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Wassie LA, Mekonnen CK, Tiruneh YM, Melkam M, Belachew EA, Zegeye AF. Advanced-stage presentation of cancer at the time of diagnosis and its associated factors among adult cancer patients at Northwest Amhara comprehensive specialized hospitals, Northwest Ethiopia 2022. BMC Cancer 2024; 24:68. [PMID: 38216966 PMCID: PMC10785453 DOI: 10.1186/s12885-024-11835-4] [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: 06/15/2023] [Accepted: 01/03/2024] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION Screening of cancer is the maximum effort and critical element for providing health related care in order to decrease cancer related dealt because of the disease burden is in its advanced stages. Unfortunately, advanced-stage presentation and late diagnosis of cancers endure a problem in low-income countries including Ethiopia. However, there is scarcity of published articles about the problem in Ethiopia. OBJECTIVE This study aimed to assess the prevalence of advanced-stage -stage presentation of cancer at the time of diagnosis and associated factors among adult cancer patients at Northwest Amhara comprehensive Specialized Hospitals, oncology treatment units, Northwest Ethiopia, 2022. METHODS An institution based cross-sectional study was conducted in Northwest Amhara public referral hospitals on 422 study participants. A systematic random sampling technique was performed. The data were collected through face to face interview and document review via structured, pretested questionnaires. Epi. Data version 4.6 and Stata version 14.0 software's were used for data entry and analysis respectively. Logistic regression were carried out to recognize factors associated with advanced-stage -stage presentation of cancer at the time of diagnosis. Adjusted odds ratio with a 95% confidence interval were used to measure the strength of association. Variables having p-value less than 0.2 in bivariable analysis were entered in to multivariable analysis; variables with a p-value < 0.05 were declared significantly associated with advanced-stage -stage presentation of cancer at the time of diagnosis. RESULTS The overall prevalence of advanced-stage presentation of cancer at the time of diagnosis was found to be 67.57%. Age ≥ 60 years old patients (AOR = 6.10, 95%: (1.16-32.1)), patients had have a feeling of burden (AOR = 1.82, 95%, CI: (1.04-3.20)), and cancer patients with comorbidity illness (AOR = 2.40, 95%, CI: (1.40-4.12)) were significantly associated with advanced-stage presentation of cancer at the time of diagnosis. CONCLUSION The prevalence of advanced-stage presentation of cancer at the time of diagnosis was found to be high. Its better, health care providers in oncology treatment facilities need to give special attention to older patients, having feeling of burden and cancer patient with comorbidity to reduce the risk of developing late stage presentation of cancer.
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Affiliation(s)
- Likinaw Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Chilot Kassa Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yenework Mulu Tiruneh
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eyayaw Ashete Belachew
- Department of clinical pharmacology of pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Panken E, Frydenlund N, Mistry N, Prabhu R, Wong J, Kundu S, Victorson D, Amarasekera C. Heteronormative biases and distinctive experiences with prostate cancer among men who have sex with men: a qualitative focus group study. BMC Urol 2024; 24:10. [PMID: 38184578 PMCID: PMC10771696 DOI: 10.1186/s12894-023-01398-0] [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: 05/21/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Men who have sex with men (MSM) face many challenges and biases in healthcare. Within urology there is a need to better understand how prostate cancer impacts MSM given the unique ways in which side effects that accompany treatment may affect this population. The goal of this study is to explore the experience of MSM with prostate cancer to advance the existing literature in this area and inform implementation and delivery of clinical practice and policy guidelines. METHODS Four focus groups were conducted with a semi-structured interview guide. Using a phenomenological qualitative approach consistent with grounded theory [1] and naturalistic inquiry principles we sought to better understand the direct experiences of MSM with prostate cancer. Audio transcriptions were thematically analyzed to identify themes that impact MSM throughout their prostate cancer journey. An iterative, team-wide classification process was used to identify, organize, and group common codes into higher-order categories and themes. RESULTS Patient's choice of provider and their interactions with the healthcare system were strongly impacted by their sexual identities. Participants commented on navigating the heteronormative healthcare environment and the impact of assumptions they encountered. MSM experienced the sexual side effects of prostate cancer treatment in unique ways. Issues with erectile dysfunction and ejaculatory dysfunction had significant impacts on patient's sexual experience, with some describing being forced to explore new modes of sexual expression. Anejaculation was a theme that was distressing for many participants. The emotional impact of a prostate cancer diagnosis was significant in the men interviewed. Common themes included loss of identity and fear for future relationships. CONCLUSIONS MSM have unique concerns after prostate cancer treatment that differ from men who don't identify as MSM. It is critical that providers familiarize themselves with the concerns of this patient population regarding prostate cancer treatment. An important step toward reducing heteronormative bias in prostate cancer care is to better understand the goals, identity, and sexual practices of MSM and to provide informed anticipatory guidance.
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Affiliation(s)
- Evan Panken
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA.
| | - Noah Frydenlund
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
| | - Neil Mistry
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
| | - Rahul Prabhu
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
| | - Jeffrey Wong
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Shilajit Kundu
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
| | - David Victorson
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Channa Amarasekera
- Department of Urology, Northwestern University, 675 N. St. Clair St, Chicago, IL, 60611, USA
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Rencsok EM, Stopsack KH, Slopen N, Odedina FT, Ragin C, Nowak J, McSwain L, Manarite J, Heath E, George DJ, Kantoff PW, Vinson J, Villanti P, Haneuse S, Mucci LA. Experience with the US health care system for Black and White patients with advanced prostate cancer. Cancer 2023; 129:2532-2541. [PMID: 37246339 PMCID: PMC10524970 DOI: 10.1002/cncr.34885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The purpose of this study was to assess differences in reported information about treatment, integration into care, and respect by self-identified Black and White individuals with advanced prostate cancer in the United States. PATIENTS AND METHODS This is a prospective cohort study of 701 participants (20% identifying as Black) enrolled in the International Registry for Men with Advanced Prostate Cancer at 37 US sites from 2017 to 2022. Participants were asked six questions from the Cancer Australia National Cancer Control Indicators about their experience with care at study enrollment. Prevalence differences by self-reported race were estimated using marginal standardization of logistic-normal mixed effects models (adjusted for age at enrollment and disease state at enrollment), and 95% CIs were estimated using parametric bootstrapping. RESULTS Most participants reported a high quality of care for each question. Black participants generally reported higher care quality compared with White participants. Black participants reported more frequently that they were offered a written assessment and care plan (71%) compared with White participants (58%; adjusted difference, 13 percentage points; 95% CI, 4-23). Black participants also reported more frequently being given the name of nonphysician personnel who would support them (64%) than White participants (52%; adjusted difference, 10; 95% CI, 1-20). Prevalence differences did not differ by disease state at enrollment. CONCLUSIONS Black participants generally reported a higher quality of care compared with White participants. This study calls attention to the need to study potential mediating factors and interpersonal aspects of care in this population to improve survivorship.
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Affiliation(s)
- Emily M Rencsok
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, Massachusetts, USA
| | - Konrad H Stopsack
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Folakemi T Odedina
- Mayo Clinic Comprehensive Cancer Center, Jacksonville, Florida, USA
- Prostate Cancer Transatlantic Consortium (CaPTC), Jacksonville, Florida, USA
| | - Camille Ragin
- Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
- African-Caribbean Cancer Consortium, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | - Philip W Kantoff
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Convergent Therapeutics, Cambridge, Massachusetts, USA
| | - Jacob Vinson
- Prostate Cancer Clinical Trials Consortium (PCCTC), New York, New York, USA
| | | | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Öcalan S, Üzar-Özçetin YS. "I am in a Fight with My Brain": A Qualitative Study on Cancer-Related Ruminations of Individuals with Cancer. Semin Oncol Nurs 2023; 39:151450. [PMID: 37210226 DOI: 10.1016/j.soncn.2023.151450] [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: 12/19/2022] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE This study aimed to determine the cancer-related ruminations from the subjective perspectives of individuals with cancer. DATA SOURCES The study adopted a qualitative design, and participants (N = 16) were individuals with cancer. The analysis and interpretation of data were carried out according to the phenomenological-hermeneutical method. CONCLUSION The following four themes emerged as a result of the analysis of qualitative data revealing the experiences of individuals with cancer: (1) attributed meanings to cancer-related ruminations, (2) perceived ruminations toward an uncertain future, (3) losing against intrusive ruminations, and (4) fighting with ruminations. The results underline the negative impact of ruminative thoughts on the disease process and social life of individuals with cancer. Individuals with cancer struggle with intense thoughts about the cause, treatment, and future of the disease from the moment they are diagnosed with cancer. In order to stop ruminative thoughts, individuals with cancer have tried solutions such as distracting activities and avoiding thoughts. IMPLICATIONS FOR NURSING PRACTICE Nurses have an important role in catching verbal and nonverbal cues for rumination, as they are constantly together with individuals with cancer and make observations. Therefore, nurses can raise awareness about their ruminative thoughts and teach coping skills to individuals with cancer.
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Affiliation(s)
- Sinem Öcalan
- MSc, PhD Candidate, RN, Research Assistant, Psychiatric Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey.
| | - Yeter Sinem Üzar-Özçetin
- PhD, RN, Associate Professor, School of Nursing, Midwifery, and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
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Lehto US, Aromaa A, Tammela T. Psychological recovery and well-being of spouses of patients with prostate cancer 5 years after primary treatment in Finland: a follow-up survey. BMJ Open 2023; 13:e063435. [PMID: 37105703 PMCID: PMC10151865 DOI: 10.1136/bmjopen-2022-063435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE AND SETTING To study longitudinally cancer-related experiences of spouses of patients with prostate cancer and the predictors of their psychological recovery and quality of life (QOL) by following the participants of our previous survey at primary cancer treatment in a university hospital. DESIGN A 5-year longitudinal cohort design. PARTICIPANTS AND PROCEDURE A follow-up questionnaire was mailed to the female spouses/partners who participated in our previous survey (n=104). We quantitatively explored the spouses' prostate cancer-related experiences since the previous survey and measured their current psychological symptom distress and well-being/QOL. Seventy-seven (74%) of the initial participants responded. OUTCOMES The main outcome measures were the spouses' psychological recovery (psychological symptoms at the initial survey vs currently) and well-being/QOL (depressive symptoms, domains of QOL) at 5 years. We analysed their predictors with regression analyses. RESULTS The treatment had been prostatectomy in 70% of the patients. Psychological distress had alleviated in 76% of spouses (p<0.001) and emotional changes decreased (p=0.02), but a deteriorating impact on the partnership (from 4% to 16%) and on sex life ('strong impact' from 23% to 37%) had increased. The outcomes were inversely associated with negative depression-related psychological symptoms and emotional changes either initially or at follow-up. However, some early experiences also predicted the outcomes when other factors were controlled for. Prostate cancer-related information received by the spouses from several sources (leaflets/handouts, TV/radio, internet) predicted better recovery and well-being/QOL, whereas the patients' prostate cancer and treatment-related symptoms (pain, irritability/anger, bowel dysfunction) predicted poorer recovery and well-being/QOL in spouses. CONCLUSIONS A major negative impact of prostate cancer was experienced by the spouses still 5 years after primary treatment. Early prostate cancer-related experiences predicted long-term psychological recovery and QOL. Responding to the early information needs of spouses and effective symptom management for the patients are likely to enhance the spouses' long-term recovery and well-being.
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Affiliation(s)
- Ulla-Sisko Lehto
- Population Health/ Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Arpo Aromaa
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teuvo Tammela
- Department of Surgery, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Medical Technology, University of Tampere, Tampere, Finland
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Kazımoğlu H, Ulutaşdemir N, Kulakaç N, Uzun S. Postoperative symptom management perceptions and coping experiences of individuals with prostate cancer. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2023. [DOI: 10.1111/ijun.12345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Hatem Kazımoğlu
- Department of Urology, School of Medicine Sanko University Gaziantep Turkey
| | - Nilgün Ulutaşdemir
- Department of Healthcare Management, Faculty of Health Sciences Gümüşhane University Gümüşhane Turkey
| | - Nurşen Kulakaç
- Department of Nursing, Faculty of Health Sciences Gümüşhane University Gümüşhane Turkey
| | - Sevda Uzun
- Department of Nursing, Faculty of Health Sciences Gümüşhane University Gümüşhane Turkey
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Launonen M, Vehviläinen-Julkunen K, Mattila L, Savela RM, Kvist T. Older patients' perceptions of the quality of acute cancer care: An integrative review-A mixed-method approach. Int J Older People Nurs 2023; 18:e12503. [PMID: 36168107 DOI: 10.1111/opn.12503] [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: 07/04/2021] [Revised: 07/15/2022] [Accepted: 09/03/2022] [Indexed: 01/15/2023]
Abstract
AIM This integrative review aimed to describe the perceptions of the quality of care of older patients (aged 65 and above) living with cancer in acute-care settings. METHODS We identified relevant research suitable for inclusion criteria through systematic searches of the PubMed®, EBSCOhost Academic Search Premier®, Scopus® and Web of Science® databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and the Synthesis Without Meta-analysis (SWiM) guidelines were used to conduct the research and report the results. The quality of the studies was evaluated using the modified Critical Skills Appraisal Programme (CASP) checklist. RESULTS A total of 24 studies met the inclusion criteria. The data analysis revealed that care quality could be described through three distinct themes: individuality, a sense of security and respectful encounters. CONCLUSION The perceptions of older people living with cancer regarding the quality of acute care have not been extensively covered in the literature. Health- and age-related challenges, patients' overall life situation, clear, realistic information about care and the future and respect during encounters should be given attention. IMPLICATIONS FOR PRACTICE Patient-centred and tailored care, considering the heterogeneity of the population and support for independence, is needed.
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Affiliation(s)
- Minna Launonen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.,Kuopio University Hospital, Kuopio, Finland
| | - Laura Mattila
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Doykov M, Chervenkov L, Tsvetkova-Trichkova S, Doykova K, Georgiev A. Assessment of the Utility of Multiparametric Magnetic Resonance Imaging for Initial Detection of Prostate Cancer. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: An accurate diagnosis is essential for the effective treatment of prostate cancer (PCa) and for the patients’ well-being.
AIM: Thе main purpose of this study was to assess the utility of multiparametric magnetic resonance imaging (mp-MRI) for initial detection of PCa among the Bulgarian population of men with prostate diseases.
MATERIALS AND METHODS: Fifty-three patients, aged 44 to 82 years, were evaluated for clinically significant PCa. Assessment methods included prostate-specific antigen (PSA) serum levels, transrectal ultrasonography (TRUS), GE Discovery 3T MRI, and 12-core TRUS biopsy.
RESULTS: mp-MRI showed 83.20% concordance with TRUS biopsy: sensitivity of 91.43% (76.90–98.20), specificity of 75.00% (34.90–96.80), positive predictive values 94.10% (82.80–98.20) and negative predictive values 66.70% (38.70–86.40). Of the patients classified in prostate imaging–reporting and data system (PI-RADS) levels 4 and 5, 94.12% had positive TRUS biopsy, as well as 44.40% of PI-RADS had level 3. Irrespective of the patients’ age and PSA, PI-RADS was found to be a significant predictor of a positive TRUS biopsy (p = 0.009). PSA serum levels showed a low concordance with TRUS biopsy (area under the curve = 0.539; 95% confidence interval [CI]: 0.363–0.712) and a low, although significant, correlation with PI-RADS (rs = 0.416; 95% CI: 0.164–0.617).
CONCLUSION: According to our findings, mp-MRI and TRUS biopsy have a high level of concordance for the initial detection of PCa. The incorporation of mp-MRI into the diagnostic pathway for PCa can significantly reduce the number of incorrect diagnoses based on PSA serum levels and/or suspicious physical and digital examinations.
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Stewart RJ, Humphris GM, Donaldson J, Cruickshank S. Does Cancer Type Influence the Impact of Recurrence? A Review of the Experience of Patients With Breast or Prostate Cancer Recurrence. Front Psychol 2021; 12:635660. [PMID: 34267696 PMCID: PMC8276075 DOI: 10.3389/fpsyg.2021.635660] [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: 11/30/2020] [Accepted: 06/04/2021] [Indexed: 12/02/2022] Open
Abstract
Objective: Patients will experience a plethora of issues when faced with a recurrence of their cancer. It is unclear if cancer type is a significant factor in how recurrence is experienced by an individual. The aim of the current review is to explore the evidence base and summarise the experiences of patients specifically with a recurrence of breast or prostate cancer (the most common for women and men, respectively) and then provide a comparison of these experiences. These experiences include the physical, psychological and psychosocial issues that arise at this time. Methods: A systematic search was conducted of studies published between January 1994 and April 2019. Due to the mix of research designs used previously in the literature, this review was conducted in an integrative manner; allowing for inclusion of diverse research designs. Results were synthesised narratively, with data categorised according to physical, psychological, and psychosocial indices of quality of life. The review protocol was registered in the international database of prospective systematic reviews in health and social care- (CRD42019137381). Results: Fifteen breast cancer and six prostate cancer articles were identified, each reporting one relevant study. Patients reported several negative issues at the time of a breast or prostate cancer recurrence. Similarities were found between cancer types, with physical problems such as fatigue, psychological issues including anxiety and depressive symptoms, and psychosocial concerns such as issues with healthcare professionals common in both cancers. Certain findings were inconsistent across studies, with some experiences differing between studies rather than due to cancer type. Conclusions: Differences in the experience of recurrent cancer appear to be more heavily influenced by individual factors, rather than cancer type. Findings are confounded by gender; and should be considered preliminary. Effects of recurrence should be studied in samples where cancer type and gender are not confounded. Concerns are raised about available study quality and differing outcome measures in this interpretation. Care and support of the individual at the time of a cancer recurrence is a key focus. Future research suggestions with implications for clinical practise are included. Systematic Review Registration: PROSPERO 2019 CRD42019137381.
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Affiliation(s)
- Ross James Stewart
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | | | - Jayne Donaldson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Susanne Cruickshank
- Royal Marsden National Health Service Foundation Trust, London, United Kingdom
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Tiirola H, Poutanen VM, Vornanen R, Pylkkänen L. Development of cancer support services for patients and their close ones from the Cancer Society of Finland's perspective. Int J Qual Stud Health Well-being 2021; 16:1915737. [PMID: 33880972 PMCID: PMC8079123 DOI: 10.1080/17482631.2021.1915737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: This study examined what support cancer patients and their close ones need and how this support should be organized when developing cancer care pathways. The study focused on the opinions of professionals of the Cancer Society of Finland (CSF), who play a central role in presenting the third sector’s perspective on care pathways. Method: Six semi-structured group interviews were carried out with counselling nurses (n = 12) and managers (n = 9) of the CSF during summer 2017. The results were analysed using content analysis. Results: Both patients and their close ones need more information, psychosocial support and financial counselling after diagnosis, during rehabilitation and follow-up, at relapse and during the palliative care phase; additionally, close ones require support after the patient’s death. Participants emphasized close collaboration between public healthcare and the CSF to meet the needs of patients and their close ones. Conclusion: Psychosocial support can—and should—be provided as part of the care pathway. This support can be provided by organizations in the third sector, such as the CSF, which have resources in this area.
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Affiliation(s)
- Heli Tiirola
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, University of Eastern Finland, Kuopio, Finland
| | - Veli-Matti Poutanen
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, University of Eastern Finland, Kuopio, Finland
| | - Riitta Vornanen
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, University of Eastern Finland, Kuopio, Finland
| | - Liisa Pylkkänen
- Clinical Oncology, Department of Oncology, University of Turku, Turku, Finland
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Effect of Kegel exercises on the prevention of urinary and fecal incontinence in patients with prostate cancer undergoing radiotherapy. Eur J Oncol Nurs 2021; 51:101913. [PMID: 33639454 DOI: 10.1016/j.ejon.2021.101913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE This is a nonrandomized experimental study conducted to evaluate the effect of Kegel exercises on the prevention of urinary and fecal incontinence in prostate cancer patients undergoing radiotherapy. METHOD The study was conducted with 30 patients in the intervention group (IG) and 30 patients in the control group (CG). Data were collected using a patient information form, CTCAE, EORTC QLQ-C30, and a follow-up form reporting weekly Kegel exercises. Before radiotherapy, the IG was provided with Kegel exercise training via visual training material; exercises were performed under the supervision of the researcher, and the exercise pamphlet was handed out. During radiotherapy, weekly follow-ups were performed by face-to-face contact or phone calls. No similar application was provided to the CG. CTCAE and EORTC QLQ-C30 were evaluated three times (baseline, 4th and 8th weeks of exercises). RESULTS At the end of the 4th week of exercises, 1st-grade urinary incontinence (UI) developed in the IG (10%) and in the CG (13.3%). At the end of the 8th week, 2nd-grade UI (3.3%) developed in the IG and 1st-grade (10%) and 2nd-grade UI (6.7%) developed in the CG. Fecal incontinence developed in neither group. At the end of the intervention, there was a significant improvement in Role, Social function and Global Health Status in the IG compared with the 4th week scores. In addition, less Fatigue, Diarrhea, Anorexia and Constipation scores were found compared with the baseline. CONCLUSION Kegel exercises can be recommended as an approach in the prevention of urinary incontinence and to improve quality of life.
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Baba N, Schrage T, Hartmann A, Baba K, Wuensch A, Schultze-Seemann W, Weis J, Joos A. Mental distress and need for psychosocial support in prostate cancer patients: An observational cross-sectional study. Int J Psychiatry Med 2021; 56:51-63. [PMID: 32597270 DOI: 10.1177/0091217420938896] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Prostate cancer is the most common cancer in German men and associated with various physical and psychosocial problems. This study investigated the association between mental distress and the subjective need for psychosocial support comparing subgroups of patients with different treatments and disease stages. METHOD We performed an observational, cross-sectional study including patients with four medical conditions: Active Surveillance, radical prostatectomy, biochemical relapse, metastasized disease. Mental distress (NCCN Distress-Thermometer), symptoms of depression and anxiety (PHQ-9, GAD-7), psychosocial needs and coping resources (self-designed questionnaire) were assessed. RESULTS N = 130 patients were included. 33.3% showed distress, 16.5% symptoms of moderate depression and 13% symptoms of moderate anxiety. We found no significant differences between the four groups. An association was present between distress and wish for psychosocial support (χ2 = 4.3; p < 0.05; ϕ = 0.19). Almost 90% lived with a partner, which represents a resource. CONCLUSIONS Prostate cancer patients showed low levels of mental distress, depression and anxiety with no difference in terms of disease stage and treatment modality. Therefore, careful psychosocial screening of all patients is essential to identify those in need for support. Distressed patients express a need for psychosocial support more often. Interpersonal relationships, most often wives and children, represent important coping resources.
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Affiliation(s)
- Naomi Baba
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Theresa Schrage
- Comprehensive Cancer Center, Department of Selfhelp Research, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Armin Hartmann
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Kenji Baba
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Alexander Wuensch
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.,Psychosocial Counselling for Cancer Outpatients, Comprehensive Cancer Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Joachim Weis
- Comprehensive Cancer Center, Department of Selfhelp Research, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Andreas Joos
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
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Sheikh MM, Qayyum R, Panda M. Relationship of Physicians' Rapport with Patients' Satisfaction and Psychological Well-being During Hospitalization. Cureus 2019; 11:e4991. [PMID: 31497422 PMCID: PMC6707819 DOI: 10.7759/cureus.4991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective The purpose of this study was to assess the association between the psychological well-being and satisfaction of patients with physicians during their hospitalization. Methods This cross-sectional study was conducted at a local hospital using the following surveys: Brief Inventory of Thriving (BIT), tool to assess inpatient satisfaction with care from hospitalists (TAISCH) survey, and Erlanger Internal Patient satisfaction survey addressing demographic questions and questions on physicians' quality of care and etiquette. Mixed linear regression models were created to examine the effect of psychological well-being on patient satisfaction. Models were adjusted for age, race, and gender, and all analyses were performed in R 3.1.1 using the 'lme4' package with statistical significance set at p<0.05. Results A total of 360 patients were enrolled in this analysis and the mean age of the cohort was 54.5 years. In the unadjusted analysis, each unit increase in BIT score was associated with a 0.3% (95% CI:0.19-0.4, p<0.001) increase in mean satisfaction score using the five-domain questionnaire and a 0.25% (95%CI:0.16-0.34, p<0.01) increase in mean satisfaction score using the TAISCH questionnaire. Multivariable models, after adjusting confounding variables, also showed the direct and statistically significant relationship between patients' level of psychological well-being and patient satisfaction. Each unit increase in BIT score was associated with a 0.31% (95% CI:0.20-0.43, p<0.001) and 0.26% (95% CI:0.17-0.36, p<0.001) increase in mean satisfaction scores across the five-domain questionnaire and TAISCH questionnaire. Conclusions There is a positive correlation between the level of patients' psychological well-being and satisfaction with his/her physician with a statistical significance. With patient-specific strategies, we can further improve patient rapport with their physicians, resulting in positive patient outcomes.
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Affiliation(s)
| | - Rehan Qayyum
- Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - Mukta Panda
- Internal Medicine, University of Tennessee College of Medicine, Health and Science Center, Chattanooga, USA
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Gordon L, Dickinson A, Offredy M. Information in radiotherapy for men with localised prostate cancer: An integrative review. Eur J Cancer Care (Engl) 2019; 28:e13085. [PMID: 31066129 DOI: 10.1111/ecc.13085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/05/2019] [Accepted: 04/17/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Men with prostate cancer may receive radiotherapy as part of their management. They encounter a range of information related to radiotherapy, and a crucial role for therapeutic radiographers and other healthcare practitioners is ensuring patients receive appropriate information related to their treatment. This integrative review aims to identify, synthesise and analyse literature reporting experiences of men with localised prostate cancer related to information in radiotherapy. METHODS A systematic literature search encompassing database and hand searches was carried out between February and March 2017 with date limits of 2000-2017 applied. Initially, 4,954 articles were identified. Systematic screening and detailed examination identified that 33 met the inclusion criteria. Data were synthesised and analysed thematically. RESULTS Few studies explicitly addressed the issue of information in radiotherapy for men with localised prostate cancer. Themes that emerged and were explored are information needs, information regarding adverse effects, information and time, information preferences, satisfaction with information related to radiotherapy and patient experience related to radiotherapy information. CONCLUSION This review suggests that although several aspects related to information for men with localised prostate cancer have been documented, few were explored in detail with respect to radiotherapy indicating that further research in this area is warranted.
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Affiliation(s)
- Lynne Gordon
- Department of Allied Health, Midwifery and Social work, University of Hertfordshire, Hertfordshire, UK
| | - Angela Dickinson
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK
| | - Maxine Offredy
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK
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Feldman-Stewart D, Tong C, Brundage M, Bender J, Robinson J. Making their decisions for prostate cancer treatment: Patients' experiences and preferences related to process. Can Urol Assoc J 2018; 12:337-343. [PMID: 29989912 DOI: 10.5489/cuaj.5113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We sought to determine the experiences and preferences of prostate cancer patients related to the process of making their treatment decisions, and to the use of decision support. METHODS Population surveys were conducted in four Canadian provinces in 2014-2015. Each provincial cancer registry mailed surveys to a random sample of their prostate cancer patients diagnosed in late 2012. Three registries' response rates were 46-55%; the fourth used a different recruiting strategy, producing a response rate of 13% (total n=1366). RESULTS Overall, 90% (n=1113) of respondents reported that they were involved in their treatment decisions. Twenty-three percent (n=247) of respondents wanted more help with the decision than they received and 52% of them (n=128) reported feeling well-informed. Only 51% (n=653) of all respondents reported receiving any decision support, but an additional 34% (n=437) would want to if they were aware of its existence. A quarter (25%, n=316) of respondents found it helpful to use a decision aid, a type of decision support that provides assistance to decision processes and provides information, but 64% (n=828) reported never having heard of decision aids; 26% (n=176) of those who had never heard of decision aids wanted more help with the decision than they received compared to 13% (n=36) of those who had used a decision aid. CONCLUSIONS The majority of respondents wanted to participate in their treatment decisions, but a portion wanted more help than they received. Half of those who wanted more help felt well-informed, thus, needed support beyond information. Decision aids have potential to provide information and support to the decision process.
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Affiliation(s)
- Deb Feldman-Stewart
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Christine Tong
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Michael Brundage
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Jackie Bender
- ELLICSR Health, Wellness & Cancer Survivorship Centre, Department of Supportive Care, University Health Network, Toronto, ON, Canada
| | - John Robinson
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
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Sharpley CF, Bitsika V, Christie DRH. " The Worst Thing Was…": Prostate Cancer Patients' Evaluations of Their Diagnosis and Treatment Experiences. Am J Mens Health 2018; 12:1503-1509. [PMID: 29708020 PMCID: PMC6142165 DOI: 10.1177/1557988318772752] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The objective of the current study was to identify the patient-perceived "worst aspects" of their diagnostic and treatment processes for prostate cancer (PCa) so as to inform targeted interventions aimed at reducing patient anxiety and depression. Two hundred and fifty-two patients who had received their diagnoses less than 8 years ago answered a postal survey about (a) background information, (b) their own descriptions of the worst aspects of their diagnosis and treatment, and (c) their ratings of 13 aspects of that process for (i) how these aspects made them feel stressed, anxious, and depressed and (ii) how they affected their relationships with significant others. They also answered standardized scales of anxiety and depression. The worst aspects reported by patients were receiving the initial diagnosis of PCa, plus the unknown outcome of that diagnosis, because of the possibility of death, loss of quality of life and/or partner, and the shock of the diagnosis. The most common coping strategy was to "just deal with it," but participants also thought that more information would help. Principal contributors to feeling stressed, anxious, and depressed were also the diagnosis itself, followed by surgery treatment effects. The aspects that most affected relationships were receiving the diagnosis and the side effects of hormone therapy. The identification of these specific worst aspects of the PCa experience provides a set of potential treatment and prevention "targets" for psychosocial care in PCa patients.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, Australia
- Christopher F Sharpley, Brain-Behaviour Research Group, University of New England, PO Box 378, Coolangatta, QLD 4225, Australia.
| | - Vicki Bitsika
- Centre for Autism Spectrum Disorders, Bond University, Gold Coast, Australia
| | - David R. H. Christie
- Genesiscare, Tugun, Queensland & Brain-Behaviour Research Group, University of New England, Armidale, Australia
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17
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Harju E, Rantanen A, Kaunonen M, Helminen M, Isotalo T, Åstedt-Kurki P. Changes in the health-related quality of life of patients with prostate cancer and their spouses. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2018. [DOI: 10.1111/ijun.12157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Eeva Harju
- Doctoral Researcher, Doctoral Researcher Faculty of Social Sciences, Nursing Science; University of Tampere; Tampere Finland
| | - Anja Rantanen
- Docent, University Teacher Faculty of Social Sciences, Nursing Science; University of Tampere; Tampere Finland
| | - Marja Kaunonen
- Professor, Doctoral Researcher Faculty of Social Sciences, Nursing Science; University of Tampere; Tampere Finland
- Department of General Administration; Pirkanmaa Hospital District; Tampere Finland
| | - Mika Helminen
- Biostatistician, Faculty of Social Sciences; University of Tampere; Tampere Finland
- Science Centre; Pirkanmaa Hospital District; Tampere Finland
| | - Taina Isotalo
- Chief Urologist, Department of Surgery; Päijät-Häme Central Hospital; Lahti Finland
| | - Päivi Åstedt-Kurki
- Professor, Department of General Administration; Pirkanmaa Hospital District; Tampere Finland
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Feldman-Stewart D, Tong C, Brundage M, Bender J, Robinson J. Prostate cancer patients' experience and preferences for acquiring information early in their care. Can Urol Assoc J 2018; 12:E219-E225. [PMID: 29405903 DOI: 10.5489/cuaj.4754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Prostate cancer patients' information needs are well-described, but little is known about their preferred sources and media for obtaining information. We sought to determine prostate cancer patients' experiences and preferences for acquiring information after diagnosis, a time of high information need. METHODS Population surveys were conducted in four Canadian provinces in 2014-2015. Each provincial cancer registry surveyed a random sample of prostate cancer patients diagnosed in late 2012. RESULTS A total of 1366 patients responded across provinces. Respondents most frequently tried to obtain information from their urologist; 86% found that easy and 9% found it difficult. Seventy-nine percent of respondents who saw only a urologist felt well-informed compared to 86% of those who saw both a urologist and a radiation oncologist. Eighty-five percent of respondents wanted printed information; 68% wanted it electronically. Respondents' most frequent barriers to obtaining information from physicians were: not actually having enough time (31%), worrying about having enough time (23%), and worrying about asking too many questions (18%). Their most frequent barriers related to internet/printed information, respectively, were uncertainty about quality (63%/49%) and unclear if personally applicable (56%/49%). Recommended facilitators were having a navigator (85%), providing printed information (85%), and someone to answer questions: in person (90%), by phone (66%), or via email (58%). CONCLUSIONS Prostate cancer patients want urologists to provide them with information and are more likely to report being informed if they see both a urologist and a radiation oncologist. Optimal information provision requires that it be provided both on the internet and in print.
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Assessing the information and support needs of radical prostate cancer patients and acceptability of a group-based treatment review: a questionnaire and qualitative interview study. JOURNAL OF RADIOTHERAPY IN PRACTICE 2018. [DOI: 10.1017/s1460396917000644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractAimsCurrent literature suggests the information and support needs of oncology patients undergoing radical radiotherapy to the prostate often remain unmet and can impact quality of life. We aimed to explore the effectiveness of delivery and opportunities for service improvement, including a group-based treatment review.MethodsA total of 60 prostate patients completing radical radiotherapy (mean age 70, range 47–79) in a UK cancer-centre completed a self-designed questionnaire assessing information and support. To explore views on a group-based treatment review, 11% took part in a semi-structured interview. Descriptive data were computed and interviews transcribed and analysed thematically.ResultsIn all, 87% were satisfied with information and support when delivered by radiographers. However, 26% were only ‘sometimes’ able to complete bladder-filling, suggesting information regarding treatment delays would improve this. In total, 49% preferred both Doctor and Urology nurse reviews whereas 26% preferred nurse only; 70% stated their ‘concerns were always addressed’ by a nurse and 49% by a Doctor. Interviews revealed that a group review was generally acceptable with peer support an influencing factor.FindingsOverall patients felt their needs were being met. Suggestions for improvement (more information on preparation, side effects and delays) will be implemented locally. Future work will explore the feasibility of group reviews in patients undergoing radical radiotherapy to the prostate.
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Edwards LB, Greeff LE. Exploring grassroots feedback about cancer challenges in South Africa: a discussion of themes derived from content thematic analysis of 316 photo-narratives. Pan Afr Med J 2017; 28:173. [PMID: 29541319 PMCID: PMC5847259 DOI: 10.11604/pamj.2017.28.173.11894] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 08/14/2017] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Cancer is an important health problem in Africa with projections that incidence could double by 2030. While sparse, the literature on cancer control in African low- and middle-income countries suggests poor cancer planning, overburdened services and poor outcomes. South Africa has established oncology health care services but also has low cancer awareness, poor cancer surveillance and widespread service challenges. METHODS Data for this study was derived from 316 photovoice interviews with cancer patients, families of cancer patients and oncology workers across South Africa. The objectives of the study were to collect first-hand feedback about cancer challenges and to develop recommendations for the improvement of cancer control strategies. RESULTS 9 themes of cancer challenges were distinguished via thematic content analysis of the photo-narratives. The identified themes of cancer challenges were physical and treatment challenges, emotional, poor services, transport, finances, information, powerlessness, stigma, and schooling challenges. CONCLUSION The findings of this study offer the patient and family perspective of cancer challenges as a valid contribution to our body of cancer knowledge. The 9 themes of cancer challenges profile the emotional, physical and social impact of cancer on patients and families, and offer detailed subjective information about problem occurrence in the trajectory of care. Recommendations following from the 9 themes of cancer challenges include training for improved patient-centred care standards, the need for cancer surveillance, innovative and locally appropriate cancer awareness campaigns, private and government health care partnerships and the development of psychosocial services. The advocating of findings and recommendations to influence cancer control strategies in South Africa, is indicated.
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Affiliation(s)
| | - Linda Estelle Greeff
- Clinical Oncology Social Worker, GVI Head Oncology Social Work, Cape Town, South Africa
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21
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Edwards LB, Greeff LE. Evidence-based feedback about emotional cancer challenges experienced in South Africa: A qualitative analysis of 316 photovoice interviews. Glob Public Health 2017; 13:1409-1421. [DOI: 10.1080/17441692.2017.1357187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Nanton V, Appleton R, Dale J, Roscoe J, Hamborg T, Ahmedzai SH, Arvanitis TN, Badger D, James N, Mendelsohn R, Khan O, Parashar D, Patel P. Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team. JMIR Res Protoc 2017; 6:e147. [PMID: 28754653 PMCID: PMC5554351 DOI: 10.2196/resprot.7667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 05/07/2017] [Accepted: 05/08/2017] [Indexed: 12/30/2022] Open
Abstract
Background The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Objective Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. Methods A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Results Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to encourage engagement and uptake by clinical teams. Recruitment to the second phase of the study, the feasibility trial, commenced March 2017. Conclusions To our knowledge, this study is the first in the United Kingdom to trial an online holistic needs assessment for men with prostate cancer, with data shared between patients and primary and secondary care providers. This study addresses recommendations in recent policy documents promoting the importance of data sharing and enhanced communication between care providers as a basis for care integration. We anticipate that this model of care will ultimately provide important benefits for both patients and the National Health Service. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 31380482; http://www.isrctn.com/ISRCTN31380482 (Archived by WebCite at http://www.webcitation.org/6s8I42u5N)
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Affiliation(s)
- Veronica Nanton
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Rebecca Appleton
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Jeremy Dale
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Julia Roscoe
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Thomas Hamborg
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Sam H Ahmedzai
- Medical School, University of Sheffield, Sheffield, United Kingdom
| | - Theodoros N Arvanitis
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
| | - Douglas Badger
- South Warwickshire Prostate Support Association, Stratford, United Kingdom
| | - Nicholas James
- The Cancer Centre, University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Omar Khan
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
| | - Deepak Parashar
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Prashant Patel
- Department of Urology, University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Harju E, Rantanen A, Kaunonen M, Helminen M, Isotalo T, Åstedt-Kurki P. The health-related quality of life of patients with prostate cancer and their spouses before treatment compared with the general population. Int J Nurs Pract 2017; 23. [DOI: 10.1111/ijn.12572] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 04/04/2017] [Accepted: 05/18/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Eeva Harju
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
| | - Anja Rantanen
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
| | - Marja Kaunonen
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
- Department of General Administration; Pirkanmaa Hospital District; Finland
| | - Mika Helminen
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
- Science Centre; Pirkanmaa Hospital District; Finland
| | - Taina Isotalo
- Department of Surgery; Päijät-Häme Central Hospital; Lahti Finland
| | - Päivi Åstedt-Kurki
- Faculty of Social Sciences, Nursing Science; University of Tampere; Finland
- Department of General Administration; Pirkanmaa Hospital District; Finland
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Stinesen Kollberg K, Wilderäng U, Thorsteinsdottir T, Hugosson J, Wiklund P, Bjartell A, Carlsson S, Stranne J, Haglind E, Steineck G. How badly did it hit? Self-assessed emotional shock upon prostate cancer diagnosis and psychological well-being: a follow-up at 3, 12, and 24 months after surgery. Acta Oncol 2017; 56:984-990. [PMID: 28303734 DOI: 10.1080/0284186x.2017.1300320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND We were interested in examining if there was a link between self-assessed emotional shock by prostate cancer diagnosis and psychological well-being at 3, 12, and 24 months after surgery. MATERIAL AND METHODS Information was derived from patients participating in the LAPAroscopic Prostatectomy Robot Open (LAPPRO) trial, Sweden. We analyzed the association between self-assessed emotional shock upon diagnosis and psychological well-being by calculating odds ratios (ORs). RESULTS A total of 2426 patients (75%) reported self-assessed emotional shock by the prostate cancer diagnosis. Median age of study participants was 63. There was an association between emotional shock and low psychological well-being after surgery: adjusted OR 1.7: (95% confidence interval [CI]), 1.4-2.1 at 3 months; adjusted OR 1.3: CI, 1.1-1.7 at 12 months, and adjusted OR 1.4: CI, 1.1-1.8 at 24 months. Among self-assessed emotionally shocked patients, low self-esteem, anxiety, and having no one to confide in were factors more strongly related with low psychological well-being over time. CONCLUSION Experiencing self-assessed emotional shock by prostate cancer diagnosis may be associated with low psychological well-being for up to two years after surgery. Future research may address this high rate of self-assessed emotional shock after diagnosis with the aim to intervene to avoid this negative experience to become drawn out.
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Affiliation(s)
- Karin Stinesen Kollberg
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Ulrica Wilderäng
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | | | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Peter Wiklund
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Stefan Carlsson
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden
| | - Johan Stranne
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Eva Haglind
- Department of Surgery, Institute of Clinical Sciences, SSORG – Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Gunnar Steineck
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
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Lehto US, Aromaa A, Tammela TL. Experiences and psychological distress of spouses of prostate cancer patients at time of diagnosis and primary treatment. Eur J Cancer Care (Engl) 2017. [DOI: 10.1111/ecc.12729] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Ulla-Sisko Lehto
- Health Monitoring Unit; National Institute for Health and Welfare THL; Helsinki Finland
| | - Arpo Aromaa
- Health Monitoring Unit; National Institute for Health and Welfare THL; Helsinki Finland
| | - Teuvo L. Tammela
- Department of Surgery; Tampere University Hospital; Tampere Finland
- School of Medicine; University of Tampere; Tampere Finland
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Lehto US, Tenhola H, Taari K, Aromaa A. Patients' perceptions of the negative effects following different prostate cancer treatments and the impact on psychological well-being: a nationwide survey. Br J Cancer 2017; 116:864-873. [PMID: 28222069 PMCID: PMC5379142 DOI: 10.1038/bjc.2017.30] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 12/27/2016] [Accepted: 01/19/2017] [Indexed: 12/23/2022] Open
Abstract
Background: Although the prognosis of localised prostate cancer is good, the negative effects of prostate cancer treatment often impair patient quality of life. A growing number of men experience these negative effects over a longer time because of the increased incidence of and prolonged survival in prostate cancer, and the ageing of the population. Only a few studies have investigated the adverse effects of different prostate cancer treatments using large population-based samples. Methods: We conducted a nationwide survey (n=1239) to collect detailed information regarding the negative effects (i.e., the occurrence, perceived level and perceived bother since the beginning of the treatment) of prostate cancer treatments: radical prostatectomy, external beam radiotherapy, brachytherapy, hormone therapy and surveillance. Furthermore, we measured patient satisfaction with the outcome of the treatment and their psychological well-being (i.e., psychological symptoms and satisfaction with life) 5 years after diagnosis. The negative effects between the treatments were compared, and the determinants of satisfaction and psychological well-being were investigated. Results: The negative effects of all types of active prostate cancer treatments were common and persistent (33–48% reported symptoms at 5 years) and showed the known differences between the treatments. Prostatectomy and the radiotherapies caused urinary leakage; radiotherapy also caused symptoms of urinary irritation; and external radiation also caused bowel dysfunction. Most symptoms were considered highly bothersome. Most respondents (81−93%) reported that their treatment negatively affected their sex lives; 70–92% reported sexual dysfunction; and 20–58% reported that their sex lives with their spouses had ended. Urinary symptoms were especially associated with poorer psychological outcomes. The perception of symptom level and bother had a greater effect on patient satisfaction and well-being than the symptoms per se. Conclusion: Multiple and persistent negative effects follow active prostate cancer treatment, and these effects predict long-term patient satisfaction and psychological well-being. The harms and benefits associated with prostate cancer treatments should be considered when selecting whether and how to actively treat prostate cancer.
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Affiliation(s)
- Ulla-Sisko Lehto
- National Institute for Health and Welfare THL, Health Monitoring Unit, Helsinki FI00271, Finland
| | - Heli Tenhola
- National Institute for Health and Welfare THL, Health Monitoring Unit, Helsinki FI00271, Finland.,University of Helsinki, Division of Social Pharmacy; DRA Consulting Oy, Helsinki FI01510, Finland
| | - Kimmo Taari
- University of Helsinki; Helsinki University Hospital, Department of Urology, Helsinki FI00029, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare THL, Health Monitoring Unit, Helsinki FI00271, Finland
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Harju E, Rantanen A, Kaunonen M, Helminen M, Isotalo T, Åstedt-Kurki P. Marital relationship and health-related quality of life after prostate cancer diagnosis. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2016. [DOI: 10.1111/ijun.12131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Eeva Harju
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
| | - Anja Rantanen
- University Teacher, School of Health Sciences, Nursing Science, University of Tampere; Arvo FI-33014 University of Tampere Finland
| | - Marja Kaunonen
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Department of General Administration; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
| | - Mika Helminen
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Science Centre; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
| | - Taina Isotalo
- Department of Surgery; Päijät-Häme Central Hospital; Keskussairaalankatu 7 FI-15850 Lahti Finland
| | - Päivi Åstedt-Kurki
- School of Health Sciences, Nursing Science; University of Tampere; Arvo FI-33014 University of Tampere Finland
- Department of General Administration; Pirkanmaa Hospital District; FI-33521 Tampere University Hospital Finland
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Maintaining intimacy for prostate cancer patients on androgen deprivation therapy. Curr Opin Support Palliat Care 2016; 10:55-65. [PMID: 26761788 DOI: 10.1097/spc.0000000000000190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW Androgen deprivation therapy (ADT) causes erectile dysfunction and increases patients' emotionality while diminishing their sexual interest. ADT has been linked to erosion of spousal bonds; however, this is not an invariant outcome. Understanding the factors that lead to these various outcomes may help couples deal with ADT. RECENT FINDINGS A subset of couples report that they became closer as a result of the patients going on ADT. Recent data suggest that what helps couples most is preemptive awareness of ADT's side-effects and congruence in how patients and their partners understand and accept the psychosexual impact of ADT. Sex therapy for prostate cancer patients divides along gendered lines, with distinctly 'male' (recovery of erections) and 'female' (promoting sexual practices that are not erection dependent) approaches. Unfortunately, neither is very effective for couples when the patient is on ADT. Options beyond the standard gendered framework, such as use of an external penile prosthesis, may be worth offering to ADT patients trying to find a 'new normal' that is sexually rewarding for them. SUMMARY Intimacy is sharing something with someone that one shares with no one else. Exploring novel sexual practices can help couples stay intimate, even when the patient is on ADT.
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Vandecasteele T, Debyser B, Van Hecke A, De Backer T, Beeckman D, Verhaeghe S. Patients' perceptions of transgressive behaviour in care relationships with nurses: a qualitative study. J Adv Nurs 2015; 71:2822-33. [PMID: 26345718 DOI: 10.1111/jan.12764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 11/27/2022]
Abstract
AIM To gain insight in the onset and meaning of transgressive behaviour in care relationships with nurses, from the perspective of patients. BACKGROUND Aggression and transgressive behaviour in health care have been a focus of research over the last decades. Most studies describe staff experiences on patient aggression. Patient' perspectives on aggression and transgressive behaviour in interactions with nurses are rarely sought. DESIGN Qualitative interview study. METHODS Twenty patients were purposefully sampled from six wards of two general hospitals. Semi-structured interviews were carried out in 2011. Data were analysed using the constant comparative method influenced by the grounded theory approach. FINDINGS On elaborating on what constitutes experiences of transgressive behaviour, patients employ a framework of suppositions towards hospital care and nurse-patient relationships. This framework leads to implicit ideas on how competent professional caregivers will be and on how relationships with nurses will be characterized as normal human interactions. When these anticipated ideas are not met, patients feel obliged to address this discrepancy by adjusting their expectations or behaviour. Patients become more vigilant with regard to care given by nurses; search for own solutions; make excuses for nurses or reprioritize their expectations. Because of this adjustment, perceptions of transgressive behaviour are reinforced, mitigated or put into perspective. CONCLUSION Patients adjust their behaviour based on what they experience in care relationships with nurses or the hospital care. It is crucial that patients feel free to discuss their assumptions or untoward needs and nurses learn to understand and reflect on those experiences.
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Affiliation(s)
- Tina Vandecasteele
- Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Belgium.,VIVES University College - Department Health Care, Roeselare, Belgium
| | - Bart Debyser
- VIVES University College - Department Health Care, Roeselare, Belgium
| | - Ann Van Hecke
- Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Belgium.,University Hospital Ghent, Belgium
| | - Tineke De Backer
- VIVES University College - Department Health Care, Roeselare, Belgium
| | - Dimitri Beeckman
- Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Belgium
| | - Sofie Verhaeghe
- Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Belgium.,VIVES University College - Department Health Care, Roeselare, Belgium
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