The appraisal of positive life changes following cancer diagnosis: An interview study

Lifestyle choices following head and neck cancer treatment: A qualitative study

BACKGROUND

The benefits of a healthy lifestyle in reducing risk of cancer and chronic disease are well-documented. Many individuals who have had head and neck cancer (HNC) report complex social situations with a history of poor dietary habits, smoking and alcohol abuse. Survivorship can be a strong motivator to make positive lifestyle changes, reducing risk of cancer recurrence and ill-health. Research investigating whether HNC survivors adopt healthy lifestyle recommendations is lacking.

AIM

To explore the health-related practices of post-treatment HNC patients, seeking to identify barriers and motivators to following recommended health guidelines.

METHODS

Tape-recorded interviews were conducted with 20 HNC survivors, and comparisons made to Department of Health recommendations.

RESULTS

80% of participants made lifestyle changes following HNC treatment. The most prevalent changes were to diet and alcohol intake. Key motivators were reducing cancer risk and ill-health; barriers included lack of motivation, support and misinformation. Treatment side-effects presented both motivators and barriers. There was widespread recognition of the "5 a day" message, and harm caused by smoking. Other public health recommendations were less well-known; 98% were unaware of current alcohol guidelines, physical activity was overestimated, and only one participant took vitamin D.

CONCLUSION

In this study HNC survivors were highly motivated to make healthy lifestyle changes. Further work is required to increase awareness of Government guidelines, as health messages are not always reaching the public or are misinterpreted.

The Interaction Between Hematological Cancer Patients and Family Caregivers and Their Life Changes: A Qualitative Dyadic Approach

BACKGROUND

Diagnosis of hematological cancer affects patients and caregivers as a unit. Few studies have focused on the relationship between hematological cancer patients and their caregivers.

OBJECTIVE

To explore (a) the interaction between patients receiving treatment for hematological cancer in a hematology-oncology clinic and their family caregivers and (b) perceived changes in lives of patients receiving treatment for hematological cancer in a hematology-oncology clinic and their family caregivers.

METHODS

We used a qualitative descriptive design with a dyadic approach. The study sample included 11 patients with hematological cancer and 11 family caregivers selected through purposive sampling. In-depth interviews were conducted using a semistructured interview format.

RESULTS

As a result of a content analysis, 3 themes emerged: hidden emotions, companionship, and life changes. Both the patients and the family caregivers described coping by hiding their feelings, thoughts, and needs and reducing communication with each other. Dyad members described commitment to each other and an increase in confidence. In addition, the patients and the family caregivers experienced changes in their roles and perspectives during the diagnosis and treatment process.

CONCLUSION

Patients with hematological cancer and family caregivers need nurses' support. Nurses should be prepared to provide patient-caregiver-based interventions.

IMPLICATION FOR PRACTICES

It is important that nurses take action to strengthen the relationship between patients and their caregivers, particularly with a focus on carrying out interventions to improve communication between them. Nurses can also strengthen dyads' coping by drawing attention to positive developments in their perspectives and relationships.

Posttraumatic growth experiences and its contextual factors in women with breast cancer: An integrative review

In this article, we synthesize current research that examines determinants and manifestations of posttraumatic growth (the phenomenon of posttraumatic growth can be embodied in several domains) in women with breast cancer. The findings of the integrative literature review may contribute to facilitating person-centered oncology care by raising health care professionals' awareness and understanding of posttraumatic growth phenomenon among breast cancer survivors. The identification of factors contributing to posttraumatic growth and manifestations of posttraumatic growth are important in increasing the effectiveness of interventions in supporting women during their breast cancer journey. The methods proposed by Whittemore and Knafl ( 2005 ) were adopted to guide this integrative review. Quality assessment was conducted using recognized critical appraisal tools relating to quantitative and qualitative studies. Four main manifestations were synthesized from the literature: new perception of self; relatedness to others; new life philosophy; and spiritual and religious growth. Personal characteristics, illness factors, cognitive processing, coping strategies, social support, religion and spirituality, the body's role and physical activities were identified as influencing posttraumatic growth in women with breast cancer.

Regard sur l'expérience de vivre avec le cancer : Le cancer comme occasion de changement chez des personnes âgées de 60 à 73 ans

ABSTRACTIt is possible for individuals with a diagnosis of cancer to see the illness as an opportunity to change and to make certain decisions that could improve their chances of recovery. We aimed, through qualitative research, to understand the experience of cancer in older adults through new behaviors and habits, intentions to change and maintenance of old behaviors and habits in the context of the disease. Our participants were 10 people aged 60 to 73 with a diagnosis of cancer. The majority of participants expressed intentions to change or adopted new behaviors or habits. Relatives had very little influence on participant's choices and participants did not seek information on cancer or ways to contribute to healing. However, they were very receptive to the recommendations made by physicians.

Changes and challenges to patients' lifestyle patterns following treatment for head and neck cancer

AIM

This paper is a report of a study to explore the changes and challenges to patients' lifestyles following treatment for head and neck cancer.

BACKGROUND

Head and neck cancer affects some of the most basic aspects of daily functioning, such as eating and speaking. There has been a rapid increase in the number of studies on the quality of life for people with head and neck cancer, but most studies have used quantitative methodology.

METHODS

Using a qualitative approach, data were collected in 2004 using semi-structured interviews with a purposive sample of 10 participants who had completed treatment 6-12 months earlier for head and neck cancer. A thematic analysis was employed to interpret the findings.

FINDINGS

Following thematic analysis seven broad themes were identified, five of which covered areas of changes and challenges to participants' lifestyles following treatment. These were: physical changes, concerns about cancer, work and day-to-day tasks, interpersonal relationships and social functioning. The concerns and challenges experienced following treatment were not limited to one aspect of an individual's lifestyle but spanned a number of the themes identified, highlighting the complexity of needs following treatment for head and neck cancer. The other two themes concerned personal attributes that facilitated or inhibited posttreatment coping and specific information needs in the posttreatment period.

CONCLUSION

Specific posttreatment concerns and challenges cannot be viewed as unitary or discrete aspects of life, but should be considered within a biopsychosocial context, to address patients' needs holistically.

Posttraumatic growth in cancer: reality or illusion?

Research in posttraumatic growth (PTG) among cancer patients has been triggered primarily by the inclusion of serious illnesses among the events that can lead to posttraumatic stress disorder (PTSD); increasing survival rates among cancer patients; and, attempts at encouraging a positive psychology that focuses on a patient's ability to fight adversity. The difficulties encountered in clearly defining the processes associated with this subjective feeling of growth following recovery raise doubts concerning the real or illusory nature of the phenomenon and its adaptative value. This paper explains why cancer may be different than other traumas and why PTG may interact with this ecology of circumstances in different ways. Difficulty in identifying a single stressor, the internal source of the event, cancer as a future, ongoing and chronic integration threat, and greater perceived control differences between cancer and others traumas. This review brings together the latest studies of PTG in cancer, and focuses in the debate of the real or illusory nature of the PTG and his adaptative value. The ongoing threat, uncertainty and vulnerability associated with cancer are the variables that have been related most consistently with PTG and tend to confuse the relationship between PTG and emotional well-being, too.