1
|
Koppel PD, Park HYK, Ledbetter LS, Wang EJ, Rink LC, De Gagne JC. Rapport between nurses and adult patients with cancer in ambulatory oncology care settings: A scoping review. Int J Nurs Stud 2024; 149:104611. [PMID: 37879272 DOI: 10.1016/j.ijnurstu.2023.104611] [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: 11/02/2022] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Although the importance of the nurse-patient relationship in oncology is established, a consolidated body of research describing nurse-patient rapport, especially in ambulatory care, is lacking. OBJECTIVES This scoping review aimed to explore knowledge about rapport between adult patients with cancer and their nurses in ambulatory oncology care, including nurse, patient, nurse-patient dyad, and system-level factors that influence rapport. METHODS A scoping review was conducted to explore sources of evidence and gaps in knowledge pertinent to future research. The Joanna Briggs Institute methodology for Systematic Reviews was used with searches in MEDLINE, CINAHL, and ProQuest Dissertations and Theses Global databases. Experimental, descriptive observational, and qualitative study designs that focused on patients with cancer and their nurses within an ambulatory care setting were included. Results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS The search strategy collected 4538 studies of which 10 met study criteria after screening. Forward and backward citation tracking of included articles resulted in 4 additional studies. In total, 14 studies were extracted and analyzed. Synthesis of results from the individual sources resulted in three key observations: (a) there is an absence of studies that focus directly on nurse-patient rapport; (b) the majority of extracted data on rapport-related factors described aspects of nurses' attitudes; and (c) there was minimal information on patient, nurse-patient dyad, and system-level factors reported in these studies. CONCLUSIONS The lack of studies focused specifically on nurse-patient rapport in oncology ambulatory care indicates a notable gap in our empirical understanding of relationship-based care, a hallmark of cancer care provision. TWEETABLE ABSTRACT Nurse-patient rapport in oncology ambulatory care requires additional research @paula_koppel.
Collapse
Affiliation(s)
| | | | | | - Emily J Wang
- School of Nursing, Duke University, Durham, NC, USA
| | | | | |
Collapse
|
2
|
Skyttä M, Pietilä AM, Stolt M, Kangasniemi M. Identifying personal health-related resources of women with breast cancer for nursing: An integrative review. Scand J Caring Sci 2023; 37:884-896. [PMID: 34908177 DOI: 10.1111/scs.13054] [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: 06/29/2021] [Revised: 10/11/2021] [Accepted: 11/29/2021] [Indexed: 12/09/2022]
Abstract
Personal health-related resources are essential for women with breast cancer, as these help them to maintain their own health and well-being during different phases of their illness. The purpose of this integrative review was to identify, describe and synthetise what personal health-related resources have already been identified for this patient group. We carried out an integrative review to find papers that focused on personal health-related resources for women with breast cancer aged 18-64 years. The search covered 1 January 2005 to 31 May 2021 and was carried out using the CINAHL, PubMed, PsycINFO, Web of Science and Cochrane Library databases. It was limited to peer-reviewed scientific papers with abstracts published in English and 23 papers met the inclusion criteria. The data were analysed using content analysis. Personal health-related resources for women with breast cancer consisted of three different, but inherently interconnected, categories of personal strengths, person-centred cancer care and social support from and involvement in their cultural community. Personal health-related resources for women with breast cancer were multifaceted. Women need nursing support to identify and use these resources and future studies are needed to strengthen how they are measured.
Collapse
Affiliation(s)
- Marika Skyttä
- Department of Nursing Science, University of Turku, Turku, Finland
- Cancer Society of Finland, Helsinki, Finland
| | - Anna-Maija Pietilä
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, University of Turku, Turku, Finland
- Satakunta Regional Hospital, Pori, Finland
| |
Collapse
|
3
|
Lize N, Raijmakers N, van den Berg M, Emmaneel L, Kok A, Lagendijk M, van Leeuwen-Bouwhuis K, van Lieshout R, Nagel Z, Beijer S. Patients with cancer experience high impact of emotional consequences of reduced ability to eat: A cross sectional survey study. Eur J Cancer Care (Engl) 2022; 31:e13595. [PMID: 35474252 DOI: 10.1111/ecc.13595] [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: 06/18/2021] [Revised: 03/16/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Patients with cancer can experience emotional consequences of reduced ability to eat, their impact is unknown. This study assesses the impact of these emotional consequences, and patients' satisfaction with healthcare professionals' (HCPs) support. METHODS A cross-sectional survey was conducted among patients with head/neck, lung cancer and lymphoma, who experienced reduced ability to eat in the past year. Patients were recruited through patient organisations and hospitals. The questionnaire encompassed the impact of emotional consequences of reduced ability to eat (scale 1-10) and satisfaction with HCPs' support for reduced ability to eat (scale 1-10). The differences in patient characteristics between unsatisfied (Score < 6) and satisfied patients (score ≥6) were tested using independent t-tests and the chi-square or Fishers' exact tests. RESULTS Overall, 116 patients (48%) responded and 98 were included in the analyses. The most impactful emotional consequences were as follows: disappointment (mean ± SD: 8.31 ± 1.49), grief/sadness (7.90 ± 1.91), and anger (7.87 ± 1.41). Patients were less satisfied when more time had passed since their diagnosis (p < 0.002) and when they expected no improvements regarding their eating problems (p < 0.001). CONCLUSION The impact of emotional consequences of reduced ability to eat is high. Support for emotional consequences is needed, especially for patients with reduced ability to eat, which persists in recovery and remission.
Collapse
Affiliation(s)
- Nora Lize
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Natasja Raijmakers
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.,Netherlands Association for Palliative Care, Utrecht, The Netherlands
| | | | | | - Annemieke Kok
- University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | | | | | - Zola Nagel
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| |
Collapse
|
4
|
Mortensen A, Wessel I, Rogers SN, Tolver A, Jarden M. Needs assessment in patients surgically treated for head and neck cancer-a randomized controlled trial. Support Care Cancer 2022; 30:4201-4218. [PMID: 35083545 DOI: 10.1007/s00520-021-06759-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 12/13/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the effect and feasibility of a head and neck cancer-specific needs assessment tool integrated into nursing rehabilitation consultations early in the post-surgical period on quality of life, symptom burden, and referrals for multidisciplinary follow-up. METHODS Ninety-two surgically treated patients with head and neck cancer were enrolled in a two-arm randomized controlled trial. All participants received nursing rehabilitation consultations prior to discharge, and two weeks and two months post-operative. The intervention group had their needs assessed using Patient Concerns Inventory, while standard care used a systematic questioning approach. Primary outcome was quality of life. Secondary outcomes were symptom burden and referrals for multidisciplinary rehabilitation follow-up. RESULTS No significant differences were found in quality of life or symptom burden between groups. However, 35% more patients in the intervention group were referred for rehabilitation. The attrition rate was similar in both groups, with a dropout rate of six in each group. No patients declined using the Patient Concerns Inventory. CONCLUSION The intervention showed no improvement in QoL or symptom burden compared to standard care. However, the results suggest that important needs were identified and addressed. Especially emotional and existential needs, which were accommodated through referrals and professional advice. Nursing rehabilitation consultations using the Patient Concerns Inventory are feasible and may ensure that patient preferences and priorities are incorporated in their care. TRIAL REGISTRATION ClinicalTrials.com (NCT03443258). Date of registration: May 31st, 2018.
Collapse
Affiliation(s)
- Annelise Mortensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Simon N Rogers
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, L39 4QP and Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, Great Britain, UK
| | - Anders Tolver
- Data Science Lab, Department of Mathematical Sciences, University of Copenhagen, Universitetsparken 5, 2200, Copenhagen N, Denmark
| | - Mary Jarden
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University and Department of Hematology, Center for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| |
Collapse
|
5
|
Ninfa A, Crispiatico V, Pizzorni N, Bassi M, Casazza G, Schindler A, Delle Fave A. The care needs of persons with oropharyngeal dysphagia and their informal caregivers: A scoping review. PLoS One 2021; 16:e0257683. [PMID: 34555044 PMCID: PMC8460009 DOI: 10.1371/journal.pone.0257683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Besides affecting physical health, Oropharyngeal Dysphagia (OD) entails limitations in daily activities and social participation for both patients and their informal caregivers. The identification of OD-related needs is crucial for designing appropriate person-centered interventions. AIMS To explore and map the literature investigating the care needs related to OD management of adult persons with OD and their informal caregivers during the last 20 years. METHODS A scoping review was conducted and reported following PRISMA guidelines. Five electronic databases and reference lists of eligible publications were searched for original works in English or Italian, published between January 2000 and February 2021. Two independent raters assessed studies' eligibility and extracted data; a third rater resolved disagreements. Extracted care needs were analyzed using a Best fit framework synthesis approach. RESULTS Out of 2,534 records preliminarily identified, 15 studies were included in the review and 266 care needs were extracted. All studies were conducted in Western countries. Research methods primarily consisted of qualitative interviews and focus groups (14 studies, 93.3%); head and neck cancer was the most frequent cause of patients' dysphagia (8 studies, 53.3%); caregivers' perspective was seldom investigated (5 studies, 33.3%). Both patients and caregivers primarily reported social (N = 77; 28.9%) and practical (N = 67; 25.2%) needs, followed by informational (N = 55; 20.7%) and psychological (N = 54; 20.3%) ones. Only patients reported physical needs (N = 13; 4.9%), while spiritual needs were not cited. CONCLUSIONS The recurrence of personal and social needs besides physical ones highlighted the manifold impact of OD on patients' and caregivers' lives. Larger and more focused studies are required in order to design tools and interventions tailored to patients' and caregivers' needs.
Collapse
Affiliation(s)
- Aurora Ninfa
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Valeria Crispiatico
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Nicole Pizzorni
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
| | - Marta Bassi
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Casazza
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
6
|
Pleh DN, Rosted E, Thomsen TG. Key competences of outpatient nurses, as perceived by patients attending nurse-led clinics - An integrative review. J Clin Nurs 2020; 30:311-322. [PMID: 33169469 DOI: 10.1111/jocn.15557] [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: 06/29/2020] [Revised: 10/20/2020] [Accepted: 10/31/2020] [Indexed: 11/28/2022]
Abstract
AIM The aim of this review was to identify key competences of outpatient nurses, as perceived by patients attending nurse-led clinics. BACKGROUND The increased demand for nurses to manage treatment and care in hospital outpatient clinics requires a better understanding of nurses' competences important to outpatients. DESIGN An integrative review using Whittemore and Knafl's five-stage model. METHODS Relevant studies were located by systematically searching PubMed, CINAHL and Scopus. A group of three researchers assessed the studies found and the quality of the included studies using the CASP tool. Data were extracted and analysed by thematic analyses. The current study was evaluated using PRISMA checklist. RESULTS Nine studies met the inclusion criteria. Three key competences emerged: providing access, sharing knowledge and establishing relationships. The key competences were supported by ten sub-themes that were characterised by nurses' actions and qualities, derived from the included studies. CONCLUSIONS The identified key competences reflected a holistic approach that encompasses knowledge, skills and attitudes, indicating outpatient nurses being able to manage different ways of involving patients, which may lead to the consideration of outpatient consultations as a kind of negotiation, based on a respectful dialogue. RELEVANCE TO CLINICAL PRACTICE The findings are usable when optimising the performance and quality of the health workforce, including outpatient nurses, as recommended by WHO (World Health Organization, Global strategy on human resources for health: Workforce 2030, 2016). Furthermore, the identified knowledge emphasises the need for clinical skills training and academic education, specially targeted outpatient nurses, in order to enable the nurses to become experts in specific practice settings.
Collapse
Affiliation(s)
- Denise Nana Pleh
- Department of Gynecology and Obstetrics, Zealand University Hospital, Roskilde, Denmark
| | - Elizabeth Rosted
- Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Thora Grothe Thomsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
| |
Collapse
|
7
|
Patient and carer experience of nutrition care throughout treatment for head and neck cancer: a systematic qualitative review and thematic synthesis. Support Care Cancer 2020; 28:5633-5647. [PMID: 32642952 DOI: 10.1007/s00520-020-05576-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023]
Abstract
Nutrition care plays a critical role in the provision of best practice care to head and neck cancer (HNC) patients, with carers playing an important role in supporting patients to maintain nutrition intake. This qualitative systematic review investigated patient and carer experience of nutrition care throughout and beyond HNC treatment. Five databases were systematically searched for qualitative studies reporting on patient and carer experience of nutrition care throughout HNC. Twenty-five studies including 435 patients and 46 carers were identified, revealing three themes: information and support in the healthcare setting, enteral feeding challenges and management, and life outside hospital. Findings highlight the importance of providing individualised person-centred nutrition care to patients with HNC and their carers. Further qualitative research is needed to inform healthcare professionals about the needs of patients and carers to provide appropriate support throughout the treatment trajectory across and between different treatment modalities.
Collapse
|
8
|
Koinberg I, Olofsson EH, Carlström E, Olsson LE. Impact of a person-centered intervention for patients with head and neck cancer: a qualitative exploration. BMC Nurs 2018; 17:48. [PMID: 30479562 PMCID: PMC6249743 DOI: 10.1186/s12912-018-0319-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 11/13/2018] [Indexed: 11/10/2022] Open
Abstract
Background People affected by head and neck cancer (HNC) experience a variety of multifaceted health-related problems during the treatment process, based on both the disease and side effects, several years after the treatment is complete. This study investigated a person-centred intervention using transition theory as a framework. Aim Thus, the aim of the present study was to explore patients’ experience of the transition and person centred care from diagnosis to the end of the treatment period. Methods Interviews were conducted with 12 persons included in the person-centred intervention group. The patients were recruited from a randomised controlled study. We used a directed deductive content analysis as an analysis method. Results There was a distinct transition between being a healthy person to being diagnosed with a serious disease. The majority of the participants felt that the diagnosis had put their lives in the balance; they felt both healthy and sick at the same time, and all participants described that their symptoms and side effects were the worst possible and totally unexpected. Of great importance was the health-care plan, comprising self-management goals which were formed in partnership between the patient and the nurse. The participants experienced that their interaction and engagement with lay persons and healthcare professionals supported a gradual acceptance of the situation and a sense of relief with a kind of awareness of the disease. Conclusion The intervention played a significant role in promoting a healthy transition. Person-centredness and transition theory can help healthcare professionals to be more confident and resourceful in supporting people affected by HNC.
Collapse
Affiliation(s)
- Ingalill Koinberg
- 1The Sahlgrenska Academy - Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,2Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.,3Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elisabeth Hansson Olofsson
- 1The Sahlgrenska Academy - Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,2Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden
| | - Eric Carlström
- 1The Sahlgrenska Academy - Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,2Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden
| | - Lars-Eric Olsson
- 1The Sahlgrenska Academy - Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,2Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden
| |
Collapse
|
9
|
Gyllensten H, Koinberg I, Carlström E, Olsson LE, Hansson Olofsson E. Economic evaluation of a person-centred care intervention in head and neck oncology: results from a randomized controlled trial. Support Care Cancer 2018; 27:1825-1834. [PMID: 30171334 PMCID: PMC6449490 DOI: 10.1007/s00520-018-4436-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 08/20/2018] [Indexed: 11/30/2022]
Abstract
Purpose Head and neck cancer and its treatment deteriorate quality of life, but symptoms improve with person-centred care. We examined the cost-effectiveness of a person-centred care intervention versus standard medical care. Methods In this randomized clinical trial of a person-centred intervention, patients were planned for outpatient oncology treatment in a Swedish university hospital between 2012 and 2014 and were followed during 1 year. Annual healthcare costs were identified from medical records and administrative register data. Productivity costs were calculated from reported sick leave. Health-related quality of life was collected using the EuroQol Group’s five-dimension health state questionnaire. Results Characteristics were similar between 53 patients in the intervention group and 39 control patients. The average total cost was Euro (EUR) 55,544 (95% confidence interval: EUR 48,474–62,614) in the intervention group and EUR 57,443 (EUR 48,607–66,279) among controls, with similar health-related quality of life. Conclusions This person-centred intervention did not result in increased costs and dominated the standard medical care. Trial registration ClinicalTrials.gov (registration number: NCT02982746).
Collapse
Affiliation(s)
- Hanna Gyllensten
- Centre for Person-centred Care (GPCC), University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden. .,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.
| | - Ingalill Koinberg
- Centre for Person-centred Care (GPCC), University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.,Department of Oncology, Sahlgrenska University Hospital, Gothenburg, SE-413 46, Sweden
| | - Eric Carlström
- Centre for Person-centred Care (GPCC), University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
| | - Lars-Eric Olsson
- Centre for Person-centred Care (GPCC), University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
| | - Elisabeth Hansson Olofsson
- Centre for Person-centred Care (GPCC), University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
| |
Collapse
|
10
|
Papadakos J, McQuestion M, Gokhale A, Damji A, Trang A, Abdelmutti N, Ringash J. Informational Needs of Head and Neck Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:847-856. [PMID: 28155041 DOI: 10.1007/s13187-017-1176-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The patient journey with head and neck cancer (HNC) is particularly challenging given the physical and functional impact of the cancer and treatment. The ability to perform activities of daily living can be severely compromised and have a profound impact on psychosocial well-being. These complex and long-lasting effects can affect patient quality of life for months to years and the literature shows that information for HNC patients is often insufficient. This observational cross-sectional study utilized survey methodology to investigate the informational needs of HNC patients and the preferred modalities for delivery. This was done to inform the development of resources for HNC patients. Four hundred fifty surveys were analyzed. The median age was 61 years and 58% of the cohort was born in Canada. Most were Caucasian (72%), Chinese being the next largest ethnicity (12%). A third had less than high school education and most had cancer of the oral cavity (28%) and were in long-term follow-up (41%). Comparison of the percentage of items to which a patient responded "very important" across the six domains shows variation of importance by domain (overall mixed effects regression model p < 0.0001). Additionally, each domain was compared to the medical domain and all had significantly lower mean scores (all p < 0.0001) with the medical domain scoring highest (mean score 64.6). The top preferred education modalities were teaching with a healthcare professional and pamphlets. This study highlights the type of information that HNC patients want and the format they wish to receive it in. The design provides a comprehensive way to consult with patients toward building education that responds to their specific needs.
Collapse
Affiliation(s)
- Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
- ELLICSR: Health, Wellness & Cancer Survivorship Centre, Princess Margaret Cancer Centre, PMB ELLICSR, 585 University Avenue, Toronto, ON, M5G 2N2, Canada.
| | - Maurene McQuestion
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Head and Neck Survivorship Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Anandita Gokhale
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ali Damji
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Aileen Trang
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Nazek Abdelmutti
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Jolie Ringash
- ELLICSR: Health, Wellness & Cancer Survivorship Centre, Princess Margaret Cancer Centre, PMB ELLICSR, 585 University Avenue, Toronto, ON, M5G 2N2, Canada
- Head and Neck Survivorship Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| |
Collapse
|
11
|
Head and neck cancer patient experience of a new dietitian-delivered health behaviour intervention: 'you know you have to eat to survive'. Support Care Cancer 2018; 26:2167-2175. [PMID: 29374300 PMCID: PMC5982430 DOI: 10.1007/s00520-017-4029-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/19/2017] [Indexed: 11/24/2022]
Abstract
Purpose The aim of this study was to explore head and neck cancer (HNC) patient experiences of a novel dietitian delivered health behaviour intervention. Methods This study is a qualitative study which employed semi-structured individual interviews using open and axial coding and then final selective coding to organise the data. Patients with HNC who had participated in a dietitian delivered health behaviour intervention to reduce malnutrition were invited to discuss their experience of this intervention. Individual interviews were conducted, transcribed and analysed using grounded theory. Results Nine patients participated in the interviews. Four dimensions were identified in the initial coding process: ‘information’, which described patients’ desire for tailored advice during their treatment; ‘challenges of treatment experience’, which described the difficulties related to treatment side effects; ‘key messages: importance of eating and maintaining weight’, which covered perceived integral messages delivered to patients by dietitians; and ‘dietitian’s approach’ describing patient experiences of empathic and compassionate dietitians. Two overarching themes resulted from examining the connections and relationships between these dimensions: ‘survival’, a connection between eating and living; and ‘support’, describing the valued working partnership between dietitian and patient. Conclusions Dimensions and themes overlapped with the qualitative literature on HNC patient experience of treatment. However, some themes, such as the empowerment of a message linking eating to survival, appeared unique to this study. Patients found this message to be delivered in a supportive manner that motivated change. Electronic supplementary material The online version of this article (10.1007/s00520-017-4029-5) contains supplementary material, which is available to authorized users.
Collapse
|
12
|
Hong JS, Hua YJL, Su L, Zhang HR, Lv WL, Chen XY, Tian J, Zhang WJ. Modified-Nutrition Index is a Significant Prognostic Factor for the Overall Survival of the Nasopharyngeal Carcinoma Patients who Undergo Intensity-modulated Radiotherapy. Nutr Cancer 2017; 69:1011-1018. [PMID: 28937797 DOI: 10.1080/01635581.2017.1359311] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To explore whether the modified-nutrition index (m-NI) is a prognostic factor for the overall survival (OS) in nasopharyngeal carcinoma (NPC) patients who undergo intensity-modulated radiotherapy (IMRT). METHODS Clinical data were prospectively collected from NPC patients who underwent IMRT at our hospital between October 2008 and December 2014. The patient nutritional status before radiotherapy was evaluated using the m-NI, based on eight nutrition indicators including body mass index, arm muscle circumference, albumin, total lymphocyte count, red blood cell count, hemoglobin, serum pre-albumin, and transferrin. The independent prognostic value of m-NI for the OS was evaluated. RESULTS A total of 323 patients (229 males, 94 females) were included in this study, and the follow-up rate was 99.7% (322/323). The 1-, 3-, and 5-yr OS rates between malnutrition and normal nutrition groups by using the m-NI were 93.0% vs. 96.9%, 76.4% vs. 82.8%, and 61.8% vs. 77.1%, respectively. A regression analysis showed that the m-NI was the significant prognostic value for the OS in NPC. CONCLUSIONS The m-NI before radiotherapy is a significant prognostic factor for the OS in NPC patients. Further validation of our instrument is needed in other NPC patients.
Collapse
Affiliation(s)
- Jin-Sheng Hong
- a Department of Radiation Oncology, First Affiliated Hospital , Fujian Medical University , Fuzhou , Fujian , China.,b Key Laboratory of Radiation Biology (Fujian Medical University) , Fujian Province University , Fuzhou , Fujian , China.,c Fujian Key Laboratory of Individualized Active Immunotherapy , Fujian Medical University , Fuzhou , Fujian , China
| | - Yang-Jing-Ling Hua
- d Department of Epidemiology and Health Statistics , Fujian Medical University , Fuzhou , Fujian , China
| | - Li Su
- a Department of Radiation Oncology, First Affiliated Hospital , Fujian Medical University , Fuzhou , Fujian , China.,b Key Laboratory of Radiation Biology (Fujian Medical University) , Fujian Province University , Fuzhou , Fujian , China.,c Fujian Key Laboratory of Individualized Active Immunotherapy , Fujian Medical University , Fuzhou , Fujian , China
| | - Hai-Rong Zhang
- d Department of Epidemiology and Health Statistics , Fujian Medical University , Fuzhou , Fujian , China
| | - Wen-Long Lv
- a Department of Radiation Oncology, First Affiliated Hospital , Fujian Medical University , Fuzhou , Fujian , China.,b Key Laboratory of Radiation Biology (Fujian Medical University) , Fujian Province University , Fuzhou , Fujian , China.,c Fujian Key Laboratory of Individualized Active Immunotherapy , Fujian Medical University , Fuzhou , Fujian , China
| | - Xiu-Ying Chen
- a Department of Radiation Oncology, First Affiliated Hospital , Fujian Medical University , Fuzhou , Fujian , China.,b Key Laboratory of Radiation Biology (Fujian Medical University) , Fujian Province University , Fuzhou , Fujian , China.,c Fujian Key Laboratory of Individualized Active Immunotherapy , Fujian Medical University , Fuzhou , Fujian , China
| | - Jun Tian
- d Department of Epidemiology and Health Statistics , Fujian Medical University , Fuzhou , Fujian , China
| | - Wei-Jian Zhang
- a Department of Radiation Oncology, First Affiliated Hospital , Fujian Medical University , Fuzhou , Fujian , China.,b Key Laboratory of Radiation Biology (Fujian Medical University) , Fujian Province University , Fuzhou , Fujian , China.,c Fujian Key Laboratory of Individualized Active Immunotherapy , Fujian Medical University , Fuzhou , Fujian , China
| |
Collapse
|
13
|
McGrath P. Financial Assistance for Patients Who Relocate for Specialist Care in Hematology: Practical Findings to Inform Nursing Supportive Care. Nurs Forum 2017; 52:55-61. [PMID: 28152210 DOI: 10.1111/nuf.12167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 11/16/2015] [Accepted: 02/28/2016] [Indexed: 11/28/2022]
Abstract
AIMS This article examines findings on the need for, awareness of, and critical time for referral to financial assistance for patients who have to relocate for specialist care for hematological malignancies. DESIGN The study involved descriptive qualitative research based on in-depth interviews that were audio-recorded, transcribed verbatim, coded, and thematically analyzed. PARTICIPANTS Forty-five hematology patients purposively selected from the client database of the Leukaemia Foundation of Queensland were interviewed for the study. RESULTS AND CONCLUSION The findings indicate that there is a critical period at the initial point of diagnosis and start of treatment when patients are experiencing shock, confusion, and a sense of being overwhelmed by stress, fear, and uncertainty about the future. The stress can be exacerbated by the loss of work and a period of waiting to access income (e.g., from superannuation or approval to receive a pension). For some patients, this is a critical period when individuals need support and advice to avoid long-term financial problems. However, at this point in time, many individuals do not know how to access financial advice or assistance from leading cancer supportive care organizations. The findings have practical implications to inform the work by many nurses who provide psychosocial care to hematology patients.
Collapse
Affiliation(s)
- Pam McGrath
- Pam McGrath, BSocWk, MA, PhD, is, Associate Professor and Senior Research Fellow, Centre for Community Science, Griffith University, Meadowbrook Qld, Queensland, Australia
| |
Collapse
|
14
|
Stenhammar C, Isaksson J, Granström B, Laurell G, Ehrsson YT. Changes in intimate relationships following treatment for head and neck cancer—A qualitative study. J Psychosoc Oncol 2017; 35:614-630. [DOI: 10.1080/07347332.2017.1339224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Christina Stenhammar
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Brith Granström
- Department of Clinical Science, Unit of Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala, Sweden
| |
Collapse
|
15
|
Hansson E, Carlström E, Olsson LE, Nyman J, Koinberg I. Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study. BMC Nurs 2017; 16:9. [PMID: 28239295 PMCID: PMC5320778 DOI: 10.1186/s12912-017-0206-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/16/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The incidence of head and neck cancer is increasing slightly. Head and neck cancer but also it's necessary and often successful treatment may affect general domains of health-related quality of life and provoke a variety of adverse symptoms and side effects, both during and after treatment. The objective of this study was to compare a person-centred care intervention in terms of health-related quality of life, disease-specific symptoms or problems, with traditional care as a control group for patients with head and neck cancer. METHODS In this randomized controlled trial, person-centred-care intervention and traditional care (control) groups comprised 54 and 42 patients, respectively. Outcome measures used were: the EORTC QLQ-C30 and the EORTC QLQ-C35. Both groups answered the questionnaires at baseline and after 4, 10, 18 and 52 weeks from start of treatment. The questionnaires' scores were compared between groups by using independent samples test and non-parametric test for continuous variables. For categorical data, Fisher's exact test was used. Longitudinal data were analysed using generalized linear models for normally distributed repeated measures data. RESULTS At baseline, the intervention and control groups were comparable in terms of medical and sociodemographic variables, clinical characteristics, health-related quality of life and disease-specific symptoms or problems. At all the follow-up points, even during the worst period for the patients, the person-centred-care group consistently reported better scores than the control group. The differences were numerically but not always statistically significant. When testing longitudinal data, statistically significant results were found for head and neck cancer-specific problems, swallowing (p = 0.014), social eating (p = 0.048) and feeling ill (p = 0.021). CONCLUSIONS The results from this study suggest that adopting the person-centred-care concept practiced here could be a way to improve function and wellbeing in patients with head and neck cancer. TRIAL REGISTRATION The study was retrospectively registered in 2016-12-05 in Clinical Trials gov. "Can a Person-centred-care Intervention Improve Health-related Quality of Life in Patients With Head and Neck Cancer" registration number: NCT02982746.
Collapse
Affiliation(s)
- Elisabeth Hansson
- The Sahlgrenska Academy-Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden
| | - Eric Carlström
- The Sahlgrenska Academy-Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.,University College of South East Norway, Notodden, Norway
| | - Lars-Eric Olsson
- The Sahlgrenska Academy-Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden
| | - Jan Nyman
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingalill Koinberg
- The Sahlgrenska Academy-Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.,Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
16
|
From an illusion of certainty into a reality of uncertainty: A longitudinal qualitative study of how people affected by laryngeal cancer use information over time. Eur J Oncol Nurs 2016; 23:15-23. [PMID: 27456371 DOI: 10.1016/j.ejon.2016.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 03/04/2016] [Accepted: 03/09/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Patients diagnosed with laryngeal cancer and their families face unique challenges. Providing information is an essential component of care. However little is known about the way in which they use information. This study aims to explore the different types of information used by laryngeal cancer patients and their carers from diagnosis into the follow up phase. METHOD The study adopted an interpretive longitudinal design using qualitative interviews at two specific time points. Twenty laryngeal cancer patients and 17 carers were interviewed. Data were analysed using Framework Analysis. RESULT Two main categories of information: professional and experiential, were found to be used, drawn from a range of sources. The information received at diagnosis appeared to contribute to an 'illusion of certainty' that life would return to normal at the end of treatment. However, as patients progressed into follow-up, many were propelled into a 'reality of uncertainty' due to the "disconnect" between the expectations both patient and carer developed from information received over the cancer trajectory. CONCLUSION The findings from this longitudinal study suggest that people affected by laryngeal cancer use two broad categories of information derived from a range of different sources and influenced by their own experiences. Health professionals need to situate information in the context of the individual's understanding and prior knowledge of health and illness to help generate more realistic expectations of treatment outcomes. The level of uncertainty experienced by both patients and their carers after treatment suggests a clear need for continued supportive care.
Collapse
|
17
|
Salander P, Isaksson J, Granström B, Laurell G. Motives that head and neck cancer patients have for contacting a specialist nurse - an empirical study. J Clin Nurs 2016; 25:3160-3166. [PMID: 27301274 DOI: 10.1111/jocn.13283] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study is to systematically explore the motives for patients with head and neck cancer to contact a specialist nurse during two years postdiagnosis. BACKGROUND Research focusing on the role of specialist nurses in cancer care almost exclusively concern cancers other than head and neck cancer. DESIGN Qualitative, descriptive study based on the contacts between patients with head and neck cancer and a specialist nurse. METHODS Patients were invited to contact a specialist nurse by telephone. The specialist nurse took systematic field notes, that is, she registered who contacted her, the nature of the call and the outcome. Sixty patients were included. RESULTS In descending order, the motives for contact were questions about practical and uncomplicated matters, consultations about medical troubles/worries, presenting a report of the patient's situation, requests for additional information about the treatment plan and requests for medical information. The pattern of the patients' motivations for calling was not related to medical or social factors, suggesting that the initiative to make contact is very much a question of the complexity of individual life circumstances. Very few referrals were sent from the specialist nurse to other professionals. CONCLUSIONS The specialist nurse turned out to be more than just a coordinator of health-care resources. The findings bring up questions about the potential of the nurse's function as a coordinator, but also as a potential attachment figure, and questions about the nurse's relationships to other professionals. RELEVANCE TO CLINICAL PRACTICE When implementing a specialist nurse function, it is important to decide whether the function should be inspired by a broader relational perspective. In addition to the indispensible competence and experience in the clinical field of head and neck cancer, training in counselling and acquaintance with object-relational psychology will then be desirable.
Collapse
Affiliation(s)
- Pär Salander
- Department of Social Work, Umeå University, Umeå, Sweden.
| | | | - Brith Granström
- Department of Clinical Sciences/Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences - Otolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| |
Collapse
|
18
|
Balfe M, O' Brien K, Timmons A, Butow P, O' Sullivan E, Gooberman-Hill R, Sharp L. What factors are associated with posttraumatic growth in head and neck cancer carers? Eur J Oncol Nurs 2016; 21:31-7. [DOI: 10.1016/j.ejon.2015.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 10/27/2015] [Accepted: 11/24/2015] [Indexed: 02/03/2023]
|
19
|
Bjuresäter K, Larsson M, Athlin E. Patients’ experiences of home enteral tube feeding (HETF) – a qualitative study. J Res Nurs 2015. [DOI: 10.1177/1744987114568655] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Use of home enteral tube feeding (HETF) has increased in Western countries but research is scarce, especially about patients’ experiences of daily life when being treated with HETF. This study aimed to explore what it means to live with HETF and how the situation can be managed. A qualitative method was carried out according to Grounded Theory. In total, 22 interviews were performed with 11 patients treated with HETF for between 8 weeks and 2 years, using open-ended questions. Sampling, data collection and data analysis were carried out simultaneously. To be treated with HETF was experienced as positive as it meant survival, but the most prominent finding told about experiences of restrictions, practical problems and distress in the patients’ daily lives. How daily life turned out seemed to depend on the patient’s ability to manage problems, but was also strongly related to the amount and quality of information and support they received from health professionals. Lacking preparation before discharge as well as lacking support at home meant insecurity and uncertainty. The findings stress the need for comprehensive preparation and support from health professionals, and improvements are needed to facilitate HETF patients’ daily life.
Collapse
Affiliation(s)
- Kaisa Bjuresäter
- Senior Lecturer, Institution of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Maria Larsson
- Associate Professor, Institution of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Elsy Athlin
- Professor, Institution of Health Sciences, Karlstad University, Karlstad, Sweden
| |
Collapse
|
20
|
A national survey of healthcare professionals' views on models of follow-up, holistic needs assessment and survivorship care for patients with head and neck cancer. Eur J Cancer Care (Engl) 2015; 24:873-83. [DOI: 10.1111/ecc.12285] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 11/26/2022]
|
21
|
Komatsu H, Yagasaki K. The power of nursing: guiding patients through a journey of uncertainty. Eur J Oncol Nurs 2014; 18:419-24. [PMID: 24721178 DOI: 10.1016/j.ejon.2014.03.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 03/04/2014] [Accepted: 03/13/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE The objective of this qualitative study was to understand the experiences of oncology nurses in patient counseling and support services in the ambulatory care setting. METHODS AND SAMPLE A qualitative study was conducted using grounded theory methods. Data were generated through four focus group interviews with 21 oncology nurses currently providing counseling and support services for cancer patients in Japan. The content was analyzed based on a constant comparison approach. RESULTS The power of nursing was identified through three themes: connecting with the patient (shared needs); personalized coordination (shared action); and realizing the patient's potential (reassurance). Oncology nurses should guide patients through the uncertain cancer trajectory by identifying patients' true needs based on an established relationship, providing personalized coordination, and developing their potential. Patient-centered care can be provided in non-physical care settings such as counseling and support services. CONCLUSIONS Our study describes the uniqueness and significance of nursing, and provides insights into realizing the full potential of nurses. This conceptual model can be used as a guide for practice and an educational tool to build professional identity of nurses. Oncology nurses can take a leadership role in enhancing the visibility of the nurses in multidisciplinary environments.
Collapse
Affiliation(s)
- Hiroko Komatsu
- Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Kaori Yagasaki
- Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| |
Collapse
|
22
|
Nurse-Patient Communication in Follow-up Consultations After Head and Neck Cancer Treatment. Cancer Nurs 2014; 37:E1-9. [DOI: 10.1097/ncc.0b013e318288d3f3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
23
|
Olsson C, Athlin E, Sandin-Bojö AK, Larsson M. Sexuality is not a priority when disease and treatment side effects are severe: conceptions of patients with malignant blood diseases. J Clin Nurs 2013; 22:3503-12. [PMID: 24003940 DOI: 10.1111/jocn.12333] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2013] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe how patients with malignant blood diseases conceive the influence of chemo- or chemoimmunotherapy on sexuality, and their need of support related to this issue. BACKGROUND Sexuality is often negatively affected in cancer patients with sex-specific diagnoses. For patients with malignant blood diseases, the research is limited with regard to the effect on sexuality. Knowledge about their need for support related to sexuality is also needed as nurses are found to often avoid this area of their responsibility. DESIGN Qualitative design. METHODS Twelve patients treated for malignant blood diseases were interviewed twice. Phenomenography was used for the analysis. RESULTS The analyses revealed an outcome space consisting of two main categories: 'Sexuality is overshadowed by the cancer experience' and 'No need of support but timely information might be helpful', both comprehensively related to three interrelated description categories 'Affected strength', 'Affected sexual desire' and 'Affected body image', which describe conceptions of how sexuality was affected. CONCLUSION Patients experienced negative effects on sexual function and sexual relationship during and after treatment period due to affected strength, sexual desire and negatively body image. However, when disease and side effects were experienced as severe, thoughts and interest of sexuality were overshadowed, and the need or wish for support related to this issue was very low. It is important to note that some patients expressed that pre- or post-treatment information might have been helpful. RELEVANCE TO CLINICAL PRACTICE It is acknowledged in the cancer care of today that cancer follow-up should address psychosocial support in which sexuality is an important area. Therefore, it is imperative that cancer care is organised in a patient centred way, with adequate time for nurses to provide continuity in the nurse-patient relation and supportive care also during cancer rehabilitation.
Collapse
Affiliation(s)
- Cecilia Olsson
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | | | | | | |
Collapse
|
24
|
Lang H, France E, Williams B, Humphris G, Wells M. The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psychooncology 2013; 22:2648-63. [PMID: 23840037 DOI: 10.1002/pon.3343] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To summarise patients' experiences of head and neck cancer (HNC) by examining the findings of existing qualitative studies METHODS We undertook a systematic review and meta-synthesis of qualitative studies in 29 published articles using Noblit and Hare's 'meta-ethnography' approach to synthesise findings. The inclusion criteria were primary qualitative studies, focusing on HNC patients' experience and an English abstract. Seven databases were systematically searched. RESULTS The articles focused on the experience of having HNC, the experience of treatments and the role of information. Our synthesis identified six core concepts-uncertainty and waiting, disruption to daily life, the diminished self, making sense of the experience, sharing the burden and finding a path. People experienced significant disruption to normal daily activities, because of the physical and emotional effects of HNC and its treatment. Day-to-day challenges were compounded by social and existential changes and a palpable loss of the individual's sense of self and future. In order to find a way through the considerable uncertainty and daily challenge of living with and beyond HNC, patients made continual efforts to make sense of their experience. Supportive relationships with their social network, HNC peers and healthcare professionals were particularly important, but support following treatment completion was sometimes limited. Perceptions of the future were affected by whether they saw life as diminished, merely changed or even enhanced by the experience of cancer. CONCLUSIONS This review supports further specific research into these emerging themes and provides a context for future work, informing interventions to improve patients' experiences.
Collapse
Affiliation(s)
- Heidi Lang
- School of Nursing and Midwifery, University of Dundee, Dundee City, UK
| | | | | | | | | |
Collapse
|
25
|
de Leeuw J, Larsson M. Nurse-led follow-up care for cancer patients: what is known and what is needed. Support Care Cancer 2013; 21:2643-9. [DOI: 10.1007/s00520-013-1892-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/24/2013] [Indexed: 11/29/2022]
|
26
|
Longitudinal quality of life in Turkish patients with head and neck cancer undergoing radiotherapy. Support Care Cancer 2013; 21:2171-83. [PMID: 23475195 DOI: 10.1007/s00520-013-1774-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 02/25/2013] [Indexed: 11/12/2022]
Abstract
PURPOSE This study aims to assess the quality of life and to define its determinants in patients with head and neck cancer undergoing radiotherapy. METHOD This prospective study was performed in an outpatient clinic of radiation oncology with a sample of 54 consecutive patients. Interview forms-European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire and Head and Neck Module to measure quality of life, Radiation Therapy Oncology Group criteria to determine radiation toxicity, and Patient-Generated Subjective Global Assessment to assess nutritional status-were used to obtain personal and disease-related data before, at the end of radiotherapy, and 1 and 3 months post-therapy. RESULTS It was determined that various subscales of functional and symptom scales of quality of life were deteriorated at the end of radiotherapy and started to improve at 1 month after treatment. However, dry mouth and sticky saliva symptom scales did not follow the same pattern, and they took more time to improve. Quality of life (QoL) was found to be worse in younger age, higher education, higher income level, type of cancer, advanced stage, presence of tracheostomy, chemoradiation, higher dose of RT, bad nutritional status, and radiation toxicity. CONCLUSIONS Our results emphasize the vital need of support for head and neck cancer patients during radiotherapy, especially during the first month.
Collapse
|
27
|
de Leeuw J, van den Berg MGA, van Achterberg T, Merkx MAW. Supportive care in early rehabilitation for advanced-stage radiated head and neck cancer patients. Otolaryngol Head Neck Surg 2013; 148:625-32. [PMID: 23348870 DOI: 10.1177/0194599812474797] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the health-related quality of life (HRQoL) and supportive follow-up care needs 1 month posttreatment for patients with advanced-stage (stage III or IV) radiated head and neck cancer (HNC) who were treated with curative intent. STUDY DESIGN An exploratory, descriptive analysis of HRQoL data obtained from 3 treatment groups: conventional radiotherapy (RT, n = 21), surgery + radiotherapy (SRT, n = 10), and chemoradiation (CRT, n = 21). SETTING The head and neck oncology center of a university hospital. SUBJECTS AND METHODS Fifty-two patients completed the EORTC QLQ-C30 and EORTC QLQ H&N35 self-report questionnaires 1 month posttreatment. Descriptive statistics and clinically relevant differences between the groups were analyzed. RESULTS The HRQoL outcomes between groups differed. Clinically relevant difference was observed in the RT and CRT groups with respect to dry mouth, coughing, feeling ill, use of painkillers, and the use of nutritional supplements. The RT group differed from the other groups with respect to pain and swallowing. The CRT group differed from the other groups regarding role functioning. CONCLUSION Health-related quality of life differs between RT, SRT, and CRT patients 1 month posttreatment. The RT- and CRT-treated patients reported higher impairment than the patients who were treated with SRT. Nutritional intake and oral function emphasize the importance of providing supportive care to radiated advanced-stage HNC patients throughout the treatment trajectory and the need for continuation during the first few posttreatment months.
Collapse
Affiliation(s)
- Jacqueline de Leeuw
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
| | | | | | | |
Collapse
|
28
|
Donovan M, Glackin M. The lived experience of patients receiving radiotherapy for head and neck cancer: a literature review. Int J Palliat Nurs 2012; 18:448-55. [PMID: 23124055 DOI: 10.12968/ijpn.2012.18.9.448] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
It is estimated that 60% of patients diagnosed with head and neck cancer will receive radiotherapy at some stage in their disease trajectory. The aim of this literature review was to find and analyse papers pertaining to the lived experiences of patients with head and neck cancer receiving radiotherapy. The review identified a limited number of high-quality research papers focusing on this topic, with only 10 papers fitting the inclusion/exclusion criteria. The majority of the investigative studies were not generalisable owing to small sample sizes and many of them being conducted in only one centre. However, the findings do highlight and contribute to the understanding of the lived experiences of this patient group and provide some insight into the unique physical, social, and psychological difficulties they encounter as a result of their treatment. There appears to be a need for further high-level research into these patients, particularly focusing on the provision of support and information prior to, during, and following radiotherapy. Further attention needs to be paid to preparing patients for the slow recovery following radiotherapy. Interventional studies are also required to develop clinical guidelines and protocols that can assist health professionals in meeting the holistic needs of this patient group.
Collapse
Affiliation(s)
- Monica Donovan
- Northern Ireland Cancer Centre, Belfast Health and Social Care Trust
| | | |
Collapse
|
29
|
Bala SV, Samuelson K, Hagell P, Svensson B, Fridlund B, Hesselgard K. The experience of care at nurse-led rheumatology clinics. Musculoskeletal Care 2012; 10:202-211. [PMID: 22745012 DOI: 10.1002/msc.1021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To describe how people with rheumatoid arthritis (RA) experience the care provided by Swedish nurse-led rheumatology outpatient clinics. METHODS Eighteen adult people with a diagnosis of RA who had had at least three documented contact sessions with a nurse-led clinic were interviewed. The interviews were analysed with qualitative content analysis. RESULTS Care was expressed in three categories: social environment, professional approach and value-adding measures. A social environment including a warm encounter, a familial atmosphere and pleasant premises was desired and contributed to a positive experience of care. The nurses' professional approach was experienced as empathy, knowledge and skill, as well as support. The care was described as person centred and competent, as it was based on the individual's unique experience of his/her disease and needs. The nurses' specialist knowledge of rheumatology and rheumatology care was highly valued. The offered care represented added value for the participants, instilling security, trust, hope and confidence. It was perceived as facilitating daily life and creating positive emotions. The nurse-led clinics were reported to be easily accessible and provided continuity of the care. These features were presented as fundamental guarantees for health care safety. CONCLUSION The experiences emphasized the need for a holistic approach to care. In this process, the organization of care and the role and skills of the nurse should be focused on the individual's needs and perspectives. The social environment, professional approach and value-adding measures are particularly relevant for optimal care at nurse-led rheumatology outpatient clinics.
Collapse
|
30
|
Albornoz CR, Pusic AL, Reavey P, Scott AM, Klassen AF, Cano SJ, Cordeiro PG, Matros E. Measuring health-related quality of life outcomes in head and neck reconstruction. Clin Plast Surg 2012; 40:341-9. [PMID: 23506775 DOI: 10.1016/j.cps.2012.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A qualitative study was undertaken to understand the impact of omitted health concepts in existing patient-reported outcome (PRO) instruments for health-related quality of life (HR-QOL) evaluation following head and neck (H&N) cancer reconstruction. Twenty-six patients were interviewed. Patients described a broad range of symptoms. Oral competence, rhinorrhea, facial sensation, smile, vision and eye discharge are missing from existing PRO instruments. Altered appearance was a major stressor; both function and appearance changes had a negative psychosocial impact leading to social isolation and embarrassment. This framework is the foundation for development of a more complete PRO instrument, the FACE-Q Oncology.
Collapse
Affiliation(s)
- Claudia R Albornoz
- Plastic and Reconstructive Surgical Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, MRI 1007, New York, NY 10065, USA
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Nurse-led follow-up care for head and neck cancer patients: a quasi-experimental prospective trial. Support Care Cancer 2012; 21:537-47. [DOI: 10.1007/s00520-012-1553-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 07/23/2012] [Indexed: 11/26/2022]
|
32
|
Symptom experience and regaining normality in the first year following a diagnosis of head and neck cancer: a qualitative longitudinal study. Palliat Support Care 2012; 10:197-204. [PMID: 22613011 DOI: 10.1017/s147895151200020x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Symptom experiences and their interference with life are not well-researched in head and neck cancer patients. The aim of the study was to explore and understand the experience of receiving treatment for head and neck cancer with particular focus on symptom experiences over a one year period from diagnosis. METHODS A qualitative study design was used with a heterogeneous sample of 16 patients with head and neck cancer. Interviews, conducted at four time points over 12 months, provided a total of 50 interview datasets. RESULTS Key themes derived include nutritional concerns, tiredness, and experiences related to the radiotherapy mask and regaining normality. These data highlight issues of importance in the first year of living with head and neck cancer: impact of nutritional changes on the lives of patients, including weight loss, dysphagia, xerostomia and taste changes; debilitation from ongoing fatigue; unpreparedness for and distress from the radiotherapy mask; and attempts to maintain a normal life amidst the interference of symptoms. CONCLUSION Multitude of symptoms impact the patients' life, particularly nutritional symptoms and fatigue, and interfere with the patients' survivorship and quality of life. The changing nature of symptoms over the first year from diagnosis in head and neck cancer patients and the identified issues in the attempt to normalize their lives need to be incorporated more fully into the supportive care of head and neck cancer patients in order to improve their experience and enhance their survivorship.
Collapse
|
33
|
Norell M, Ziegert K, Kihlgren A. Dealing with daily emotions-supportive activities for the elderly in a municipal care setting. Int J Qual Stud Health Well-being 2012; 7:QHW-7-9510. [PMID: 22312410 PMCID: PMC3272264 DOI: 10.3402/qhw.v7i0.9510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2011] [Indexed: 11/14/2022] Open
Abstract
There are diverse descriptions of supportive activities in nursing to be found in the literature. What they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting, registered nurses (RN) work in a consultative way and they describe a part of their tasks as comprising supportive activities without specifying what kind of supportive activities they mean. The aim of the study was to explore the main concern of the support given by RN to a group of patients in an elderly home care setting. The study was conducted using Grounded Theory. Data were collected using nonparticipant observations regarding the supportive activities of 12 RN at the home of 36 patients between the ages of 80 and 102. Most of the home visit lasted about 40 min but some lasted for 90 min. The central category was about dealing with daily emotions. This was done by encouraging the situation and reducing the patient's limitations, but situations also occurred in which there was a gap of support. Support was about capturing the emotions that the patient expressed for a particular moment, but there were also situations in which RN chose not to give support. To develop a holistic eldercare, more knowledge is needed about the factors causing the RN to choose not to provide support on some occasions.
Collapse
Affiliation(s)
- Margaretha Norell
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | | | | |
Collapse
|
34
|
Penedo FJ, Traeger L, Benedict C, Thomas G, Dahn JR, Krause MH, Goodwin WJ. Perceived social support as a predictor of disease-specific quality of life in head-and-neck cancer patients. ACTA ACUST UNITED AC 2011; 10:119-23. [PMID: 22088826 DOI: 10.1016/j.suponc.2011.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 07/22/2011] [Accepted: 09/01/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Treatment for head-and-neck cancer (HNC) can lead to severe decrements in disease-specific quality of life (DSQOL) due to disfigurement and disability in speech, eating, and/or breathing. Psychosocial factors such as social support may explain individual variance in DSQOL outcomes. OBJECTIVE The researchers sought to evaluate changes in perceived availability of social support from pretreatment to posttreatment and to determine whether decreases in perceived social support predicted poorer posttreatment DSQOL among HNC patients, controlling for disease- and treatment-related factors. METHODS Participants (n = 32) were newly diagnosed with HNC and were awaiting surgery and/or radiation treatment. Measures included the ENRICHD Social Support instrument (ESSI) to assess perceived social support and the Functional Assessment of Cancer Therapy-Head & Neck (FACT-H&N) to assess DSQOL. Paired-samples t-tests and hierarchical regression analyses were conducted to determine relationships between pretreatment and posttreatment perceived social support and DSQOL. RESULTS Perceived social support decreased significantly from pre- to posttreatment (F[31] = -2.71, P < .01). After adjusting for relevant covariates and pretreatment DSQOL, change in perceived social support remained a significant predictor of posttreatment DSQOL (β = .47, P < .01). LIMITATIONS This study included a relatively small sample of HNC patients, which limited power to evaluate mechanisms of observed relationships. CONCLUSIONS Increased social isolation may be a risk factor for poorer physical recovery from, or adjustment to, treatment-related side effects. Social support may be an important target for psychosocial interventions for patients who face challenging treatment side effects.
Collapse
Affiliation(s)
- Frank J Penedo
- Department of Psychology, University of Miami, University of Miami Miller School of Medicine, FL, USA.
| | | | | | | | | | | | | |
Collapse
|
35
|
Assenat E, Thezenas S, Flori N, Pere-Charlier N, Garrel R, Serre A, Azria D, Senesse P. Prophylactic percutaneous endoscopic gastrostomy in patients with advanced head and neck tumors treated by combined chemoradiotherapy. J Pain Symptom Manage 2011; 42:548-56. [PMID: 21477980 DOI: 10.1016/j.jpainsymman.2011.01.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 01/07/2011] [Accepted: 01/21/2011] [Indexed: 10/18/2022]
Abstract
CONTEXT Few studies have evaluated outcomes of combined chemoradiotherapy for Stage III-IV head and neck squamous cell carcinoma in terms of the use of nutritional support by means of percutaneous endoscopic gastrostomy (PEG). OBJECTIVES To compare nutritional status and treatment interruption because of acute toxicity in patients with advanced head and neck tumors who were treated by combined chemoradiotherapy and received or did not receive prophylactic PEG tubes. METHODS This was a retrospective study that evaluated data obtained from a cancer center in Montpellier, France. A total of 139 consecutive patients treated for Stage III-IV head and neck squamous cell carcinoma from January 1, 1998 to June 30, 2003 were evaluated in terms of nutritional status before and after therapy, treatment interruption because of toxicity, and duration of hospitalization. RESULTS Seventy-eight of the 139 patients (58%) did not receive prophylactic PEG feeding, and 61 patients (44%) received PEG feeding. Pretreatment nutritional status was worse in the PEG group. Compared with the initial nutritional status, nutritional status at the end of treatment was unchanged in the PEG group and much worse in the group that did not receive the PEG (P<0.05). Cumulative incidence of treatment interruption because of toxicity was significantly lower in the PEG group than in the no-PEG group (100 and 236 days of interruption, respectively, P=0.03) and hospitalization was significantly shorter (P=0.003). CONCLUSION Prophylactic PEG sustains nutritional status and reduces the cumulative incidence of treatment interruption caused by toxicity and duration of hospitalization. A randomized study is warranted to validate these results.
Collapse
Affiliation(s)
- Eric Assenat
- Department of Gastro-Nutrition, Val d'Aurelle Cancer Institute, Montpellier, France
| | | | | | | | | | | | | | | |
Collapse
|
36
|
McQuestion M, Fitch M, Howell D. The changed meaning of food: Physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 2011; 15:145-51. [DOI: 10.1016/j.ejon.2010.07.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Revised: 06/25/2010] [Accepted: 07/16/2010] [Indexed: 10/19/2022]
|
37
|
Bjuresäter K, Larsson M, Athlin E. Struggling in an inescapable life situation: being a close relative of a person dependent on home enteral tube feeding. J Clin Nurs 2011; 21:1051-9. [PMID: 21418362 DOI: 10.1111/j.1365-2702.2010.03596.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To explore what it means to be a close relative of a person dependent on home enteral tube feeding (HETF) and how they can manage this situation. BACKGROUND Previous studies have shown that the situation of close relatives in home care in general can be burdensome and difficult. Research is scarce about experiences of close relatives when patients are treated with HETF. DESIGN A qualitative design was used, in accordance with grounded theory (GT). METHODS Twelve close relatives were interviewed twice, using open-ended questions. Five were relatives of patients supported by home care services or advanced home care teams. Using the GT method, sampling, data collection and data analysis were carried out simultaneously. RESULTS One core category, 'Struggling in an inescapable life situation' and eight categories were found. The situation led to involuntary changes in the lives of the close relatives, something they could do little about. Their lives had become completely upturned and restricted by the HETF. Togetherness and pleasure was lost and they felt lonely. The relatives faced a new role of being informal caregivers and they had to adjust their daily life accordingly. They felt forced to take on a heavy responsibility for which they lacked support. The close relatives struggled to manage and to make the best of their new situation. CONCLUSIONS This study highlighted the demands and vulnerability which is embedded in the role of being a close relative of a patient with HETF. It also pointed out their need for comprehensive support from the health care system. RELEVANCE TO CLINICAL PRACTICE Support to facilitate the situation of close relatives should be given from the health care. One way to organise the care could be through a nurse-led clinic, which provides continuous support, information and counseling.
Collapse
|
38
|
Arving C, Holmström I. Creating a new profession in cancer nursing? Experiences of working as a psychosocial nurse in cancer care. J Clin Nurs 2011; 20:2939-47. [PMID: 21366744 DOI: 10.1111/j.1365-2702.2011.03709.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To describe the nature of being a psychosocial nurse in cancer care. BACKGROUND Psychosocial nurses in cancer care are a new profession in cancer nursing in Sweden, with potential to offer unique support to patients regarding somatic and psychological needs. This new profession is hitherto unexplored. DESIGN A qualitative inductive interview approach was used. METHODS A strategic sample of five nurses working as psychosocial nurses in cancer care in Sweden was interviewed. A thematic stepwise analysis was performed. RESULTS The analysis revealed the twofold experience of being a psychosocial nurse in cancer care. The nurses felt as if they had two professions: nurse and therapist. They used skills from both professions to help the person, who had cancer and a psychosocial problem. It was stimulating to be able to combine the knowledge and practices of two professions. It was also difficult because they felt an uncertainty about what their roles and responsibilities really were. CONCLUSIONS This new profession seems to need role descriptions and formal education so that psychosocial nurses receive respect and appreciation in their new and relatively unknown work in cancer care. RELEVANCE TO CLINICAL PRACTICES: The adjustment to the cancer disease and treatment side effects can be difficult for the patients and their families, which has highlighted the need for psychosocial support. To meet this need the health care system has to provide such support. Nurses are available and can be successfully educated to handle psychosocial problems among cancer patients. A new profession among nurses is emerging, which the present study aimed at describing. The present findings have potential to make healthcare professionals grasp what the core of psychosocial cancer nursing is, as well as its potential and pitfalls.
Collapse
Affiliation(s)
- Cecilia Arving
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | | |
Collapse
|
39
|
What to eat when off treatment and living with involuntary weight loss and cancer: a systematic search and narrative review. Support Care Cancer 2010; 19:1-17. [DOI: 10.1007/s00520-010-0964-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Accepted: 07/20/2010] [Indexed: 11/25/2022]
|
40
|
Björklund M, Sarvimäki A, Berg A. Living with head and neck cancer: a profile of captivity. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1752-9824.2010.01042.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
41
|
Athlin E, Idvall E, Jernfält M, Johansson I. Factors of importance to the development of pressure ulcers in the care trajectory: perceptions of hospital and community care nurses. J Clin Nurs 2009; 19:2252-8. [PMID: 19886875 DOI: 10.1111/j.1365-2702.2009.02886.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The study aimed at describing contributing factors for the progression or regression of pressure ulcers in the care trajectory as they were understood by nurses working in hospitals or community care. BACKGROUND The development of pressure ulcers is considered to be connected with early prevention and awareness among nurses and some studies have indicated that the care trajectory may be a weak point. DESIGN The study was carried out with a qualitative design. METHOD Fifteen nurses from two Swedish hospitals and 15 nurses from community care were interviewed during 2005. Qualitative content analysis was used to make an understanding of patterns possible. FINDINGS Three main categories arose, showing that pressure ulcers were considered to be affected in the care trajectory by factors related to the individual patient, to the healthcare personnel and to the healthcare structure. Hospital and community care nurses mostly had corresponding perceptions of these factors. CONCLUSION The study both confirmed previous findings and added new knowledge about factors that may affect pressure ulcer in the trajectory of care. The informants' views of nurses' responsibilities and their attitudes towards the care of pressure ulcers could, along with their views on the organisation of care, increase the understanding of the occurrence of pressure ulcers. The need for development and clarification of the organisation and responsibility of pressure ulcer care in the care trajectory was stressed. Relevance to clinical practice. The study highlighted attitudes and values among registered nurses, as well as to how to preserve their commitment and increase their knowledge concerning prevention of pressure ulcers.
Collapse
Affiliation(s)
- Elsy Athlin
- Department of Nursing, Karlstad University, Karlstad, Sweden.
| | | | | | | |
Collapse
|
42
|
Björklund M, Sarvimäki A, Berg A. Health promoting contacts as encountered by individuals with head and neck cancer. ACTA ACUST UNITED AC 2009. [DOI: 10.1111/j.1752-9824.2009.01029.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
43
|
Abstract
PURPOSE OF REVIEW Nurses can play an essential role in the treatment of head and neck cancer and the care of patients and their families. The role and influence of nursing is dependent on available evidence to fulfill that role and on the sociopolitical and organizational factors that shape the context for nursing and interdisciplinary practice. RECENT FINDINGS Nurses influence treatment for head and neck cancer through symptom management and tobacco cessation to improve quality of life and patient-reported outcomes. Nurses and interdisciplinary teams in the United States and Europe report successful, novel nurse-led care models that optimize influence on management. SUMMARY Current research suggests that nurses can influence head and neck cancer treatment through emphasis on symptom management, tobacco and alcohol cessation, and on patient and family education and care coordination. Nonetheless, evidence for practice remains scant. Only continued research, employing qualitative and quantitative approaches, conducted by nurse and interdisciplinary investigator teams will advance head and neck cancer management and optimize influence of nursing within it. Novel models for nursing care that are well fit into the organizations and society in which care is delivered may further improve care and patient outcomes. Evaluation of such models is further required to document improvements.
Collapse
|
44
|
From I, Johansson I, Athlin E. The meaning of good and bad care in the community care: older people's lived experiences. Int J Older People Nurs 2009; 4:156-65. [PMID: 20925772 DOI: 10.1111/j.1748-3743.2008.00156.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In spite of a considerable body of research in the past decades on what does or does not constitute good care for older people, there are still few studies addressing this question in which older people narrate their experiences of being dependent on community care. This study was therefore carried out aiming to explore older people's lived experiences of what good and bad care meant to them, when it was offered by community care services. Nineteen older persons in three Swedish communities participated in the study, which used a phenomenological-hermeneutic approach. Data were collected through unstructured interviews and Colaizzi's framework was utilized in the analysis of the data. The key theme arising from the analysis was that of being encountered as a human being by caregivers who, through the provision of safe and secure care, provide opportunities for living life as usual. When any of these circumstances are lacking, bad care will be the consequence. As the general intention in society is to ensure good quality of care to older people as well as others, the findings in our study should have important implications for providers of community care for older people.
Collapse
Affiliation(s)
- Ingrid From
- Lecturer in Nursing, School of Health and Social Sciences, Högskolan Dalarna, Falun, and Doctoral Student, Department of Nursing, Karlstad University, Karlstad, SwedenAssociate Professor in Nursing, Department of Nursing, Karlstad University, Karlstad, Sweden, and Professor in Nursing, Department of Nursing, Gjøvik University College, Gjøvik, NorwayProfessor in Nursing, Department of Nursing, Karlstad University, Karlstad, Sweden
| | | | | |
Collapse
|