSN, RN, Head Nurse, Department of Gastrointestinal Colorectal and Anal Surgery, The First Hospital of Jilin University, Changchun, China
| | - Chulei Tang
- PhD, RN, Lecturer, School of Nursing, Nanjing Medical University, Nanjing, China
| | - Lei Ba
- PhD, Associate Professor, National Health Commission Contraceptives Adverse Reaction Surveillance Center, Jiangsu Health Development Research Center, Nanjing, China
| | - Qin Xu
- MS, RN, Professor, School of Nursing, Nanjing Medical University, Nanjing, China
| |
Collapse
|
2
|
Luo X, Xu H, Zhang Y, Liu S, Xu S, Xie Y, Xiao J, Hu T, Xiao H. Identifying the unmet needs of post-treatment colorectal cancer survivors: A critical literature review. Eur J Oncol Nurs 2024; 70:102570. [PMID: 38574419 DOI: 10.1016/j.ejon.2024.102570] [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: 11/03/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Following treatment completion, colorectal cancer (CRC) survivors experience various unmet needs. This review aims to synthesize the unmet needs of CRC survivors after treatment and to identify demographic, disease or treatment-related, healthcare-related, and psychosocial factors correlated with unmet needs. METHOD English or Chinese articles that focused on CRC survivors' post-treatment unmet needs were systematically searched from the five electronic databases, which included CINAHL, PubMed, Embase, PsycINFO, and the China Academic Journal Full-text Database, from the launch of databases to July 2023. The reference lists of the subsequent articles were further screened. RESULTS 136 individual needs extracted from 50 manuscripts were classified into nine domains based on the Supportive Care Framework. The top four unmet needs identified by CRC survivors were assistance with fears of cancer recurrence, information about managing illness and side effects at home, emotional or psychological support and reassurance, and help with sexuality problems. Following surgery, CRC survivors showed strong demand in the physical, psychological, and information domains. Survivors completed treatment within 1-year had more diverse needs than those who completed 1-3 years. Unmet needs may be greater among CRC survivors who were young, female, more educated, and unmarried. Furthermore, greater unmet needs were associated with distress, anxiety, depression, and worse quality of life. CONCLUSIONS Despite diverse needs experienced by post-treatment CRC survivors, a predominant focus on fears of cancer recurrence, information, psychological support, and sexuality needs is noted. Future studies should further explore the needs of CRC survivors after specific treatment and in different post-treatment periods.
Collapse
Affiliation(s)
- Xingjuan Luo
- School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Haiying Xu
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Yanting Zhang
- School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Sirun Liu
- School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Shan Xu
- School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Yali Xie
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Juan Xiao
- Institute of Neuroscience and Brain Diseases, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
| | - Tingting Hu
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
| | - Hong Xiao
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
| |
Collapse
|
3
|
Liu C, Song Q, Qu Y, Yin G, Wang J, Lv X. Course and predictors of supportive care needs among colorectal cancer survivors with ostomies: a longitudinal study. Support Care Cancer 2024; 32:395. [PMID: 38816568 DOI: 10.1007/s00520-024-08607-y] [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: 01/24/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Although there is a growing emphasis on supportive care for cancer patients, those with colorectal cancer (CRC) who have ostomies require special attention in terms of their physical, psychological, spiritual, and social needs. However, there has been a lack of significant progress in meeting the supportive care needs of CRC survivors with ostomies. To bridge this gap, we conducted a prospective longitudinal study to track the trends in supportive care needs among CRC survivors with ostomies and identify any predictors over 6-month period. METHODS A prospective longitudinal study was conducted at the wound and stoma clinic of Dalian University Affiliated Xinhua Hospital, focusing on CRC survivors with ostomies. A total of 143 participants completed self-report questionnaires on the 34-item Short-Form Supportive Care Needs Survey (SCNS-SF34-C (Mandarin)) and stoma complications at the first, third, and sixth month after surgery. ANOVA with repeated measure was utilized to assess the course of supportive care needs, with Generalized Estimating Equation (GEE) applied to identify predictors of SCNS. RESULTS The supportive care needs and five dimensions scores were statistically significant at three time points (P < 0.05). The ratings of patients at the first, third, and sixth month after surgery revealed a decreasing trend in the scores for patient care and support, psychological needs, physical and daily living needs, and health system and information needs. However, the score for sexual needs showed an increased tendency. Higher levels supportive care needs were generally connected with a short duration after ostomy, high income level, resident medical insurance, spouse caregiver, other chronic disease, and stoma complications. CONCLUSIONS Survivors' supportive care needs showed a dynamic trend over 6 months after surgery. Through three rounds, the primary needs were health system and information needs. It is recommended to integrate interdisciplinary health professionals and establish a comprehensive support and care system to effectively meet the diverse needs at different stages. Priority should be given to individuals with ostomies during the first and third month after surgery, particularly those with higher income levels, employee medical insurance, spouse caregivers, other chronic diseases, and stoma complications.
Collapse
Affiliation(s)
- ChunE Liu
- Nursing Department, Dalian University Affiliated Xinhua Hospital, No.156 Wansui Street, Shahekou District, Dalian, 116021, China
| | - QinFen Song
- Nursing Department, Dalian University Affiliated Xinhua Hospital, No.156 Wansui Street, Shahekou District, Dalian, 116021, China.
- Wound and Stoma Clinic, Dalian University Affiliated Xinhua Hospital, No.156 Wansui Street, Shahekou District, Dalian, 116021, China.
| | - Yan Qu
- Anorectal Surgery, Dalian University Affiliated Xinhua Hospital, No.156 Wansui Street, Shahekou District, Dalian, 116021, China
| | - GuangXiao Yin
- Orthopedics, Affiliated Zhongshan Hospital of Dalian University, No.6 Jiefang Street, Zhongshan District, Dalian, 116001, China
| | - JingJing Wang
- Emergency Unit, Dalian University Affiliated Xinhua Hospital, No.156 Wansui Street, Shahekou District, Dalian, 116021, China
| | - Xue Lv
- Wound and Stoma Clinic, Dalian University Affiliated Xinhua Hospital, No.156 Wansui Street, Shahekou District, Dalian, 116021, China
| |
Collapse
|
4
|
Armoogum J, Harcourt D, Foster C, Llewellyn A, Hepburn J, Prior M, McCabe C. Healthcare professionals' knowledge, understanding and confidence to manage chronic pain after cancer treatment: A UK survey. Eur J Oncol Nurs 2024; 71:102610. [PMID: 38914026 DOI: 10.1016/j.ejon.2024.102610] [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: 02/20/2024] [Revised: 05/03/2024] [Accepted: 05/14/2024] [Indexed: 06/26/2024]
Abstract
INTRODUCTION Healthcare professionals are vital in preparing people living with and beyond cancer about the risks of chronic pain after cancer treatment. To do so, healthcare professionals need to be knowledgeable and confident about chronic pain after cancer treatment, yet little is known about their understanding or confidence of this common long-term and late side effect of cancer treatment. AIM To identify healthcare professionals' knowledge and understanding of chronic pain after cancer treatment and consider how confident they are to inform, listen and signpost people living with and beyond cancer to appropriate information and support. METHOD A cross sectional online survey was distributed to healthcare professionals in the UK via cancer and primary care networks, cancer alliances and social media. The survey consisted of four domains: 1) knowledge and understanding, 2) information and support, 3) confidence and 4) barriers. Quantitative data were analysed with descriptive statistics and free text comments were analysed using qualitative content analysis. RESULTS Healthcare professionals reported limited knowledge and understanding of chronic pain after cancer treatment. Healthcare professionals lacked confidence to talk to people about chronic pain after cancer treatment and viewed their lack of knowledge as a barrier. Additional barriers included 'Limited service provision', 'Conflict between services', 'Not my role' and 'Challenges in diagnosing chronic pain in cancer survivors'. CONCLUSION Chronic pain after cancer can be a significant issue for those living with and beyond cancer, yet healthcare professionals report limited knowledge of it or understanding of the impact. More education is needed to increase healthcare professionals' knowledge and confidence in chronic pain after cancer treatment.
Collapse
Affiliation(s)
- J Armoogum
- University of the West of England, Bristol, UK.
| | - D Harcourt
- University of the West of England, Bristol, UK
| | | | - A Llewellyn
- University of the West of England, Bristol, UK
| | | | | | - C McCabe
- University of the West of England, Bristol, UK; Dorothy House Hospice, Winsley, UK
| |
Collapse
|
5
|
Osowiecka K, Dolińska A, Szwiec M, Działach E, Nowakowski JJ, Rucińska M. Validation of the Standardized Needs Evaluation Questionnaire in Polish Cancer Patients. Cancers (Basel) 2024; 16:1451. [PMID: 38672533 PMCID: PMC11048258 DOI: 10.3390/cancers16081451] [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: 02/29/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Cancer influences various aspects of patients' functioning. Cancer patients face not only medical problems but also organizational, socio-psychological, and spiritual problems. Their needs often seem to be unrecognized because patients do not express their concerns and clinicians do not ask appropriate questions. Unmet needs impact patients' quality of life. The aim of this study was to select, adapt, validate, and introduce a simple instrument for estimating cancer patients' unmet needs in Poland. METHODS The Needs Evaluation Questionnaire (NEQ) was chosen for validation in a Polish population. The Polish version of the NEQ was developed with a back-translation procedure, as approved by a psycho-oncologist and a public health specialist. The psychometric properties of the NEQ (content analysis, reliability, construct validity, comprehensibility, and acceptability) were measured. RESULTS This study was performed on a group of 121 cancer patients. The median time of completion for the NEQ was 10 min. The form, length, and font size of the NEQ were accepted by the respondents. Overall, the meaning of the questions was well understood, with only a few cases of discreetly heterogeneous interpretation of the content. The questionnaire showed good reliability and internal factor structure validity. CONCLUSION The NEQ is a simple, easy-to-administer instrument with good psychometric properties and seems to be useful in assessing the unexpressed needs of cancer patients.
Collapse
Affiliation(s)
- Karolina Osowiecka
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland
| | - Anna Dolińska
- Psychology Outpatient Clinic, University Hospital in Zielona Gora, Zyty 26, 65-046 Zielona Gora, Poland;
| | - Marek Szwiec
- Department of Surgery and Oncology, Faculty of Medicine and Health Sciences, University of Zielona Gora, Zyty 28, 65-046 Zielona Gora, Poland;
| | - Eliza Działach
- Department of Public Health, Faculty of Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 41-902 Bytom, Poland;
| | - Jacek J. Nowakowski
- Department of Botany and Evolutionary Ecology, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Plack Łódzki 3, 10-727 Olsztyn, Poland;
| | - Monika Rucińska
- Department of Oncology, Collegium Medicum University of Warmia and Mazury in Olsztyn, Wojska Polskiego 37, 10-228 Olsztyn, Poland;
| |
Collapse
|
6
|
Çelik H, Aslan H. The Relationship Between Cancer Patients' Supportive Care Needs and Their Attitudes Toward Complementary and Alternative Medicine. Niger J Clin Pract 2024; 27:415-423. [PMID: 38679761 DOI: 10.4103/njcp.njcp_377_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 03/01/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Cancer patients have high supportive care needs related to the nature of the disease and treatment methods. To meet these needs or reduce symptoms, patients can be expected to resort to alternative treatment methods. AIM To examine the relationship between the supportive care needs of cancer patients and their attitudes toward complementary and alternative medicine (CAM). METHODS This was a cross-sectional study involving 289 cancer patients at the Oncology Hospital in east of Turkey. Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF 29) and Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were standard instruments used for data collection. The association between supportive care needs and attitude toward CAM was determined. RESULTS The mean age of the study participants was 56.7 ± 12.7 years. There were 180 females (62.3%) and 109 males (37.7%). The mean score of the SCNS-SF 29 of the study participant was 101.19 ± 33.97. It was found that the patients' psychological needs were the highest, followed by health services and information, daily life, and sexuality needs, respectively. The mean score of the HCAMQ was 27.16 ± 9.54. There was a weak, significant negative correlation between HCAM and psychological supportive care needs (r: -0.240, P: 0.003). However, there was no significant relationship between needs related to health services information, daily life sexuality, and attitudes toward CAM. CONCLUSIONS Cancer patients have high supportive care requirements. Those with high psychological needs have a positive attitude toward HCAM. Incorporation of HCAM in the care of cancer patients may improve their quality of care.
Collapse
Affiliation(s)
- H Çelik
- Department of Fundamentals of Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| | | |
Collapse
|
7
|
Cihan E, Vural F. Effect of a telephone-based perioperative nurse-led counselling programme on unmet needs, quality of life and sexual function in colorectal cancer patients: A non-randomised quasi-experimental study. Eur J Oncol Nurs 2024; 68:102504. [PMID: 38310665 DOI: 10.1016/j.ejon.2024.102504] [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: 09/07/2023] [Revised: 12/13/2023] [Accepted: 01/04/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE To investigate the effect of perioperative nurse-led counselling intervention on unmet needs, sexual function and quality of life in colorectal cancer patients. METHOD This quasi-experimental study included 82 patients who underwent colorectal cancer surgery (control n = 45, intervention n = 37). The telephone-based perioperative nurse-led counselling intervention, which contained implementation, follow-up, and assessment, was applied to start from pre-surgery to post-surgery 3rd month. Data were collected with the Unmet Needs of Cancer Survivors Scale, European Organisation for Treatment and Research of Cancer Quality of Life Scale-30, Colorectal-29, Female Sexual Function Index, and International Index of Erectile Function pre- and post-surgery 3rd-6th months. The control data was collected before the pandemic, and the intervention group throughout the pandemic. The Mann-Whitney-U, Wilcoxon rank test was used. RESULTS Compared to the control group, intervention group patients reported lower unmet and total needs scores (p = 0.000); higher quality of life (p = 0.000), physical, emotional (p = 0.000), role (p = 0.001), and social functioning scores (p = 0.002); lower fatigue (p = 0.000), constipation (p = 0.034), pain (p = 0.018), nausea-vomiting (p = 0.004), and insomnia scores (p = 0.003); and higher body image, anxiety (p = 0.000) and weight scores (p = 0.003), lower urinary frequency buttock pain (p = 0.000), dysuria (p = 0.001), abdominal pain (p = 0.001), fluctuance (p = 0.000), stool frequency (p = 0.002), and faecal incontinence (p = 0.006) scores at the sixth month (p < 0.05). There were no statistically significant differences between male and female sexual function scores (p > 0.05). CONCLUSIONS Perioperative nurse-led counselling reduced unmet needs and increased the overall quality of life by decreasing symptom levels but did not affect sexual health outcomes in patients with colorectal cancer surgery.
Collapse
Affiliation(s)
- Emel Cihan
- Department of Surgical Nursing, Faculty of Health Sciences, Kutahya Health Sciences University, 43100, Kutahya, Turkey.
| | - Fatma Vural
- Department of Surgical Nursing, Faculty of Nursing, Dokuz Eylul University, 35100, Izmir, Turkey.
| |
Collapse
|
8
|
Zeneli A, Leombruni P, Miniotti M, Scarpi E, Maltoni M, Cavalieri S, Legni V, Nanni C, Tarca M, Rustignoli M, Montalti S. Psychometric Properties of the Italian Version of the Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF34-It): A Multicenter Validation Study. NURSING REPORTS 2024; 14:303-316. [PMID: 38391068 PMCID: PMC10885028 DOI: 10.3390/nursrep14010023] [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: 11/15/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
This study aimed to evaluate psychometric properties of the Italian version of the Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF34) in a cancer population. A multicenter prospective observational study was carried out in outpatient and inpatient settings. The evaluated psychometric properties were as follows: the five-domain structure, the internal consistency, the convergent validity with the Edmond Symptom Assessment System (ESAS) questionnaire, the discriminant validity and test-retest reliability. A total of 714 patients with different types, stages and treatment settings of cancer were recruited. A total of 56% of participants were women, the median age 59 years (range 18-88). The prevalence of patients reporting at least one unmet need was 78.7%. The factor analysis explained 71.3% of the total variance, confirming the five-domain structure of the original model. Internal consistency was good, with Cronbach's alpha values ranging from 0.87 ("psychosocial need", "patient support and health system", "information") to 0.90 ("sexuality"). The convergent validity of the SCNS-SF34-It with the ESAS scale was low, suggesting that these questionnaires cover different concepts. The SCNS-SF34-It was able to discriminate differences between groups, and the test-retest reliability was good (ICC 0.72-0.84). The SCNS-SF34-It proved to be a reliable instrument for use in clinical practice for evaluating unmet needs in the Italian population of cancer patients. This study was not registered.
Collapse
Affiliation(s)
- Anita Zeneli
- Nursing and Technical Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Via Maroncelli 40, 47014 Meldola, Italy
| | - Paolo Leombruni
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
| | - Marco Miniotti
- "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
| | - Emanuela Scarpi
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Via Maroncelli 40, 47014 Meldola, Italy
| | - Marco Maltoni
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Sara Cavalieri
- Nursing and Technical Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Via Maroncelli 40, 47014 Meldola, Italy
| | - Valentina Legni
- Nursing and Technical Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Via Maroncelli 40, 47014 Meldola, Italy
| | - Cristina Nanni
- Nursing and Technical Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Via Maroncelli 40, 47014 Meldola, Italy
| | - Mihaiela Tarca
- Nursing and Technical Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Via Maroncelli 40, 47014 Meldola, Italy
| | - Michela Rustignoli
- Nursing and Technical Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Via Maroncelli 40, 47014 Meldola, Italy
| | - Sandra Montalti
- Nursing and Technical Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), Via Maroncelli 40, 47014 Meldola, Italy
| |
Collapse
|
9
|
Collaço N, Lippiett KA, Wright D, Brodie H, Winter J, Richardson A, Foster C. Barriers and facilitators to integrated cancer care between primary and secondary care: a scoping review. Support Care Cancer 2024; 32:120. [PMID: 38252169 PMCID: PMC10803398 DOI: 10.1007/s00520-023-08278-1] [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: 06/22/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
PURPOSE This scoping review identifies and characterises reported barriers and facilitators to providing integrated cancer care reported in the international literature, and develops recommendations for clinical practice. METHODS This scoping review included literature published between 2009 and 2022 and describes the delivery of integrated cancer care between primary and secondary care sectors. Searches were conducted of an online database Ovid Medline and grey literature. RESULTS The review included thirty-two papers. Barriers and facilitators to integrated cancer care were identified in three core areas: (1) at an individual user level around patient-healthcare professional interactions, (2) at an organisational level, and (3) at a healthcare system level. The review findings identified a need for further training for primary care professionals on cancer care, clarity in the delineation of primary care and oncologist roles (i.e. who does what), effective communication and engagement between primary and secondary care, and the provision of protocols and guidelines for follow-up care in cancer. CONCLUSIONS Information sharing and communication between primary and secondary care must improve to meet the increasing demand for support for people living with and beyond cancer. Delivering integrated pathways between primary and secondary care will yield improvements in patient outcomes and health economic costs.
Collapse
Affiliation(s)
- Nicole Collaço
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England
| | - Kate A Lippiett
- School of Health Sciences, University of Southampton, Southampton, England
| | - David Wright
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England
| | - Hazel Brodie
- School of Health Sciences, University of Southampton, Southampton, England
| | - Jane Winter
- Wessex Cancer Alliance, Oakley Road, Southampton, England
| | - Alison Richardson
- School of Health Sciences, University of Southampton, Southampton, England
- University Hospital Southampton NHS Foundation Trust, Southampton, England
| | - Claire Foster
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England.
| |
Collapse
|
10
|
Armoogum J, Foster C, Llewellyn A, Harcourt D, McCabe C. 'I think it affects every aspect of my life, really': Cancer survivors' experience of living with chronic pain after curative cancer treatment in England, UK. PLoS One 2023; 18:e0290967. [PMID: 37656690 PMCID: PMC10473538 DOI: 10.1371/journal.pone.0290967] [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: 04/07/2022] [Accepted: 08/19/2023] [Indexed: 09/03/2023] Open
Abstract
AIM To explore cancer survivors' experiences of living with chronic pain after curative cancer treatment in England, UK. METHODS A qualitative study using telephone interviews with adult cancer survivors experiencing chronic pain after curative cancer treatment. Interview data was analysed using a reflexive thematic approach [1-3]. FINDINGS Nineteen participants: 14 female, 5 male, mean age 62.4 years, 1.5-48 years since cancer diagnosis, eight tumour groups represented. Six participants (31.6%) developed chronic pain more than ten years after completing cancer treatment (range 0-25 years). Five themes were generated which highlighted the experience of chronic pain after cancer treatment for cancer survivors: 1) 'Hear me… believe me…. Please'. Survivors felt that they had not been listened to when they tried to talk about their chronic pain after cancer treatment, nor at times, believed. 2) 'Expectation versus reality'. Survivors had anticipated returning to pre cancer quality of life yet living in chronic pain prevented them from doing so. 3) 'They don't understand…. We don't understand'. Cancer survivors did not feel informed or prepared for the risk or reality of chronic pain after cancer treatment and this compounded the difficulties of coping with and managing their pain. They felt health care professionals lacked knowledge and understanding of chronic pain after cancer. 4) 'Negotiating the maze'. Cancer survivors encountered unclear and limited pathways for support, often bouncing from one support team to another. Identifying and accessing services was a challenge, and the responsibility of this was often left to the survivor. 5) 'Validate my pain, validate me'. Palpable relief and benefit was felt when health care professionals diagnosed and acknowledged their chronic pain after cancer treatment. CONCLUSIONS Cancer survivors can feel ill prepared for the risk of chronic pain after cancer treatment and can experience challenges accessing support from healthcare professionals and clinical services.
Collapse
Affiliation(s)
- Julie Armoogum
- College of Health, Science and Society, University of the West of England, Bristol, United Kingdom
| | - Claire Foster
- Centre for Psychosocial Research in Cancer, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Alison Llewellyn
- College of Health, Science and Society, University of the West of England, Bristol, United Kingdom
- Dorothy House Hospice, Winsley, United Kingdom
| | - Diana Harcourt
- College of Health, Science and Society, University of the West of England, Bristol, United Kingdom
| | - Candida McCabe
- College of Health, Science and Society, University of the West of England, Bristol, United Kingdom
- Dorothy House Hospice, Winsley, United Kingdom
| |
Collapse
|
11
|
Wang IY, Jane SW, Hsu HC, Lin YC, Tsai WS, Young CY, Beaton RD, Huang HP. The Longitudinal Trends of Care Needs, Psychological Distress, and Quality of Life and Related Predictors in Taiwanese Colorectal Cancer Survivors. Semin Oncol Nurs 2023; 39:151424. [PMID: 37100635 DOI: 10.1016/j.soncn.2023.151424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/26/2023] [Accepted: 03/15/2023] [Indexed: 04/28/2023]
Affiliation(s)
- I-Ya Wang
- Department of Nursing, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Sui-Whi Jane
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan; Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Hung-Chih Hsu
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
| | - Yung-Chang Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Wen-Sy Tsai
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Chia-Yung Young
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Randal D Beaton
- Psychosocial & Community Health and Health Services, Schools of Nursing and Public Health, University of Washington, Seattle
| | - Hsiang-Ping Huang
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan.
| |
Collapse
|
12
|
Hinz A, Lehmann-Laue A, Richter D, Hinz M, Schulte T, Görz E, Mehnert-Theuerkauf A. The Relationship between Supportive Care Needs and Health-Related Quality of Life in Cancer Patients. Healthcare (Basel) 2023; 11:2161. [PMID: 37570401 PMCID: PMC10418502 DOI: 10.3390/healthcare11152161] [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: 06/21/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this study was to analyze the relationship between quality of life (QoL) and supportive care needs (SCNs) in cancer patients. It is difficult to relate SCNs to detriments in QoL since SCNs and QoL assessment tools generally comprise different dimensions that cannot be directly related to each other. Therefore, we developed a short questionnaire with eight dimensions for uniformly measuring SCNs, QoL, and the subjective importance of these dimensions. A total of 1108 cancer patients with mixed diagnoses assessed eight dimensions of health-related QoL concerning SCNs, satisfaction, and importance. Among the eight dimensions of QoL, physical functioning received the highest SCN assessments (M = 3.4), while autonomy (M = 20.7) and social relationships (M = 1.88) were the dimensions with the lowest SCN mean scores on the 1-5 scale. For each of the eight dimensions, high levels of SCNs were reported by those patients who had low levels of satisfaction with that dimension (r between -0.32 and -0.66). The subjective importance of the dimensions was not consistently correlated with SCNs (r between -0.19 and 0.20). Females reported higher SCNs than males in six of the eight specific dimensions. Patients with prostate and male genital cancers reported the lowest SCNs. These results suggest gender-specific SCN patterns that warrant further exploration. This study highlights the value of a unified assessment instrument for SCNs and QoL, providing a robust basis for future cancer care strategies.
Collapse
Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Germany (A.M.-T.)
| | - Antje Lehmann-Laue
- Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Germany (A.M.-T.)
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Germany (A.M.-T.)
| | - Michael Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Germany (A.M.-T.)
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, 32549 Bad Oeynhausen, Germany (E.G.)
| | - Evelyn Görz
- Rehabilitation Clinic Bad Oexen, 32549 Bad Oeynhausen, Germany (E.G.)
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, 04103 Leipzig, Germany (A.M.-T.)
| |
Collapse
|
13
|
Dong B, Zhang J, Wang F, Xie C, Qi Y, Lin L, Tian L. Supportive care needs of patients with colorectal cancer undergoing anticancer therapy: A latent class analysis. Asia Pac J Oncol Nurs 2023; 10:100216. [PMID: 37251113 PMCID: PMC10220408 DOI: 10.1016/j.apjon.2023.100216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/15/2023] [Indexed: 05/31/2023] Open
Abstract
Objective This study was aimed at identifying the potential subgroups of supportive care needs among Chinese patients with colorectal cancer (CRC) through latent class analysis (LCA) and clarifying the characteristics of patients with high needs. Methods From January to September 2020, a cross-sectional survey was conducted in the Oncology Department and Radiotherapy Department of four tertiary grade A hospitals in Suzhou by using the general information questionnaire and Comprehensive Needs Assessment Tool for patients with cancer. Potential subgroups of supportive care needs were identified through LCA, and the association between the subgroups and statistical variables was analyzed with chi-square tests to clarify the demographic characteristics of the high-need group. This study was not registered. Results A total of 403 patients with CRC were included in the survey. LCA indicated two subgroups of supportive care needs in patients with CRC: a high-need group (51.86% of patients) and a low-need group (48.14% patients). In both groups, the probability of healthcare staff and information needs was high (> 50%). Single/divorced/widowed patients had greater supportive care needs than married patients, and patients with rectal cancer had greater supportive care needs than those with colon cancer. Conclusions Patients' healthcare staff and information needs are of critical importance. Focus should be placed on unmarried, patients with rectal cancer, as well as those receiving chemotherapy plus radiotherapy or palliative treatment.
Collapse
Affiliation(s)
- Bei Dong
- The First Affiliated Hospital of Soochow University, Suzhou, China
- School of Nursing, Chengdu Medical College, Suzhou, China
| | - Jiyin Zhang
- The First Affiliated Hospital of Soochow University, Suzhou, China
- School of Nursing, Soochow University, Suzhou, China
| | - Fen Wang
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Congyan Xie
- School of Nursing, Soochow University, Suzhou, China
| | - Yishu Qi
- School of Nursing, Soochow University, Suzhou, China
| | - Lu Lin
- The First Affiliated Hospital of Soochow University, Suzhou, China
- School of Nursing, Soochow University, Suzhou, China
| | - Li Tian
- The First Affiliated Hospital of Soochow University, Suzhou, China
- School of Nursing, Soochow University, Suzhou, China
| |
Collapse
|
14
|
Schnabel A, Lordick F, Oberth P, Neuschulz M, Lehmann-Laue A, Mehnert-Theuerkauf A, Hinz A. Supportive care needs and health-related quality of life in cancer patients receiving palliative care. Front Psychol 2023; 14:1166801. [PMID: 37303901 PMCID: PMC10250608 DOI: 10.3389/fpsyg.2023.1166801] [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: 02/15/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Objective Cancer patients receiving palliative care experience a variety of impairments in their quality of life (QoL), and have corresponding supportive care needs (SCNs). The aim of this study was to analyze the relationship between SCNs, satisfaction with QoL dimensions, and the perceived importance of these dimensions. Method A sample of 152 cancer patients receiving palliative care were included in this cross-sectional study. Eight dimensions of QoL were defined and assessed concerning SCNs, satisfaction, and subjective importance using a new assessment instrument with five-point scales (range 1-5) for each dimension. Results Among the eight specific domains examined, the greatest SCNs were observed for absence of pain (M = 3.18; SD = 1.29). The patients were least satisfied with their physical functioning (M = 2.60; SD = 0.84), and the dimension social relationships (M = 4.14; SD = 0.72) received the highest perceived importance ratings. The eight dimensions' SCNs scores were significantly correlated with each other (r between 0.29 and 0.79); the lowest correlations were found for social relationships. The correlations between the satisfaction scores and the SCNs differed from dimension to dimension, with coefficients between -0.32 (absence of pain) and - 0.57 (sleep quality). Conclusion The results show that detriments in QoL do not automatically indicate high levels of SCNs in those dimensions. Health care providers should consider both factors, QoL (as measured with QoL questionnaires) and subjectively expressed SCNs, to optimize their patients' care regimens.
Collapse
Affiliation(s)
- Astrid Schnabel
- Department of Medicine (Oncology, Gastroenterology, Hepatology, Pulmonology), University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Florian Lordick
- Department of Medicine (Oncology, Gastroenterology, Hepatology, Pulmonology), University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany (CCCG), Leipzig, Germany
| | - Paula Oberth
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Markus Neuschulz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Antje Lehmann-Laue
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| |
Collapse
|
15
|
Rutherford C, Ju A, Kim B, Wiltink L, Acret L, White K. How consequences of colorectal cancer treatment are managed: a qualitative study of stakeholder experiences about supportive care and current practices. Support Care Cancer 2023; 31:255. [PMID: 37041401 PMCID: PMC10090022 DOI: 10.1007/s00520-023-07713-7] [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: 08/16/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE Colorectal cancer (CRC) survivors experience treatment-effects such as symptoms and functional impairments. There is limited evidence about how these are managed and what services or supports are available in the community. We aimed to identify current practice and available supports for managing consequences of treatment from clinician and CRC survivor perspectives. METHODS This qualitative study, informed by an interpretivist constructionist paradigm, included semi-structured interviews. Clinicians with experience of treating CRC patients and adult CRC survivors were recruited across Australia. Interviews explored experiences about problems experienced after CRC treatment and how these were managed. Data collection and analysis, using thematic analysis, was iterative whereby emergent themes during analysis were incorporated into subsequent interviews. RESULTS We interviewed 16 clinicians and 18 survivors. Survivors experienced a range of consequences of treatment amendable to support including allied health, information, and self-management. Barriers to support access included clinicians' worry about patient out-of-pocket expenses, long waitlists, lack of awareness about existing supports, and perception no therapeutic options were available. Healthcare professionals with expertise in CRC were often difficult to identify outside of cancer settings. Survivorship care could be improved with individualised timely information and identification of pathways to access healthcare providers with expertise in managing consequences of CRC treatment within primary care. CONCLUSIONS To improve CRC survivor lives posttreatment, routine assessment of consequences of treatment, individualised care planning involving relevant healthcare professionals, access to supportive care when needed, and improved information provision and engagement of a range of health professionals in follow-up care are needed.
Collapse
Affiliation(s)
- Claudia Rutherford
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia.
- University of Sydney, Faculty Science, School of Psychology, Quality of Life Office, Sydney, Australia.
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia.
| | - Angela Ju
- University of Sydney, Faculty Science, School of Psychology, Quality of Life Office, Sydney, Australia
| | - Bora Kim
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Lisette Wiltink
- Department of Radiation Oncology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Louise Acret
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Kate White
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- Sydney Local Health District, Sydney, Australia
| |
Collapse
|
16
|
Patient-Reported Outcomes and Return to Intended Oncologic Therapy After Colorectal Enhanced Recovery Pathway. ANNALS OF SURGERY OPEN 2023; 4:e267. [PMCID: PMC10431437 DOI: 10.1097/as9.0000000000000267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 01/20/2023] [Indexed: 10/19/2023] Open
Abstract
Objective: To evaluate the influence of enhanced recovery pathway (ERP) on patient-reported outcome measures (PROMs) and return to intended oncologic therapy (RIOT) after colorectal surgery. Background: ERP improves early outcomes after colorectal surgery; however, little is known about its influence on PROMs and on RIOT. Methods: Prospective multicenter enrollment of patients who underwent colorectal resection with anastomosis was performed, recording variables related to patient-, institution-, procedure-level data, adherence to the ERP, and outcomes. The primary endpoints were PROMs (administered before surgery, at discharge, and 6 to 8 weeks after surgery) and RIOT after surgery for malignancy, defined as the intended oncologic treatment according to national guidelines and disease stage, administered within 8 weeks from the index operation, evaluated through multivariate regression models. Results: The study included 4529 patients, analyzed for PROMs, 1467 of which were analyzed for RIOT. Compared to their baseline preoperative values, all PROMs showed significant worsening at discharge and improvement at late evaluation. PROMs values at discharge and 6 to 8 weeks after surgery, adjusted through a generalized mixed regression model according to preoperative status and other variables, showed no association with ERP adherence rates. RIOT rates (overall 54.5%) were independently lower by aged > 69 years, ASA Class III, open surgery, and presence of major morbidity; conversely, they were independently higher after surgery performed in an institutional ERP center and by ERP adherence rates > median (69.2%). Conclusions: Adherence to the ERP had no effect on PROMs, whereas it independently influenced RIOT rates after surgery for colorectal cancer. In this prospective multicenter study performed on 4529 patients who underwent colorectal resection, adherence to an enhanced recovery pathway showed no effect on patient-reported outcomes but independently influenced the return to intended oncologic therapy.
Collapse
|
17
|
Erickson N, Sullivan ES, Kalliostra M, Laviano A, Wesseling J. Nutrition care is an integral part of patient-centred medical care: a European consensus. Med Oncol 2023; 40:112. [PMID: 36881207 PMCID: PMC9992033 DOI: 10.1007/s12032-023-01955-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/18/2023] [Indexed: 03/08/2023]
Abstract
While healthcare is becoming more patient-centred, evidence-based nutrition interventions are still not accessible to all patients with cancer. As nutrition interventions directly improve clinical and socioeconomic outcomes, patient-centred care is not complete without nutrition care. While awareness of the negative impact of malnutrition on clinical outcomes, quality of life, and functional and emotional wellbeing in cancer is growing, there is relatively poor awareness amongst patients, clinicians, policymakers, and payers that nutrition interventions -particularly those begun in the early stages of the disease course- are an effective method for improving such outcomes. The European Beating Cancer Plan recognises the need for a holistic approach to cancer but lacks actionable recommendations to implement integrated nutrition cancer care at member state level. When considering nutrition care as a human right, the impact on quality of life and functional status must be prioritized, as these may be equally as important to patients, especially in advanced cancer where improvements in clinical outcomes such as survival or tumour burden may not be attainable. We formulate actions needed at the regional and the European level to ensure integrated nutrition care for all patients with cancer. The 4 main Take Home Messages are as follows: 1. The goals of Europe's Beating Cancer Plan cannot be achieved without integrating nutrition across the cancer care continuum. 2. Malnutrition negatively impacts clinical outcomes and has socioeconomic consequences for patients and healthcare systems. 3. Championing integrating nutrition care into cancer care is therefore the duty and ethical responsibility of clinicians (Hippocratic Oath-primum non nocere) and 4. Nutrition care is a cost effective, evidence-based therapy.
Collapse
Affiliation(s)
- Nicole Erickson
- Comprehensive Cancer Center Munich, Ludwig Maximilian University of Munich Hospital, Munich, Germany.
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK.
- European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands.
| | - Erin Stella Sullivan
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Marianna Kalliostra
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands
- The European Nutrition for Health Alliance, London, UK
| | - Alessandro Laviano
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- The European Nutrition for Health Alliance, London, UK
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Joost Wesseling
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- The European Nutrition for Health Alliance, London, UK
| |
Collapse
|
18
|
Cuthbert CA, O'Sullivan DE, Boyne DJ, Brenner DR, Cheung WY. Patient-Reported Symptom Burden and Supportive Care Needs of Patients With Stage II-III Colorectal Cancer During and After Adjuvant Systemic Treatment: A Real-World Evidence Study. JCO Oncol Pract 2023; 19:e377-e388. [PMID: 36608313 DOI: 10.1200/op.22.00462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Patients with colorectal cancer (CRC) experience a range of physical and psychologic symptoms, and supportive care needs throughout the illness trajectory. We used patient-reported outcomes and administrative health data to describe symptom burden and supportive care needs during and after adjuvant treatment and determine factors associated with changes to symptom burden. METHODS A retrospective population-based cohort study of patients who were newly diagnosed with stage II-III CRC in Alberta, Canada, between January 1, 2016, and January 31, 2019. Adults age 18 years or older who completed a patient-reported outcomes survey (Edmonton Symptom Assessment System) and supportive care needs (Canadian Problem Checklist) within 3 months after starting adjuvant treatment (during treatment) and > 7 months after starting treatment (after treatment) were included. Changes to symptom severity were stratified as stable, improved, or deteriorated. Multivariable logistic regression was used to evaluate factors associated with these changes. RESULTS We included 303 patients (median age 60 years, 62% male, 84.5% stage III, 51.2% rectal v colon). Prevalent symptoms included tiredness (80.5%), pain (50.8%), and poor well-being (50%) during treatment, and tiredness (71.3%), pain (44.2%), and poor well-being (62.1%) after treatment. The results were heterogeneous with respect to improvements, stability, or deterioration. Pain worsened for 25% of the cohort, tiredness for 28%, and depression, anxiety, and well-being for 21%, 22%, and 31%, respectively. Deterioration of some symptoms was associated with older age, stage II, comorbidities, rural setting, and higher income. CONCLUSION We demonstrated symptom severity was generally low and most symptoms remained stable or improved after treatment. Particular groups of patients were at greater risk for more severe and/or more persistent symptoms. Ongoing assessments and interventions to address physical and psychologic symptoms, and supportive care needs in patients with CRC during and after treatment are needed.
Collapse
Affiliation(s)
- Colleen A Cuthbert
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Dylan E O'Sullivan
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Devon J Boyne
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darren R Brenner
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Winson Y Cheung
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Health Services, Cancer Care, Edmonton, Alberta, Canada
| |
Collapse
|
19
|
Kriel SA, Paterson C. Providing Leadership Through Patients as Partners: Improving Australian Colorectal Survivorship Care Through Perspectives from a Nurse Who Became a Cancer Patient. Semin Oncol Nurs 2023; 39:151360. [PMID: 36424249 DOI: 10.1016/j.soncn.2022.151360] [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: 11/23/2022]
Abstract
OBJECTIVE To provide contemporary real-world, real-life insights into gaps in supportive care experiences for people affected by colorectal cancer. For the first time, this article includes a patient as a coauthor, with the aim to identify future priorities to improve care and recovery in colorectal cancer survivorship. DATA SOURCES Electronic databases, peer-reviewed literature, and real-life professional and personal experiences were used. CONCLUSION There are several problematic areas in providing supportive care for people affected by colorectal cancer that could be improved by wider access to colorectal specialist nurses, coordinated multidisciplinary teams, patient collaboration, linking survivorship care outcomes to national standards, and developing supported self-management care plans. IMPLICATIONS FOR NURSING PRACTICE A patient-led insight has underscored some fundamental failings in current service delivery among people affected by colorectal cancer. Partnering with consumers in research and service redesign is essential to stratify future priorities to optimize care and person-centered recovery.
Collapse
Affiliation(s)
- Sally-Anne Kriel
- Founder, Awakened Mumma Wellness; Clinical Nurse Consultant, Moderator of 'The Movement' for Bowel Cancer Australia.
| | - Catherine Paterson
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, ACT, Australia; SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate, Garran, ACT, Australia; School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Garthdee, Aberdeen, Scotland; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia
| |
Collapse
|
20
|
Bahrami M, Masoumy M, Sadeghi A, Mosavizadeh R. The needs of colorectal cancer patients/survivors: A narrative review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:227. [PMID: 36177430 PMCID: PMC9514244 DOI: 10.4103/jehp.jehp_1093_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/24/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Identifying and addressing the needs of Colorectal cancer (CRC) patients/survivors' is important to improve patients/survivors' quality of life (QoL) and health. The present study aimed to review studies that have investigated CRC patients/survivors' needs. MATERIALS AND METHODS In this narrative review, databases including PubMed, Scopus, Web of Science, Iranmedex, ISC, SID, and Magiran were searched during 2011-2021 using keywords included need, CRC, colon cancer, rectal cancer. RESULTS The findings of the studies showed that the needs of the CRC patients/survivors' can be categorized into the 6 domains including informational, psychological, social, physical, financial, and spiritual needs. CONCLUSIONS By identifying CRC patients/survivors' needs, healthcare providers particularly nurses can develop and design comprehensive care programs tailored to the needs and priorities of these patients/survivors to improve their QoL and health.
Collapse
Affiliation(s)
- Masoud Bahrami
- Department of Adult Health Nursing, Cancer Prevention Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Masoumy
- Department of Adult Health Nursing, Student Research Committee, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Sadeghi
- Department of Hematology-Oncology, Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rohallah Mosavizadeh
- Department of Islamic Education, ALA Cancer Prevention and Control Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
21
|
Eriksen KS, Lode K, Husebø SIE, Kørner H. Exploring variables affecting sense of coherence and social support in recovery after colorectal cancer surgery among the oldest old. Geriatr Nurs 2022; 47:81-86. [PMID: 35878524 DOI: 10.1016/j.gerinurse.2022.06.008] [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: 04/28/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore the associations between sense of coherence, perceived social support, and demographic and clinical characteristics among survivors ≥80 years treated for curable colorectal cancer. METHODS This exploratory, cross-sectional survey investigates 56 individuals surgically treated for stage I-III colorectal cancer between one and five years prior. Statistical analysis permitted exploration of associations between sense of coherence, perceived social support, and demographic- and clinical variables. RESULTS Lower sense of coherence was associated with higher age, limitations in physical function, and the need for homecare nursing. Lower perceived social support was associated with re-admission, higher age at time of surgery, and male gender. No correlations were found between sense of coherence and perceived social support. CONCLUSION The results are important for healthcare professionals to consider when dealing with older people who underwent surgery for colorectal cancer, especially in the discharge process to facilitate optimal follow-up care and recovery.
Collapse
Affiliation(s)
- Kristina Sundt Eriksen
- Department of Research, Stavanger University Hospital, Stavanger, Norway; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway; Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
| | - Kirsten Lode
- Department of Research, Stavanger University Hospital, Stavanger, Norway; Department of Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Sissel Iren Eikeland Husebø
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Hartwig Kørner
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway
| |
Collapse
|
22
|
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.
Collapse
|
23
|
The long haul: Lived experiences of survivors following different treatments for advanced colorectal cancer: A qualitative study. Eur J Oncol Nurs 2022; 58:102123. [DOI: 10.1016/j.ejon.2022.102123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 12/22/2022]
|
24
|
Cuthbert C, Nixon N, Vickers M, Samimi S, Rawson K, Ramjeesingh R, Karim S, Stein B, Laxdal G, Dundas L, Huband D, Daze E, Farrer C, Cheung WY. Top 10 research priorities for early-stage colorectal cancer: a Canadian patient-oriented priority-setting partnership. CMAJ Open 2022; 10:E278-E287. [PMID: 35351780 PMCID: PMC9259415 DOI: 10.9778/cmajo.20210046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Colorectal cancer, one of the most commonly diagnosed cancers, is now being detected earlier and treatments are improving, which means that patients are living longer. Partnering with Canadian clinicians, patients and researchers, we aimed to determine research priorities for those living with early-stage colorectal cancer in Canada. METHODS We followed the well-established priority-setting partnership outlined by the James Lind Alliance to identify and prioritize unanswered questions about early-stage (i.e., stages I-III) colorectal cancer. The study was conducted from September 2018 to September 2020. We surveyed patients, caregivers and clinicians from across Canada between June 2019 and December 2019. We categorized the responses using thematic analysis to generate a list of unique questions. We conducted an interim prioritization survey from April 2020 to July 2020, with patients, caregivers and clinicians, to determine a shorter list of questions, which was then reviewed at a final meeting (involving patients, caregivers and clinicians) in September 2020. At that meeting, we used a consensus-based process to determine the top 10 priorities. RESULTS For the initial survey, 370 responses were submitted by 185 individuals; of the 98 individuals who provided demographic information, 44 (45%) were patients, 16 (16%) were caregivers, 7 (7%) were members of an advocacy group, 26 (27%) were health care professionals and 5 (5%) were categorized as "other." The responses were refined to create a list of 66 unique unanswered questions. Twenty-five respondents answered the interim prioritization survey: 13 patients (52%), 2 caregivers (8%), 3 advocacy group members (12%) and 7 health care professionals (28%). This led to a list of the top 30 questions. The final consensus meeting involved 20 individuals (10 patients [50%], 3 caregivers [15%] and 7 health care professionals [35%]), who agreed to the top 10 research priorities. The priorities covered a range of topics, including screening, treatment, recurrence, management of adverse effects and decision-making. INTERPRETATION We determined the top research priorities for early-stage colorectal cancer using a collaborative partnership of stake-holders from across Canada. The priorities covered a broad range of topics that could be addressed by future research, including improved screening practices, the role of personalized medicine, the management of adverse effects of treatment, decision-making and prevention of recurrence.
Collapse
Affiliation(s)
- Colleen Cuthbert
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Nancy Nixon
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Michael Vickers
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Setareh Samimi
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Krista Rawson
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Ravi Ramjeesingh
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Safiya Karim
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Barry Stein
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Garry Laxdal
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Lorilee Dundas
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Diane Huband
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Emily Daze
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Christie Farrer
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| | - Winson Y Cheung
- Faculty of Nursing (Cuthbert, Daze, Farrer) and Department of Oncology, Cumming School of Medicine (Cuthbert, Nixon, Karim, Cheung), University of Calgary; Cancer Care Alberta (Nixon, Rawson, Karim, Cheung) and Patient and Family Engagement Advisory Network for Cancer Care Alberta (Laxdal, Huband), Alberta Health Services, Calgary, Alta.; Patient and Family Engagement Advisory Network for Cancer Care Alberta (Dundas), Alberta Health Services, Drumheller, Alta.; The Ottawa Hospital (Vickers) and University of Ottawa (Vickers), Ottawa, Ont.; Hôpital du Sacré-Cœur de Montréal (Samimi) and Colorectal Cancer Canada (Stein), Montréal, Que.; Department of Community Health and Epidemiology (Ramjeesingh), Dalhousie University, and Nova Scotia Cancer Care Centre (Ramjeesingh), Halifax, NS
| |
Collapse
|
25
|
Duangchan C, Steffen A, Matthews AK. Perspectives and practices regarding colorectal cancer survivorship care: Online survey results from oncology nurses in Thailand. Eur J Oncol Nurs 2021; 55:102048. [PMID: 34634574 DOI: 10.1016/j.ejon.2021.102048] [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: 08/30/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Limited research has highlighted disparities in survivorship care in low- and middle-income countries. However, such care for colorectal cancer (CRC) survivors remains unexplored, especially in Thailand. This study examined Thai oncology nurses' perceptions of responsibility, confidence levels, and frequency of survivorship care practice for CRC survivors and identified factors impeding such care. METHODS A cross-sectional study utilizing an online survey approach was conducted between October and November 2020. Thai oncology nurses (N = 155) completed the survey's demographic questionnaire, 29-item survivorship care scale, and 16-item impeding factor scale. RESULTS Oncology nurses had high levels of perceived responsibility (mean = 73.37, SD = 12.12) and confidence (mean = 65.09, SD = 14.89) for providing CRC survivorship care. However, they reported less frequency of practice (mean = 47.60, SD = 21.03), especially concerning sexual, fertility, employment, and financial issues. Nurses with higher education had significantly higher responsibility perceptions, confidence levels, and frequency of practice (all p < .05). Also, nurses with specialty training in cancer care reported higher frequency of practice (p = .013). Common factors impeding survivorship care were lack of physical facilities (60.4%), knowledge/skills (57.4%), and educational resources for family members (52.3%) and survivors (51.6%). CONCLUSIONS This study revealed inconsistencies between oncology nurses' responsibility perceptions, confidence levels, and frequency of survivorship care practice. The results can guide nurse researchers, educators, leaders, and policymakers in enhancing the quality of CRC survivorship care in low- and middle-income countries such as Thailand. Future efforts should focus on developing educational resources and training programs for survivorship care for oncology nurses and addressing factors impeding such care during healthcare service planning.
Collapse
Affiliation(s)
- Cherdsak Duangchan
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA; Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand.
| | - Alana Steffen
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Alicia K Matthews
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
26
|
Al-Husban RY, Obeidat R, Shamieh O. Unmet Supportive Care Needs of Jordanian Patients with Colorectal Cancer: A Cross-Sectional Survey. Asia Pac J Oncol Nurs 2021; 8:565-572. [PMID: 34527787 PMCID: PMC8420928 DOI: 10.4103/apjon.apjon-2110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: Colorectal cancer (CRC) is ranked the second most common cancer diagnosed in both men and women in Jordan. This paper aims to explore the unmet supportive care needs (USCNs), and their predictors among Jordanian survivors with CRC. Methods: A cross-sectional descriptive correlational research design with a convenience sample of 180 patients with CRC was conducted. Participants completed the Supportive Care Needs Survey-Short Form 34. Results: Jordanian patients with CRC reported their highest perceived level of need in the information and psychological domains. Multiple linear regression revealed that income and the number of chemotherapy sessions were significant predictors in the physical and daily living domains. Age, type of surgical treatment, and type of clinical setting were significant predictors of USCN in the psychological, patient care and support, and the health system and information domains. Conclusions: The health-care systems should work to meet all the supportive care needs for patients with CRC, particularly the informational and psychological needs domains where patients express unmet needs. Special care should be given according to age, type of surgery, and the doses of chemotherapy received. This study further confirms a disparity in the care and support provided to Jordanian cancer patients with different health-care settings in the country.
Collapse
Affiliation(s)
| | - Rana Obeidat
- Faculty of Nursing, Adult Health Nursing, Zarqa University, Zarqa, Jordan
| | - Omar Shamieh
- Department of Palliative Medicine, King Hussein Cancer Center, Amman, Jordan
| |
Collapse
|
27
|
Unmet Needs and Quality of Life of Cancer Patients and Their Families: Actor-Partner Interdependence Modeling. Healthcare (Basel) 2021; 9:healthcare9070874. [PMID: 34356252 PMCID: PMC8305838 DOI: 10.3390/healthcare9070874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 02/04/2023] Open
Abstract
Unmet needs and quality of life (QOL) are important nursing issues for both patients and their families. However, studies into their direct association, considering the dyadic relationship between them, have not been done. We investigated the associations using the actor–partner interdependence modeling for dyadic data. Data were collected from 115 patient–family dyads at a tertiary teaching hospital. The study variables were assessed using the questionnaires and clinical data. To analyze patient–family dyad data, the actor–partner interdependence modeling and structural equation modeling were used. The cancer patients and their families experienced diverse and high levels of unmet needs that affected their quality of life, both physically and mentally. The cancer patients’ unmet needs decreased their physical and mental quality of life, while those of their families had a negative impact on their own physical and mental quality of life. However, the cancer patients’ unmet needs did not have partner effects on their families’ quality of life, and vice versa. Therefore, unmet needs played important roles in their QOL taking into dyadic relationships in the model. The results suggest that nursing intervention programs to meet the needs of both patients and their families are required to improve their quality of life.
Collapse
|
28
|
Hutchinson T, Hoffe S, Saeed S, Pflanzer SA, Fleming JB, Pabbathi S. Gastrointestinal Disease-Specific Survivorship Care: A New Personalized Model Integrating Onco-Wellness. Cancer Control 2021; 28:10732748211006081. [PMID: 33926264 PMCID: PMC8204645 DOI: 10.1177/10732748211006081] [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: 11/16/2022] Open
Abstract
Although the number of gastrointestinal (GI) cancer survivors is projected to increase in the coming years, there are currently no survivorship care models that address the specific and growing needs of this population. Current survivorship care models were evaluated to assess their suitability for GI cancer survivors. A survivorship care model based on foundational wellness principles is under development to address the specific needs of GI cancer survivors. This model delivers a cohesive and collaborative care continuum for survivors of different GI malignancies. Oncology providers in GI departments and internal medicine providers in survivorship programs are positioned to provide a comprehensive approach for the care of patients treated with curative intent. Survivorship care is introduced at the conclusion of active treatment in the form of an Onco-wellness consultation, an in-person or telemedicine comprehensive care plan creation and review by our Survivorship Program. Personalized care plan including long term and late effects of treatment, nutrition, physical activity and rehabilitation recommendations, prevention of secondary malignancies and psychosocial needs are reviewed. As patients transition from active treatment to survivorship within the GI Program, the GI Advance Practice Professionals (APPs) are well-positioned to deliver comprehensive survivorship care specific to the GI patient’s needs while integrating recommendations and principles from the Onco-wellness consultation. With projected shortages of both oncology and primary care physicians, such an APP-based model has the potential to bridge gaps in the survivorship care continuum and mutually benefit patients and physicians.
Collapse
Affiliation(s)
- Tai Hutchinson
- Department of Gastrointestinal Oncology, 25301H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sarah Hoffe
- Department of Radiation Oncology, 25301H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sabrina Saeed
- 6752Brown University, College of Medicine, Providence, RI, USA
| | - Sonya A Pflanzer
- Department of Internal Medicine, 25301H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jason B Fleming
- Department of Gastrointestinal Oncology, 25301H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Smitha Pabbathi
- Department of Internal Medicine, 25301H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| |
Collapse
|
29
|
Moschopoulou E, Deane J, Duncan M, Ismail SA, Moriarty S, Sarker SJ, White P, Korszun A. Measuring quality of life in people living with and beyond cancer in the UK. Support Care Cancer 2021; 29:6031-6038. [PMID: 33783624 PMCID: PMC8410707 DOI: 10.1007/s00520-021-06105-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/24/2021] [Indexed: 11/30/2022]
Abstract
Purpose The aim of this study was to identify the most appropriate measure of quality of life (QoL) for patients living with and beyond cancer. Methods One hundred eighty-two people attending cancer clinics in Central London at various stages post-treatment, completed a series of QoL measures: FACT-G, EORTC QLQ-C30 , IOCv2 (positive and negative subscales) and WEMWBS, a wellbeing measure. These measures were chosen as the commonest measures used in previous research. Correlation tests were used to assess the association between scales. Participants were also asked about pertinence and ease of completion. Results There was a significant positive correlation between the four domain scores of the two health-related QoL measures (.32 ≤ r ≤ .72, P < .001), and a significant large negative correlation between these and the negative IOCv2 subscale scores (− .39 ≤ r ≤ − .63, P < .001). There was a significant moderate positive correlation between positive IOCv2 subscale and WEMWBS scores (r = .35, P < .001). However, neither the FACT-G nor the EORTC showed any significant correlation with the positive IOCv2 subscale. Participants rated all measures similarly with regards to pertinence and ease of use. Conclusion There was little to choose between FACT-G, EORTC, and the negative IOC scales, any of which may be used to measure QoL. However, the two IOCv2 subscales capture unique aspects of QoL compared to the other measures. The IOCv2 can be used to identify those cancer survivors who would benefit from interventions to improve their QoL and to target specific needs thereby providing more holistic and personalised care beyond cancer treatment.
Collapse
Affiliation(s)
- Elisavet Moschopoulou
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jennifer Deane
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - Morvwen Duncan
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Sharif A Ismail
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Sophie Moriarty
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Shah-Jalal Sarker
- Research Department of Medical Education, UCL Medical School, UCL, London, UK
| | - Peter White
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Ania Korszun
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
| | | |
Collapse
|
30
|
Lim CYS, Laidsaar-Powell RC, Young JM, Kao SCH, Zhang Y, Butow P. Colorectal cancer survivorship: A systematic review and thematic synthesis of qualitative research. Eur J Cancer Care (Engl) 2021; 30:e13421. [PMID: 33733545 DOI: 10.1111/ecc.13421] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/06/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION With rapid changes in treatments for colorectal cancer (CRC), qualitative research into CRC survivorship requires greater synthesis. This paper aims to fill this gap through a systematic review (PROSPERO CRD42019131576) and thematic synthesis of the qualitative literature on survivorship experiences across early-stage and advanced CRC survivors. METHODS CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched for qualitative CRC survivorship papers. Titles, abstracts and full texts were screened. Included articles (n = 81) underwent data extraction, CASP qualitative bias ratings and thematic synthesis. RESULTS Bowel dysfunction caused functional limitations and negative quality of life (QoL), while stomas posed threats to body image and confidence. Physical symptoms hindered return to work, increasing financial burdens. Survivors' unmet needs included information regarding symptom expectations and management, and ongoing support throughout recovery. Advanced and early-stage survivors shared similar experiences. Advanced survivors struggled with fear of cancer recurrence/progression and feelings of powerlessness. Functional limitations, financial impacts and sexuality in advanced survivors were underexplored areas. CONCLUSION CRC and its treatments impact survivors' QoL in all areas. A coordinated supportive care response is required to address survivors' unmet needs. Future qualitative studies should explore advanced CRC subpopulations, treatment-specific impacts on QoL and long-term (>5 years) impacts on CRC survivors.
Collapse
Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Clare Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,RPA Institute of Academic Surgery (IAS) and Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia
| | - Steven Chuan-Hao Kao
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Australian National University Research School of Population Health, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
31
|
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
|
32
|
Frankland J, Wheelwright S, Permyakova NV, Wright D, Collaço N, Calman L, Winter J, Fenlon D, Richardson A, Smith PW, Foster C. Prevalence and predictors of poor sexual well-being over 5 years following treatment for colorectal cancer: results from the ColoREctal Wellbeing (CREW) prospective longitudinal study. BMJ Open 2020; 10:e038953. [PMID: 33184080 PMCID: PMC7662451 DOI: 10.1136/bmjopen-2020-038953] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To describe prevalence and predictors of poor sexual well-being for men and women over 5 years following treatment for colorectal cancer. DESIGN Prospective longitudinal study, from presurgery to 5 years postsurgery, with eight assessment points. Logistic regression models predicted sexual well-being from presurgery to 24 months and 24 months to 60 months; time-adjusted then fully adjusted models were constructed at each stage. SETTING Twenty-nine hospitals in the UK. PARTICIPANTS Patients with Dukes' stage A-C, treated with curative intent, aged ≥18 years and able to complete questionnaires were eligible. OUTCOME MEASURES The dependent variable was the Quality of Life in Adult Cancer Survivors sexual function score. Independent variables included sociodemographic, clinical and psychosocial characteristics. RESULTS Seven hundred and ninety participants provided a sexual well-being score for at least one time point. Thirty-seven per cent of men and 14% of women reported poor sexual well-being at 5 years. Baseline predictors for men at 24 months included having a stoma (OR 1.5, 95% CI 1.02 to 2.20) and high levels of depression (OR 2.69/2.01, 95% CI 1.68 to 4.32/1.12 to 3.61); men with high self-efficacy (OR confident 0.33/0.48, 95% CI 0.18 to 0.61/0.24 to 1.00; very confident 0.25/0.42, 95% CI 0.13 to 0.49/0.19 to 0.94) and social support (OR 0.52/0.56, 95% CI 0.33 to 0.81/0.35 to 0.91) were less likely to report poor sexual well-being. Predictors at 60 months included having a stoma (OR 2.30/2.67, 95% CI 1.22 to 4.34/1.11 to 6.40) and high levels of depression (OR 5.61/2.58, 95% CI 2.58 to 12.21/0.81 to 8.25); men with high self-efficacy (very confident 0.14, 95% CI 0.047 to 0.44), full social support (OR 0.26; 95% CI 0.13 to 0.53) and higher quality of life (OR 0.97, 95% CI 0.95 to 0.98) were less likely to report poor sexual well-being. It was not possible to construct models for women due to low numbers reporting poor sexual well-being. CONCLUSIONS Several psychosocial variables were identified as predictors of poor sexual well-being among men. Interventions targeting low self-efficacy may be helpful. More research is needed to understand women's sexual well-being.
Collapse
Affiliation(s)
- Jane Frankland
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, UK
| | - Sally Wheelwright
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, UK
| | - Natalia V Permyakova
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, UK
| | - David Wright
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, UK
| | - Nicole Collaço
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, UK
| | - Jane Winter
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Deborah Fenlon
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Alison Richardson
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Peter W Smith
- Social Statistics and Demography, University of Southampton, Southampton, UK
| | - Claire Foster
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, UK
| |
Collapse
|
33
|
|
34
|
Chang YH, Lai YH, Tsai MK, Shun SC. Care Needs for Organ Transplant Recipients Scale: Development and psychometric testing. J Ren Care 2020; 47:123-132. [PMID: 32799380 DOI: 10.1111/jorc.12345] [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: 12/31/2019] [Revised: 04/03/2020] [Accepted: 05/05/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Needs assessment can determine how large the gap is between needs and available services; however, no tools are available to assess the unmet needs of renal transplant recipients. OBJECTIVES The aim of this study was to develop the Care Needs for Organ Transplant Recipients Scale (CNOTRS) and examine its psychometric properties. DESIGN A cross-sectional design for instrument development and psychometric testing. PARTICIPANTS In total, 217 renal transplant recipients were recruited through convenience sampling. METHODS An initial 36-item CNOTRS was developed after a comprehensive literature review. After the CNOTRS was tested through content validity and face validity, the factor structure was explored using exploratory factor analysis (EFA). Convergent validity was examined using Pearson's correlation between the CNOTRS and Hospital Anxiety and Depression Scale (HADS). Known-group validity was tested by comparing CNOTRS scores of patients grouped based on whether they had experienced complications or rejection. RESULTS Twenty-eight items with three factors (namely daily care and social interaction needs, psychological needs, and health system and service needs) were identified in EFA by parallel analysis and Velicer's MAP test. The psychological needs domain had a stronger positive correlation with the HADS than the other two domains. The known-group validity was supported as a significant association between complications or rejection occurrence and unmet needs. The Cronbach's α of the CNOTRS was 0.94. CONCLUSIONS The CNOTRS demonstrated satisfactory reliability and validity to assess the care needs for renal transplant recipients and can assist health care professionals to tailor more personalised care for their individual needs.
Collapse
Affiliation(s)
- Yu Hsuan Chang
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan.,School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yeur Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meng Kun Tsai
- Department of Surgery, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shiow Ching Shun
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
35
|
Trevino KM, Nelson CJ, Saracino RM, Korc-Grodzicki B, Sarraf S, Shahrokni A. Is screening for psychosocial risk factors associated with mental health care in older adults with cancer undergoing surgery? Cancer 2019; 126:602-610. [PMID: 31626346 DOI: 10.1002/cncr.32564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Surgery is a notable stressor for older adults with cancer, who often are medically and psychosocially complex. The current study examined rates of preoperative psychosocial risk factors in older adults with cancer who were undergoing elective surgery and the relationship between these risk factors and the provision of mental health services during the postoperative hospitalization. METHODS A total of 1211 patients aged ≥75 years who were referred to the geriatrics service at a comprehensive cancer center were enrolled. Patients underwent elective surgery with a length of stay of ≥3 days and were followed for at least 30 days after surgery. A comprehensive geriatric assessment was administered as part of routine preoperative care. Bivariate relationships between demographic and surgical characteristics and the preoperative comprehensive geriatric assessment and the receipt of mental health services during the postoperative hospitalization period were examined. Characteristics with bivariate relationships that were significant at the level of P < .10 were entered into a multivariable regression predicting postoperative mental health service use. RESULTS Approximately one-fifth of the total sample (20.6%) received postoperative mental health services. In multivariable analyses, high distress (P = .007) and poor social support (P = .02) were found to be associated with a greater likelihood of the receipt of mental health services. Of those patients with high distress and poor social support, only approximately one-quarter (24.6%-25.5%) received mental health care. CONCLUSIONS Distressed older adults and those with low levels of support preoperatively were found to be more likely to receive mental health services after surgery. Nevertheless, less than one-third of these patients received inpatient postoperative mental health care, indicating that barriers to translating screening into the provision of psychosocial services remain.
Collapse
Affiliation(s)
- Kelly M Trevino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rebecca M Saracino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Beatriz Korc-Grodzicki
- Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Saman Sarraf
- Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Armin Shahrokni
- Geriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|