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Andreu Y, Soto-Rubio A, Picazo C, Gil-Juliá B, Fernández S, Chulvi R. Risk of cancer-related distress by age in colorectal cancer survivors: The modulatory role of unmet support needs. J Health Psychol 2024:13591053241253358. [PMID: 38898666 DOI: 10.1177/13591053241253358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
To explore the modulating role of unmet support needs on the relationship between age and the prevalence of cancer-related distress in colorectal cancer (CRC) survivors. Two hundred and forty four participants completed the questionnaires; linear regression and odd ratios were calculated. Both the prevalence of needs and their interaction with age were predictors of cancer-related distress. The risk of significant clinically distress associated with physical and socio/family needs was high in both age subgroups. Higher risk of clinical distress was associated with life perspective, sexual, occupational and health care needs in the younger subgroup and with needs for specific support resources in the older subgroup. In reducing cancer-related distress, two key issues arise: (i) the importance of managing the persistent negative symptoms following CRC treatment in survivors of any age and (ii) the need for a differentiated attention to other care needs based on the survivor's age.
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Affiliation(s)
| | | | | | | | | | - R Chulvi
- Medical Oncology Service, Doctor Peset University Hospital, Valencia, Spain
- FISABIO, Valencia, Spain
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2
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Yi Y, Yang Y, Shi X, Yang X. The unmet rehabilitation needs of colorectal cancer survivors after surgery: A qualitative meta-synthesis. Nurs Open 2024; 11:e2051. [PMID: 38268281 PMCID: PMC10697127 DOI: 10.1002/nop2.2051] [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: 05/17/2023] [Revised: 10/28/2023] [Accepted: 11/09/2023] [Indexed: 01/26/2024] Open
Abstract
AIM To systematically review and synthesize the findings of qualitative research on the unmet rehabilitation needs of colorectal cancer survivors (CRC) after surgery. DESIGN A qualitative meta-synthesis registered with PROSPERO (CRD42022368837). METHODS CNKI, Wanfang Data, PubMed, Scopus, Embase, Cochrane, Medline, PsychINFO and CINAHL were systematically searched for qualitative studies on the rehabilitation needs of CRC survivors after surgery from the inception of each database to September 2022. RESULTS A total of 917 relevant reports were initially collected and 14 studies were finally included. A total of 49 needs were extracted and divided into 15 categories in 6 integrated findings: (1) the need to adopt healthy eating habits; (2) the need for exercise motivation and exercise guidance; (3) the conflicting needs to return to work; (4) unaddressed physiological needs; (5) spiritual needs; (6) the need for multi-dimensional social support. PATIENT OR PUBLIC CONTRIBUTION Not applicable.
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Affiliation(s)
- Yingying Yi
- School of Nursing, Hubei University of MedicineShiyanChina
| | - Yinhao Yang
- School of Nursing, Hubei University of MedicineShiyanChina
| | - Xixi Shi
- Institute of Cancer Clinical Prevention and Control & Medical Department of Jingchu University of TechnologyJingmenChina
| | - Xueqin Yang
- Institute of Cancer Clinical Prevention and Control & Medical Department of Jingchu University of TechnologyJingmenChina
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Lim CYS, Laidsaar-Powell RC, Young JM, Kao SCH, Zhang Y, Butow P. Colorectal cancer survivorship: A systematic review and thematic synthesis of qualitative research. Eur J Cancer Care (Engl) 2021; 30:e13421. [PMID: 33733545 DOI: 10.1111/ecc.13421] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/06/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION With rapid changes in treatments for colorectal cancer (CRC), qualitative research into CRC survivorship requires greater synthesis. This paper aims to fill this gap through a systematic review (PROSPERO CRD42019131576) and thematic synthesis of the qualitative literature on survivorship experiences across early-stage and advanced CRC survivors. METHODS CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched for qualitative CRC survivorship papers. Titles, abstracts and full texts were screened. Included articles (n = 81) underwent data extraction, CASP qualitative bias ratings and thematic synthesis. RESULTS Bowel dysfunction caused functional limitations and negative quality of life (QoL), while stomas posed threats to body image and confidence. Physical symptoms hindered return to work, increasing financial burdens. Survivors' unmet needs included information regarding symptom expectations and management, and ongoing support throughout recovery. Advanced and early-stage survivors shared similar experiences. Advanced survivors struggled with fear of cancer recurrence/progression and feelings of powerlessness. Functional limitations, financial impacts and sexuality in advanced survivors were underexplored areas. CONCLUSION CRC and its treatments impact survivors' QoL in all areas. A coordinated supportive care response is required to address survivors' unmet needs. Future qualitative studies should explore advanced CRC subpopulations, treatment-specific impacts on QoL and long-term (>5 years) impacts on CRC survivors.
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Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Clare Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,RPA Institute of Academic Surgery (IAS) and Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia
| | - Steven Chuan-Hao Kao
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Australian National University Research School of Population Health, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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Kaiser M, Adami S, Lucius-Hoene G, Muller-Nordhorn J, Goerling U, Breuning M, Holmberg C. Learning-by-doing: the importance of experiential knowledge sharing for meeting the information needs of people with colorectal cancer in Germany-a qualitative study. BMJ Open 2021; 11:e038460. [PMID: 33622937 PMCID: PMC7907857 DOI: 10.1136/bmjopen-2020-038460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 01/14/2021] [Accepted: 01/30/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The aim of this article is to understand how, when and why the topics of information and information needs arise when people diagnosed with colorectal cancer (CRC) narrate their illness experiences. METHODS Guided by principles of grounded theory, a qualitative interview study was conducted that collected a wide variety of illness experiences with CRC in Germany using maximum variation sampling. Sampling criteria included place of residence, age at interview, age at diagnosis, treatment, disease course and sociodemographic factors such as varying family backgrounds and professions. SETTING AND PARTICIPANTS Men and women diagnosed with CRC in different parts of Germany were sought via physicians, social workers and psychologists in hospital settings, organisations offering psychosocial support for patients with cancer, self-help groups, rehabilitation centres, newspapers and personal contacts. The interviewees in the final sample (n=41) had been diagnosed with CRC between 4 weeks and 36 years prior to the interview. RESULTS Three inter-related categories of information needs emerged from the analysis: the need for non-medical information for daily life; the challenge of integrating the bodily changes that accompany CRC in everyday life; and sources of non-medical information concerning handling daily life. Learning to live with the bodily changes of CRC in everyday life was described as a long process of learning-by-doing. While sources for medical information were clear, finding practical information was often a challenge. The best source of such information was often seen to be other people living with the disease, who shared their experiential knowledge, as well as stoma and nutritional therapists. CONCLUSION Information needs are part of the process and struggle to normalise everyday life after a disruptive diagnosis and treatment. Providing access to practical knowledge and information from others with CRC experience may be an important resource for patient support.
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Affiliation(s)
- Maleen Kaiser
- Institute of Public Health, Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Sandra Adami
- Fachklinik für Psychosomatische Medizin und Psychotherapie, Celenus Fachklinik Freiburg, Freiburg, Germany
| | - Gabriele Lucius-Hoene
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Ute Goerling
- Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Martina Breuning
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg/Havel, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg/Havel, Germany
- Berlin School of Public Health, Charite Universitätsmedizin Berlin, Berlin, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany
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McGeechan GJ, Byrnes K, Campbell M, Carthy N, Eberhardt J, Paton W, Swainston K, Giles EL. A systematic review and qualitative synthesis of the experience of living with colorectal cancer as a chronic illness. Psychol Health 2021; 37:350-374. [PMID: 33499649 DOI: 10.1080/08870446.2020.1867137] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Advances in detection and treatment mean that over 50% of people diagnosed with colorectal cancer can expect to live for more than ten years following treatment. Studies show that colorectal cancer patients can experience numerous physical and psychological late effects. The aim of this study was to conduct a systematic review and qualitative synthesis on the experiences of living with colorectal cancer as a chronic illness. METHODS Electronic searches of online databases were undertaken of peer reviewed and grey literature. Forty-seven papers were eligible for inclusion in the review, capturing the experiences of over 700 participants, the findings from which were analysed using thematic synthesis. RESULTS Three higher order concepts were identified which were prevalent across studies and countries and which related to the supportive care needs of patients; common physical and psychological late effects of cancer; and methods of psychosocial adjustment to living with and beyond colorectal cancer. CONCLUSION The results are considered in the context of existing theoretical approaches to chronic illness and the need to develop a theoretical approach which fully encapsulates the experience of living with colorectal cancer as a chronic illness in order to inform interventions to support patient adjustment.
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Affiliation(s)
- Grant J McGeechan
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Kate Byrnes
- Centre for Public Health, Teesside University, Middlesbrough, UK
| | - Miglena Campbell
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Nikki Carthy
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Judith Eberhardt
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Wendy Paton
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Katherine Swainston
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
| | - Emma L Giles
- Centre for Public Health, Teesside University, Middlesbrough, UK
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Sremanakova J, Sowerbutts AM, Todd C, Cooke R, Burden S. Healthy Eating and Active Lifestyle After Bowel Cancer (HEAL ABC): feasibility randomised controlled trial protocol. Pilot Feasibility Stud 2020; 6:176. [PMID: 33292854 PMCID: PMC7661321 DOI: 10.1186/s40814-020-00721-y] [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: 05/19/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022] Open
Abstract
Background Targeting modifiable lifestyle factors including diet and physical activity represents a potentially cost-effective strategy that could support a growing population of colorectal cancer survivors and improve their health outcomes. Currently, effective, evidence-based interventions and resources helping people after bowel cancer to adopt new lifestyle habits are lacking. The aim of this trial is to test the Healthy Eating and Active Lifestyle After Bowel Cancer (HEAL-ABC) intervention to inform a future definitive randomised controlled trial. Methods/design This is a feasibility randomised controlled trial. A total of 72 survivors who have completed surgery and all anticancer treatments will be recruited. The intervention group will receive HEAL-ABC resources based on behaviour change theory combined with supportive telephone calls informed by motivational interviewing every 2 weeks during the 3-month intervention, and once a month for 6 months to follow-up. Participants in the control group will follow usual care and have access to resources available in the public domain. The study is testing feasibility of the intervention including adherence and ability to collect data on anthropometry, body composition, diet, physical activity, behaviour change, quality of life, blood markers, contact with healthcare services, morbidities and overall survival. Discussion The proposed study will add to the evidence base by addressing an area where there is a paucity of data. This study on lifestyle interventions for people after colorectal cancer follows the Medical Research Council guidance on evaluating complex interventions in clinical practice. It focuses on people living after treatment for colorectal cancer and targets an important research area identified by cancer survivors as a research priority reported by the National Cancer Institute and James Lind Alliance UK. Trial registration ClinicalTrials.gov NCT04227353 approved on the 13th of January 2020 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-020-00721-y.
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Affiliation(s)
- Jana Sremanakova
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. .,Manchester Academic Health Science Centre, Manchester, UK.
| | - Anne Marie Sowerbutts
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.,Manchester Academic Health Science Centre, Manchester, UK
| | - Chris Todd
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.,Manchester Academic Health Science Centre, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK.,NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
| | - Richard Cooke
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Sorrel Burden
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.,Manchester Academic Health Science Centre, Manchester, UK.,NIHR Applied Research Collaboration Greater Manchester, Manchester, UK.,Salford Royal NHS Foundation Trust, Salford, UK
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Sremanakova J, Jones D, Cooke R, Burden S. Exploring Views of Healthcare Professionals, Researchers, and People Living with and beyond Colorectal Cancer on a Healthy-Eating and Active Lifestyle Resource. Nutrients 2019; 11:E2482. [PMID: 31623177 PMCID: PMC6835229 DOI: 10.3390/nu11102482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/03/2019] [Accepted: 10/09/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND People after bowel cancer are at high risk of cancer recurrences and co-morbidities, and therefore strategies are needed to reduce these risks. One promising strategy targets modifiable lifestyle factors including diet and physical activity. However, effective, evidence-based resources in adopting new lifestyle habits are currently lacking. METHODS The Healthy-Eating and Active Lifestyle After Bowel Cancer (HEAL ABC) resource was developed incorporating behavior change theory and World Cancer Research Fund and American Institute of Cancer Research guidelines. Focus groups and telephone interviews were conducted with professionals and survivors (age ≥18 years) to obtain feedback on the resource layout, structure, and content. Recorded data were transcribed verbatim and analyzed using framework analysis. RESULTS Thirty participants evaluated the resource-19 cancer survivors and 11 professionals. Survivors' mean age was 62 years (SD 11.5), 11 (58%) were females and 8 (42%) were male. Professionals were all females and mean age was 40 years (SD 6.06). Both survivors and professionals evaluated the resource as useful and provided suggestions for improvements. CONCLUSIONS HEAL ABC is an evidence-based resource designed to aid cancer survivors in translating their motivation into action. It was valued positively by both survivors and healthcare professionals and viewed as filling a gap in post-treatment advice.
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Affiliation(s)
- Jana Sremanakova
- School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
| | - Debra Jones
- School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
| | - Richard Cooke
- Department of Psychology, University of Liverpool, Bedford Street South, Liverpool L69 7ZA, UK.
| | - Sorrel Burden
- School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
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Tiranda Y, Siripul P, Sangchart B, Septiwi C. Perspectives of adult survivors of colorectal cancer with an ostomy on their needs: synthesis of qualitative research studies. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2019. [DOI: 10.15452/cejnm.2019.10.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Cavers D, Habets L, Cunningham-Burley S, Watson E, Banks E, Campbell C. Living with and beyond cancer with comorbid illness: a qualitative systematic review and evidence synthesis. J Cancer Surviv 2019; 13:148-159. [PMID: 30685822 PMCID: PMC6394454 DOI: 10.1007/s11764-019-0734-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/11/2019] [Indexed: 12/22/2022]
Abstract
Purpose To identify the qualitative evidence on the experience of cancer and comorbid illness from the perspective of patients, carers and health care professionals to identify psycho-social support needs, experience of health care, and to highlight areas where more research is needed. Methods A qualitative systematic review following PRISMA guidance. Relevant research databases were searched using an exhaustive list of search terms. Two reviewers independently screened titles and abstracts and discussed variations. Included articles were subject to quality appraisal before data extraction of article characteristics and findings. Thomas and Harden’s thematic synthesis of extracted findings was undertaken. Results Thirty-one articles were included in the review, covering a range of cancer types and comorbid conditions; with varying time since cancer diagnosis and apparent severity of disease for both cancer and other conditions. The majority of studies were published after 2010 and in high income countries. Few studies focused exclusively on the experience of living with comorbid conditions alongside cancer; such that evidence was limited. Key themes identified included the interaction between cancer and comorbid conditions, symptom experience, illness identities and ageing, self-management and the role of primary and secondary care. Conclusions In addition to a better understanding of the complex experience of cancer and comorbidity, the review will combine with research prioritisation work with consumers to inform an interview study with the defined patient group. Implications for Cancer Survivors Expanding this evidence base will help to illuminate developing models of cancer patient-centred follow-up care for the large proportion of patients with comorbid conditions. Electronic supplementary material The online version of this article (10.1007/s11764-019-0734-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Debbie Cavers
- Usher Institute, Medical School, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK.
| | - Liset Habets
- Leiden University Medical Center, University of Leiden, Albinusdreef 2, 2333, Leiden, ZA, Netherlands
| | - Sarah Cunningham-Burley
- Medical and Family Sociology, Usher Institute, Medical School, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Eila Watson
- Supportive Cancer Care, Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Marston, Oxford, OX3 0FL, UK
| | - Elspeth Banks
- , 1 Carnwath Lane, Carluke, South Lanarkshire, ML8 4QU, UK
| | - Christine Campbell
- Usher Institute, Medical School, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
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Drury A, Payne S, Brady AM. Cancer survivorship: Advancing the concept in the context of colorectal cancer. Eur J Oncol Nurs 2017; 29:135-147. [PMID: 28720260 DOI: 10.1016/j.ejon.2017.06.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/10/2017] [Accepted: 06/21/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE Previous conceptualizations of cancer survivorship have focused on heterogeneous cancer survivors, with little consideration of the validity of conclusions for homogeneous tumour groups. This paper aims to examine the concept of cancer survivorship in the context of colorectal cancer (CRC). METHOD Rodgers' (1989) Evolutionary Method of Concept Analysis guided this study. A systematic search of PUBMED, CINAHL, PsycINFO and The Cochrane Library was conducted in November 2016 to identify studies of CRC survivorship. The Braun and Clarke (2006) framework guided the analysis and interpretation of data extracted from eighty-five publications. RESULTS Similar to general populations of cancer survivors, CRC survivors experience survivorship as an individual, life-changing process, punctuated by uncertainty and a duality of positive and negative outcomes affecting quality of life. However, CRC survivors experience specific concerns arising from the management of their disease. The concept of cancer survivorship has evolved over the past decade as the importance of navigating the healthcare system and its resources, and the constellation of met and unmet needs of cancer survivors are realised. CONCLUSIONS The results highlight core similarities between survivorship in the context of CRC and other tumour groups, but underlines issues specific to CRC survivorship. Communication and support are key issues in survivorship care which may detrimentally affect CRC survivors' well-being if they are inadequately addressed. Healthcare professionals (HCP's) therefore have a duty to ensure cancer survivors' health, information and supportive care needs are met in the aftermath of treatment.
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Affiliation(s)
- Amanda Drury
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland.
| | - Sheila Payne
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland; Centre for Practice and Healthcare Innovation, School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland
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Thomsen TG, Soelver L, Hølge-Hazelton B. The influence of contextual factors on patient involvement during follow-up consultations after colorectal cancer surgery: a case study. J Clin Nurs 2017; 26:3688-3698. [PMID: 28122412 DOI: 10.1111/jocn.13741] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify the contextual factors that influence individual patient involvement during colorectal cancer surgical follow-up consultations. BACKGROUND The healthcare system is subject to the requirement and expectation of greater involvement of patients and relatives. Increased patient involvement requires the development and implementation of new communication initiatives. Research shows that it is also necessary to consider the contextual circumstances surrounding patient involvement in specific situations. DESIGN Case study of a single Danish outpatient clinic, which allows the issues and circumstances involved in an everyday situation to be captured. METHOD 12 nonparticipative observations of outpatient visits and, subsequently, seven in-depth patient interviews. ANALYSIS Content analysis based on a dialogical, interactive framework, which underpinned the identification of current contextual factors. RESULTS The results showed five contextual factors that seemed to have an impact on patient involvement. The first, 'Two dimensions of patient involvement: treatment-oriented and person-oriented' highlighted a dual interpretation of patient involvement in the consultation situation. The two dimensions seemed to be influenced by four additional factors: 'Doctors leading the agenda', 'Traditional health professional roles', 'Unclear responsibilities' and 'Guidance primarily focused on treatment'. CONCLUSION The results showed how patient involvement in clinical practice could be understood as a two-way movement, in which patients are invited to participate in clinical practice, while health professionals are invited to participate in the patients' lives. The movement will change from situation to situation and is influenced by several contextual factors. RELEVANCE TO CLINICAL PRACTICE The results can help doctors and nurses to navigate using a goal-oriented approach towards patient involvement. The study makes visible the need for research-based development of the independent role of the nursing profession in cancer care follow-up, with a view to enhanced patient-centred care.
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Affiliation(s)
- Thora G Thomsen
- Research Unit, Zealand University Hospital, Roskilde, Denmark.,Institute of Regional Health Services Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | - Lisbeth Soelver
- Bispebjerg and Frederiksberg Hospital, Digestive Center, University of Copenhagen, Copenhagen, Denmark
| | - Bibi Hølge-Hazelton
- Research Unit, Zealand University Hospital, Roskilde, Denmark.,Institute of Regional Health Services Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
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Abstract
AbstractObjectiveIn 2011, Dietitians of Canada added ‘My Goals’ to its website-based nutrition/activity tracking program (eaTracker®,http://www.eaTracker.ca/); this feature allows users to choose ‘ready-made’ or ‘write-your-own’ goals and to self-report progress. The purpose of the present study was to document experiences and perceptions of goal setting and My Goals, and report users’ feedback on what is needed in future website-based goal setting/tracking tools.DesignOne-on-one semi-structured interviews were conducted with (i) My Goals users and (ii) dietitians providing a public information support service, EatRight Ontario (ERO).SettingMy Goals users from Ontario and Alberta, Canada were recruited via an eaTracker website pop-up box; ERO dietitians working in Ontario, Canada were recruited via ERO.SubjectsMy Goals users (n23; age 19–70 years; 91 % female;n5 from Alberta/n18 from Ontario) and ERO dietitians (n5).ResultsDietitians and users felt goal setting for nutrition (and activity) behaviour change was both a beneficial and a challenging process. Dietitians were concerned about users setting poor-quality goals and users felt it was difficult to stick to their goals. Both users and dietitians were enthusiastic about the My Goals concept, but felt the current feature had limitations that affected use. Dietitians and users provided suggestions to improve My Goals (e.g. more prominent presence of My Goals in eaTracker; assistance with goal setting; automated personalized feedback).ConclusionsDietitians and users shared similar perspectives on the My Goals feature and both felt goal use was challenging. Several suggestions were provided to enhance My Goals that are relevant to website-based goal setting/tracking tool design in general.
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Lieffers JRL, Haresign H, Mehling C, Hanning RM. A retrospective analysis of real-world use of the eaTracker® My Goals website by adults from Ontario and Alberta, Canada. BMC Public Health 2016; 16:978. [PMID: 27628048 PMCID: PMC5024431 DOI: 10.1186/s12889-016-3640-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 09/05/2016] [Indexed: 11/09/2022] Open
Abstract
Background Little is known about use of goal setting and tracking tools within online programs to support nutrition and physical activity behaviour change. In 2011, Dietitians of Canada added “My Goals,” a nutrition and physical activity behaviour goal setting and tracking tool to their free publicly available self-monitoring website (eaTracker® (http://www.eaTracker.ca/)). My Goals allows users to: a) set “ready-made” SMART (Specific, Measurable, Attainable, Realistic, Time-related) goals (choice of n = 87 goals from n = 13 categories) or “write your own” goals, and b) track progress using the “My Goals Tracker.” The purpose of this study was to characterize: a) My Goals user demographics, b) types of goals set, and c) My Goals Tracker use. Methods Anonymous data on all goals set using the My Goals feature from December 6/2012-April 28/2014 by users ≥19y from Ontario and Alberta, Canada were obtained. This dataset contained: anonymous self-reported user demographic data, user set goals, and My Goals Tracker use data. Write your own goals were categorized by topic and specificity. Data were summarized using descriptive statistics. Multivariate binary logistic regression was used to determine associations between user demographics and a) goal topic areas and b) My Goals Tracker use. Results Overall, n = 16,511 goal statements (75.4 % ready-made; 24.6 % write your own) set by n = 8,067 adult users 19-85y (83.3 % female; mean age 41.1 ± 15.0y, mean BMI 28.8 ± 7.6kg/m2) were included for analysis. Overall, 33.1 % of ready-made goals were from the “Managing your Weight” category. Of write your own goal entries, 42.3 % were solely distal goals (most related to weight management); 38.6 % addressed nutrition behaviour change (16.6 % had unspecific general eating goals); 18.1 % addressed physical activity behaviour change (47.3 % had goals without information on exercise amount and type). Many write your own goals were poor quality (e.g., non-specific (e.g., missing amounts)), and possibly unrealistic (e.g., no sugar). Few goals were tracked (<10 %). Demographic variables had statistically significant relations with goal topic areas and My Goals Tracker use. Conclusions eaTracker® users had high interest in goal setting and the My Goals feature, however, self-written goals were often poor quality and goal tracking was rare. Further research is needed to better support users. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3640-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jessica R L Lieffers
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Helen Haresign
- EatRight Ontario/Dietitians of Canada, 480 University Avenue, Suite 604, Toronto, Ontario, M5G 1V2, Canada
| | - Christine Mehling
- EatRight Ontario/Dietitians of Canada, 480 University Avenue, Suite 604, Toronto, Ontario, M5G 1V2, Canada
| | - Rhona M Hanning
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
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14
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Frazelle ML, Friend PJ. Optimizing the Teachable Moment for Health Promotion for Cancer Survivors and Their Families. J Adv Pract Oncol 2016; 7:422-433. [PMID: 29226000 PMCID: PMC5679031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Melissa L Frazelle
- Loyola University Chicago, Marcella Niehoff School of Nursing, Chicago, Illinois
| | - Patricia J Friend
- Loyola University Chicago, Marcella Niehoff School of Nursing, Chicago, Illinois
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15
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Walker R, Szanton SL, Wenzel J. Working Toward Normalcy Post-Treatment: A Qualitative Study of Older Adult Breast and Prostate Cancer Survivors. Oncol Nurs Forum 2015; 42:E358-67. [PMID: 26488842 PMCID: PMC4750471 DOI: 10.1188/15.onf.e358-e367] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To develop a better understanding of how older adult survivors of early-stage breast and prostate cancer managed the work of recovery.
. RESEARCH APPROACH Multiple case study design embedded in a larger randomized, controlled trial of a nurse-led patient navigation intervention.
. SETTING Community-based research conducted via in-home visits and by phone with participants residing in non-metropolitan areas of a mid-Atlantic state.
PARTICIPANTS Rural-dwelling adults aged 60 years or older with early-stage breast or prostate cancer and the people who support them (11 dyads).
METHODOLOGIC APPROACH An approach to grounded theory analysis was used to evaluate the fit between existing theoretical knowledge and case findings and to generate new knowledge about the cancer recovery process.
FINDINGS Working toward normalcy was a core process of cancer recovery prompted by participants' internal experiences and external interactions with their environments. This ongoing, iterative, and active process involved multiple concurrent strategies that were not necessarily medically oriented or cancer specific. Working toward normalcy resulted in movement along a continuum of self-appraisal anchored between participants experiencing life as completely disrupted by cancer to a life back to normal. A greater sense of normalcy was associated with higher engagement in valued activities and increased physical and psychological well-being.
CONCLUSIONS In addition to the core process of working toward normalcy, multiple theories from nursing, sociology, psychology, and gerontology helped to explain case findings. This knowledge could serve as a foundation on which to design survivorship care that supports the goals of cancer survivors working toward normalcy post-treatment. INTERPRETATION Post-treatment wellness goals can include a desire to reestablish or maintain a sense of normalcy. Nursing actions that promote survivors' efforts to be perceived as capable, stay engaged in valued activities and roles, maintain a sense of control over their lives and bodies, and make plans for the future may help meet this goal. Existing theories about identity, dignity, inner strength, and the work of illness can inform nursing interventions.
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Affiliation(s)
- Rachel Walker
- Assistant professor in the College of Nursing at the University of Massachusetts Amherst
| | - Sarah L. Szanton
- Associate professor in the Department of Community and Public Health, School of Nursing at Johns Hopkins University in Baltimore, MD
| | - Jennifer Wenzel
- Assistant professor in the Department of Acute and Chronic Care, School of Nursing at Johns Hopkins University in Baltimore, MD
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16
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Knobf M, Cooley M, Duffy S, Doorenbos A, Eaton L, Given B, Mayer D, McCorkle R, Miaskowski C, Mitchell S, Sherwood P, Bender C, Cataldo J, Hershey D, Katapodi M, Menon U, Schumacher K, Sun V, Ah D, LoBiondo-Wood G, Mallory G. The 2014–2018 Oncology Nursing Society Research Agenda. Oncol Nurs Forum 2015; 42:450-65. [DOI: 10.1188/15.onf.450-465] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Boger E, Ellis J, Latter S, Foster C, Kennedy A, Jones F, Fenerty V, Kellar I, Demain S. Self-Management and Self-Management Support Outcomes: A Systematic Review and Mixed Research Synthesis of Stakeholder Views. PLoS One 2015; 10:e0130990. [PMID: 26162086 PMCID: PMC4498685 DOI: 10.1371/journal.pone.0130990] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/27/2015] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Self-management has received growing attention as an effective approach for long-term condition management. Little is known about which outcomes of supported self-management are valued by patients, their families, health professionals and those who commission self-management services. This study systematically reviewed published empirical evidence in accordance with PRISMA guidelines to determine the outcomes of self-management valued by these key stakeholder groups, using three prominent exemplar conditions: colorectal cancer, diabetes and stroke. AIM To systematically review the literature to identify which generic outcomes of self-management have been targeted and are considered important using three exemplar conditions (colorectal cancer, diabetes and stroke), which collectively have a range of features that are likely to be representative of generic self-management issues. METHODS Systematic searching of nine electronic databases was conducted in addition to hand searches of review articles. Abstracts were identified against inclusion criteria and appraised independently by two reviewers, using a critical appraisal tool. Synthesis of findings was conducted using mixed research synthesis. RESULTS Over 20,536 abstracts were screened. 41 studies which met the review criteria were fully retrieved and appraised. The majority of evidence related to diabetes. Few studies directly focussed on stakeholders' views concerning desired self-management outcomes; the majority of evidence was derived from studies focusing upon the experience of self-management. The views of health care commissioners were absent from the literature. We identified that self-management outcomes embrace a range of indicators, from knowledge, skills, and bio-psychosocial markers of health through to positive social networks. CONCLUSIONS Patients', families', health professionals' and commissioners' views regarding which outcomes of self-management are important have not been clearly elicited. The extent to which bio-psychosocial indicators relate to successful self-management from the perspectives of all groups of stakeholders is unknown. Further investigation regarding which self-management outcomes are considered important by all stakeholders is necessary to guide the commissioning and design of future self-management services.
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Affiliation(s)
- Emma Boger
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Jaimie Ellis
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Sue Latter
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Claire Foster
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Anne Kennedy
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Fiona Jones
- Department of Social Care and Education, St George’s and Kingston University of London, London United Kingdom
| | - Vicky Fenerty
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Ian Kellar
- Institute of Psychological Sciences, University of Leeds, Leeds, United Kingdom
| | - Sara Demain
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
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18
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Hullmann SE, Robb SL, Rand KL. Life goals in patients with cancer: a systematic review of the literature. Psychooncology 2015; 25:387-99. [PMID: 25990641 DOI: 10.1002/pon.3852] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 03/16/2015] [Accepted: 04/14/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Purposes of this systematic review of life goal research in cancer patients were to (1) identify life goal characteristics and processes being examined, (2) describe instruments used to assess life goal constructs, (3) identify theoretical models being used to guide research, and (4) summarize what is known about the impact of the cancer experience on life goal characteristics, processes, and psychological outcomes. METHODS We conducted this systematic review using MEDLINE, PubMed, CINAHL, and PsycINFO databases. Inclusion criteria were as follows: (1) published between 1993 and 2014, (2) English language, (3) cancer patient population, and (4) original research articles that assessed life goal characteristics and/or goal processes. One hundred ninety-seven articles were screened and 27 included in the final review. RESULTS Seven life goal characteristics and seven life goal processes were identified, and less than half of studies investigated associations between goal characteristics and processes. Conceptual definitions were not provided for about half of the identified life goal constructs. Studies used both validated and author-developed instruments to assess goal constructs. Twenty-four different theoretical models were identified, with self-regulation theory most frequently cited. Overall, the literature suggests that cancer impacts patients' life goal characteristics and processes, and life goal disturbance is related to poorer psychological outcomes. CONCLUSIONS The impact of the cancer experience on life goals is an important and emerging area of research that would benefit from conceptual and theoretical clarity and measurement consistency.
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Affiliation(s)
| | - Sheri L Robb
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - Kevin L Rand
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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19
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Karel MJ, Mulligan EA, Walder A, Martin LA, Moye J, Naik AD. Valued life abilities among veteran cancer survivors. Health Expect 2015; 19:679-90. [PMID: 25645124 PMCID: PMC4869069 DOI: 10.1111/hex.12343] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2014] [Indexed: 01/12/2023] Open
Abstract
Background When patients have multiple chronic illnesses, it is not feasible to provide disease‐based care when treatments for one condition adversely affect another. Instead, health‐care delivery requires a broader person‐centred treatment plan based on collaborative, patient‐oriented values and goals. Objective We examined the individual variability, thematic content, and sociodemographic correlates of valued life abilities and activities among multimorbid veterans diagnosed with life‐altering cancer. Setting and participants Participants were 144 veterans in the ‘Vet‐Cares’ study who completed a health‐care values and goals scale 12 months after diagnosis of head and neck, gastro‐oesophageal, or colorectal cancer. They had mean age of 65 years and one quarter identified as Hispanic and/or African American. Design At twelve months post‐diagnosis, participants rated 16 life abilities/activities in their importance to quality of life on a 10‐point Likert scale, during an in‐person interview. Scale themes were validated via exploratory factor analysis and examining associations with sociodemographic variables. Results Participants rated most life abilities/activities as extremely important. Variability in responses was sufficient to identify three underlying values themes in exploratory factor analysis: self‐sufficiency, enjoyment/comfort, and connection to family, friends and spirituality. Veterans with a spouse/partner rated self‐sufficiency as less important. African American veterans rated connection as more important than did White veterans. Conclusions It is feasible yet challenging to ask older, multimorbid patients to rate relative importance of values associated with life abilities/activities. Themes related to self‐sufficiency, enjoyment/comfort in daily life and connection are salient and logically consistent with sociodemographic traits. Future studies should explore their role in goal‐directed health care.
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Affiliation(s)
- Michele J Karel
- Mental Health Service, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Mulligan
- Mental Health Service, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Annette Walder
- Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Lindsey A Martin
- Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer Moye
- Mental Health Service, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Aanand D Naik
- Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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