1
|
Holmberg K, Bergkvist K, Wengström Y, Hagelin CL. Dismantle and rebuild: the importance of preparedness and self-efficacy before, during and after allogeneic haematopoietic cell transplantation. J Cancer Surviv 2024:10.1007/s11764-024-01622-2. [PMID: 38829473 DOI: 10.1007/s11764-024-01622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/23/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE The aim of this study was to explore patients' experiences of being prepared for allogenic haematopoietic cell transplantation and to explore their perceived self-efficacy and preparedness for self-care after allogenic haematopoietic cell transplantation. METHODS Nine participants, who recently underwent allo-HCT, were interviewed regarding their views on preparedness, self-efficacy and self-care. The interviews were analysed using inductive qualitative content analysis. RESULTS An overarching theme, Life is taken apart, then you have to know how to put the pieces together, and four sub-themes: Convert information into something understandable; Taking responsibility, maintaining and preparing for an uncertain time in life; Balancing vigilance with independence; and Reorientating in an altered body places new demands on self-care illustrate the dismantlement of life during treatment and how actions and approaches can build a new life. CONCLUSIONS Both participants and healthcare professionals prioritised preparing for allo-HCT in the period before admission. However, during admission, preparation decreased and the time was not used for preparatory learning. This meant that participants were well prepared for the acute phase but unprepared for life after completion of treatment. Among the participants, self-efficacy was good. They sought information about taking care of their health before and in the aftermath of allo-HCT. IMPLICATIONS FOR CANCER SURVIVORS This study provides insight into, and knowledge about, how patients prepare before, during and after treatment. This knowledge should primarily be directed towards healthcare professionals to be used for future patients who may need advice and support, as well as continued preparation for a life after transplantation.
Collapse
Affiliation(s)
- Katarina Holmberg
- Karolinska Institutet, Stockholm, Sweden.
- Sophiahemmet University, Stockholm, Sweden.
| | - Karin Bergkvist
- Karolinska Institutet, Stockholm, Sweden
- Sophiahemmet University, Stockholm, Sweden
| | - Yvonne Wengström
- Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Stockholm, Sweden
| | - Carina Lundh Hagelin
- Karolinska Institutet, Stockholm, Sweden
- Marie Cederschiöld University, Stockholm, Sweden
| |
Collapse
|
2
|
Collaço N, Lippiett KA, Wright D, Brodie H, Winter J, Richardson A, Foster C. Barriers and facilitators to integrated cancer care between primary and secondary care: a scoping review. Support Care Cancer 2024; 32:120. [PMID: 38252169 PMCID: PMC10803398 DOI: 10.1007/s00520-023-08278-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
PURPOSE This scoping review identifies and characterises reported barriers and facilitators to providing integrated cancer care reported in the international literature, and develops recommendations for clinical practice. METHODS This scoping review included literature published between 2009 and 2022 and describes the delivery of integrated cancer care between primary and secondary care sectors. Searches were conducted of an online database Ovid Medline and grey literature. RESULTS The review included thirty-two papers. Barriers and facilitators to integrated cancer care were identified in three core areas: (1) at an individual user level around patient-healthcare professional interactions, (2) at an organisational level, and (3) at a healthcare system level. The review findings identified a need for further training for primary care professionals on cancer care, clarity in the delineation of primary care and oncologist roles (i.e. who does what), effective communication and engagement between primary and secondary care, and the provision of protocols and guidelines for follow-up care in cancer. CONCLUSIONS Information sharing and communication between primary and secondary care must improve to meet the increasing demand for support for people living with and beyond cancer. Delivering integrated pathways between primary and secondary care will yield improvements in patient outcomes and health economic costs.
Collapse
Affiliation(s)
- Nicole Collaço
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England
| | - Kate A Lippiett
- School of Health Sciences, University of Southampton, Southampton, England
| | - David Wright
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England
| | - Hazel Brodie
- School of Health Sciences, University of Southampton, Southampton, England
| | - Jane Winter
- Wessex Cancer Alliance, Oakley Road, Southampton, England
| | - Alison Richardson
- School of Health Sciences, University of Southampton, Southampton, England
- University Hospital Southampton NHS Foundation Trust, Southampton, England
| | - Claire Foster
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England.
| |
Collapse
|
3
|
Pallin ND, O'Connor M, Gannon A, Browne J, Cahill MR, O'Shea D. Experiences of and preferences for self-management among low grade non-Hodgkin's lymphoma survivors: A qualitative interview study. Eur J Oncol Nurs 2023; 66:102378. [PMID: 37506608 DOI: 10.1016/j.ejon.2023.102378] [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: 05/03/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE Supporting self-management is one strategy to help cancer survivors optimise their quality of life. Low grade non-Hodgkin's lymphoma is often incurable with a chronic disease trajectory requiring lifelong self-management. This study explored the views on self-management and preferences for self-management support among survivors of low grade non-Hodgkin's lymphoma and their informal caregivers more than 6 months after completion of systemic anti-cancer therapy. METHOD In-depth semi-structured telephone interviews were conducted. Key themes and subthemes were determined using inductive and deductive thematic analysis. RESULTS The sample included eight survivors of low grade non-Hodgkin's lymphoma and two family caregivers. There were four themes. 1) The chronic nature of low grade non-Hodgkin's lymphoma shapes perceptions of self-management; participants described their cancer as a chronic condition and self-management strategies reflected this. 2) Social networks enable self-management; participants emphasised the importance of making low grade non-Hodgkin's lymphoma survivors aware of social networks. 3) Support and monitoring are needed immediately after the initial treatment phase ends. 4) Preferred components of self-management support; this included regular review with monitoring, advice on diet, and strategies to manage the psychosocial consequences of low grade non-Hodgkin's lymphoma. CONCLUSIONS Providing self-management support to those diagnosed with low grade non-Hodgkin's lymphoma is relevant given the chronic trajectory of the disease. Findings suggest that necessary components of a self-management support programme for those with low grade non-Hodgkin's lymphoma should include regular review with monitoring and practical support around facilitating engagement with social networks.
Collapse
Affiliation(s)
- Nickola D Pallin
- School of Public Health, University College Cork, Cork, Ireland.
| | | | - Alannah Gannon
- HSE National Data Protection Office, Dr Steevens Hospital, Steevens Lane, Dublin, Ireland
| | - John Browne
- School of Public Health, University College Cork, Cork, Ireland
| | - Mary R Cahill
- Department of Haematology, Cork University Hospital, Wilton, Ireland
| | - Derville O'Shea
- Department of Haematology, Cork University Hospital, Wilton, Ireland
| |
Collapse
|
4
|
Thilges S, Mumby P, Sinacore J, Clark J, Czerlanis C. Implementing a cognitive behavioral intervention for patients with head and neck cancer. Support Care Cancer 2023; 31:476. [PMID: 37466682 DOI: 10.1007/s00520-023-07948-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Sequelae of and therapies for head and neck cancers (HNC) are associated with physical and functional impairment as well as increased levels of psychological distress post treatment. Given the impact of HNC and treatment on functioning (i.e., eating and talking), health-related quality of life (HRQOL) is a significant area of survivorship concern within this population. Although prior research indicates that the incidence of anxiety and depression ranges from 15 to 50%, to date, there is a paucity of research on specific psychosocial interventions related to HNC treatment and completed studies have been limited by infrequent use of a randomized design and provision of non-standardized psychosocial interventions. This study aimed to address these gaps and utilize a brief cognitive behavioral intervention (CBI) to improve (1) self-efficacy for coping with cancer, (2) depressive symptoms, (3) other psychological symptoms, and (4) HRQOL among patients with HNC. METHODS In an effort to conduct a randomized clinical trial of those undergoing treatment for HNC, eighty-eight patients were assigned to receive either a standardized CBI or usual psychological care (N = 47 and 41, respectively) with a 1-year follow-up. The means of all variables for both groups, adjusted for baseline, were visually compared at 3, 6, and 12 months post treatment. RESULTS As has been a challenge in other longitudinal HNC studies, a high degree of attrition occurred, with a loss of 35 patients from the CBI group and 29 from the usual care group. Despite the high attrition, analysis of existing data indicated that the effect of CBI was discernable among the patients who completed the course of the study. Of the 38 comparisons, 34 showed that the CBI group had the favorable outcome. Important considerations for implementation of a structured psychotherapy intervention during active cancer treatment with multiple barriers including communication challenges and practical limitations were realized. CONCLUSIONS The impact of HNC treatment can be particularly distressing as it often results in functional impairment and markedly changed activities of daily living among survivors. However, engaging in therapeutic methods to cope and manage distress during treatment can influence QOL and mood into the survivorship phase.
Collapse
Affiliation(s)
- Sarah Thilges
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA.
| | - Patricia Mumby
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - James Sinacore
- Department of Public Health Sciences, Loyola University, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - Joseph Clark
- Department of Hematology and Oncology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - Cheryl Czerlanis
- Department of Hematology and Oncology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
| |
Collapse
|
5
|
Holmberg K, Bergkvist K, Adalsteinsdóttir S, Wengström Y, Lundh Hagelin C. Nursing as a balancing act in allogeneic hematopoietic cell transplantation -nurses' experiences through participation in workshops. Eur J Oncol Nurs 2023; 63:102300. [PMID: 36893569 DOI: 10.1016/j.ejon.2023.102300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/09/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
PURPOSE Registered nurses have a key role in supporting patients during the trajectory of allogeneic hematopoietic cell transplantation (allo-HCT). However, the circumstances for performing nursing are not previously outlined therefore the purpose of this study was to explore the conditions for nursing care in allo-HCT. METHOD An explorative design, inspired by Experienced based co-design was used to gather experiences, thoughts and visions of nursing care in allo-HCT by means of workshops. Thematic analysis was applied to analyse the data. RESULT An overarching theme that was defined from the data was nursing as a balancing act and illustrating conditions for performing nursing in a highly medical-technical environment. The theme included three sub-themes: Fragmented care vs holistic care outlining how the holistic approach to care disappeared when the care became fragmented; Proximity vs distance illuminating the balance between seeing the patient as an independent person despite illness and the need for support; Teamwork vs stand-alone demonstrating the difficulties inherent in adapting to both teamwork and independence in nursing. CONCLUSION This study shows that the conditions for RNs and nursing care in allo-HCT care is to balance tasks and approach towards the patient and themselves. RNs must weigh and balance what is most important in the moment and where something else often has to be put aside. It is difficult for RNs to find the time to plan each patient's care and to support the patient in the way they see as most optimal to prepare for discharge, self-care and rehabilitation.
Collapse
Affiliation(s)
- Katarina Holmberg
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Department of Nursing, Sophiahemmet University, Stockholm, Sweden.
| | - Karin Bergkvist
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Department of Nursing, Sophiahemmet University, Stockholm, Sweden
| | | | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Karolinska Comprehensive Cancer Centre, Karolinska University Hospital, Stockholm, Sweden; Cancer Theme, Breast Centre, Karolinska University Hospital, Stockholm, Sweden
| | - Carina Lundh Hagelin
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
| |
Collapse
|
6
|
Boland V, Drury A, Sheaf G, Brady AM. Living with or beyond lymphoma: A rapid review of the unmet needs of lymphoma survivors. Psychooncology 2022; 31:1076-1101. [PMID: 35670252 PMCID: PMC9545574 DOI: 10.1002/pon.5973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/04/2022] [Accepted: 05/29/2022] [Indexed: 11/08/2022]
Abstract
Objective To establish an understanding of the unmet needs of people living with or beyond a lymphoma diagnosis. Survivors of lymphoma are at increased risk of unmet needs due to cancer, treatment‐related toxicities and extended survivorship. Despite the rapidly growing numbers of lymphoma survivors, their needs and research priorities are underserved and undervalued, therefore left largely unaddressed. Methods A rapid review method and reflexive thematic analysis approach assimilated current knowledge. Eligibility criteria included quantitative, qualitative, or mixed approaches employing cross‐sectional, longitudinal, cohort or review designs focused on the needs of adult lymphoma survivors (any subtype or stage of disease). Five databases: CINAHL, EMBASE, Medline, PsycInfo and Scopus, were systematically searched. Results Forty‐seven studies met the inclusion criteria via a stringent screening process facilitated by NVivo. Almost 60 per cent of articles were published within the last five years and investigated a homogenous lymphoma sample. Most studies employed quantitative approaches (77%) and cross‐sectional designs (67%). Studies were of high methodological quality. Five major themes were identified: disparity in health service delivery, the psychological impact of cancer, impactful and debilitating concerns, the monetary cost of survival and insufficient provision of survivorship information. A meta‐analytical approach was not feasible due to the breadth of methodologies of included studies. Conclusions This review shows that lymphoma survivors experience a myriad of unmet needs across multiple domains, reinforcing the need for lymphoma‐specific research. However, more research is needed to advance and achieve informed decision‐making relating to survivorship care, placing due attention to the needs and research priorities of lymphoma survivors.
Collapse
Affiliation(s)
- Vanessa Boland
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland, D02 T283
| | - Amanda Drury
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland, D04 V1W8
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin, 2, Ireland
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland, D02 T283
| |
Collapse
|
7
|
Malartre-Sapienza S, Buono R, Sontag P. [Post-treatment, a delicate and insufficiently structured period]. REVUE DE L'INFIRMIERE 2022; 71:24-26. [PMID: 35843637 DOI: 10.1016/j.revinf.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In France, the number of cancer survivors is expected to increase significantly in the coming years. However, there seems to be a lack of identification and management of complications after treatment. Coordination nurses and advanced practice nurses play a fundamental and complementary role to physicians in responding to this problem.
Collapse
Affiliation(s)
| | - Romain Buono
- Centre Léon-Bérard, 28 rue Laennec, 69373 Lyon cedex 08, France
| | - Pascale Sontag
- Centre Léon-Bérard, 28 rue Laennec, 69373 Lyon cedex 08, France
| |
Collapse
|
8
|
Survivors' preferences for the organization and delivery of supportive care after treatment: An integrative review. Eur J Oncol Nurs 2021; 54:102040. [PMID: 34571444 DOI: 10.1016/j.ejon.2021.102040] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE Quality supportive care during cancer survivorship contributes to positive physical and psychosocial health. However, the potential positive impacts are influenced by survivors' perceptions of and ability to access the supportive care services that they deem important to their well-being. The purpose of this integrative review was to examine cancer survivors' preferences for the organization and delivery of supportive care services in the post-treatment period. METHODS We conducted a systematic search for relevant quantitative, qualitative and mixed methods studies. Included studies were analyzed using directed content analysis, focused on models of care and type of provider, site of care, specialized services, structural supports through transitions, and sources of information. RESULTS Sixty-nine studies were included. Overall, survivors' preferences are not static and fluctuate over time based on their perceived health needs, concerns and points of transition in care. While specialist supportive care led by consultant oncologists is often identified as the preferred model of care, survivors' also express preferences for integrated and shared models of care, involving oncology nurses, primary care and multidisciplinary professionals to optimise coordination and impact of supportive care. Flexibility in care delivery, leveraging technology and expertise, was preferred to ensure convenient and timely access to supportive care. CONCLUSIONS Cancer survivors express preferences for the organization and delivery of supportive care in the post-treatment phase that fluctuate based on their perceived health needs. The development of novel survivorship health services must consider survivors' preferences and allow flexibility in care delivery to facilitate engagement, uptake, and effectiveness.
Collapse
|
9
|
Vena JA, Copel LC. A concept analysis of remission within the domain of cancer survivorship. Nurs Forum 2021; 56:421-428. [PMID: 33634534 DOI: 10.1111/nuf.12558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 01/09/2021] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
AIM This concept analysis aims to formulate a unique theoretical definition of the term remission as used in cancer survivorship. BACKGROUND Inadequate communication between healthcare providers and cancer survivors is a shared burden affecting survivor well-being. Healthcare providers regularly use the term remission in cancer prognosis, treatment, and long-term cancer management; yet, how healthcare providers and cancer survivors define and interpret the concept of remission is less understood. DESIGN The Walker and Avant method of concept analysis was applied to define the term remission within the domain of cancer survivorship. DATA SOURCE: Three health sciences databases were chosen for the literature search, including PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Ovid Medline. REVIEW METHODS: Included research articles were evaluated to define the antecedents, attributes, consequences, and empirical referents of the term remission. RESULTS A cancer diagnosis is the most commonly cited antecedent to cancer remission. During remission, most cancer patients are free of measurable or symptomatic disease; however, the remission milestone is complemented by multiple physical and psychological symptoms. More specific cancer remission attributes include anxiety, recurrence fears, self-perseverance, and loss of social support. Both positive and negative outcomes accompany cancer remission, including acceptance of the treatment journey, appreciation for life, hope, persistent anxiety, personal relief, and triggered memories. CONCLUSIONS This concept analysis reviewed numerous publications to understand remission in the context of cancer survivorship. Advanced practice and registered nurses have a continued opportunity to improve the communication methods of patient-centered teaching and care planning for cancer patients in remission.
Collapse
Affiliation(s)
- Joseph A Vena
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| | - Linda C Copel
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| |
Collapse
|
10
|
Herrmann A, Mansfield E, Tzelepis F, Lynagh M, Hall A. Use of the supportive care framework to explore haematological cancer survivors' unmet needs: a qualitative study. BMC Health Serv Res 2020; 20:1062. [PMID: 33228652 PMCID: PMC7686725 DOI: 10.1186/s12913-020-05927-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/15/2020] [Indexed: 12/30/2022] Open
Abstract
Background Some sub-types of haematological cancers are acute and require intensive treatment soon after diagnosis. Other sub-types are chronic, relapse over many years and require life-long cycles of monitoring interspersed with bouts of treatment. This often results in significant uncertainty about the future, high levels of depression and anxiety, and reduced quality of life. Little is known about how to improve care for haematological cancer survivors. This study explored qualitatively, in a sample of haematological cancer survivors, (i) their unmet needs experienced as a result of their disease and treatment; and (ii) strategies that may help address these needs. Methods Semi-structured interviews were conducted with 17 adult haematological cancer survivors. Data was analysed using qualitative content analysis. The Supportive Care Framework guided data collection and analysis. Results Participants had a mean age of 57 years (SD 13). Most were male (n = 10, 59%). Five themes emerged from the data: (i) changes in unmet needs across the care trajectory (with greatest unmet needs experienced soon after diagnosis, at discharge from hospital and with cancer recurrence); (ii) informational unmet needs requiring improved patient-centred communication; (iii) uncertainty about treatment and the future; (iv) coordinated, tailored and documented post-treatment care planning as a strategy for optimal care delivery; and (v) ongoing support services to meet psychosocial and practical unmet needs by involving peer support, less bureaucratic transport services and flexible work arrangements. Conclusions To our knowledge, this is the first qualitative investigation using the Supportive Care Framework to explore unmet needs of haematological cancer survivors. Our findings offer fresh insights into this important area of study. Written, take-home care plans which provide simple but tailored guidance on where to seek additional support may help decrease uncertainty and feelings of vulnerability post-treatment for adult haematological cancer survivors. Future research should further develop and test strategies aimed at addressing unmet needs of haematological cancer survivors identified in this study. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-020-05927-7.
Collapse
Affiliation(s)
- Anne Herrmann
- Department for Epidemiology and Preventive Medicine, Professorship for Medical Sociology, University of Regensburg, Regensburg, Germany. .,Department of Haematology and Internal Oncology, University Hospital Regensburg, Regensburg, Germany. .,School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. .,Hunter Medical Research Institute, Newcastle, Australia.
| | - Elise Mansfield
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Marita Lynagh
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Alix Hall
- Hunter Medical Research Institute, Newcastle, Australia.,Clinical Research, Design and Statistics, Hunter Medical Research Institute, Newcastle, Australia
| |
Collapse
|
11
|
Muhsen IN, Bar M, Savani BN, Estey EH, Hashmi SK. Follow-up issues in survivors of hematologic malignancies – Current stance and future perspectives. Blood Rev 2020; 44:100674. [DOI: 10.1016/j.blre.2020.100674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 01/12/2020] [Accepted: 02/24/2020] [Indexed: 12/28/2022]
|
12
|
Abstract
BACKGROUND Survivors of lymphoma experience multiple challenges after treatment. However, a lack of knowledge of in-depth experiences of lymphoma survivors in early aftercare persists. OBJECTIVE To gain an in-depth understanding of the experiences of lymphoma survivors in early aftercare who have received an aftercare consultation based on evidence-based guideline recommendations, with an advanced practice nurse. METHODS This study used a narrative design. We recruited lymphoma survivors after a best-practice aftercare consultation with an advanced practice nurse. A total of 22 lymphoma survivors and 9 partners participated. Data were collected through narrative interviews and analyzed according to thematic narrative analysis. RESULTS Six themes emerged: living and dealing with health consequences, coping with work and financial challenges, having a positive outlook and dealing with uncertainty, deriving strength from and experiencing tensions in relationships, getting through tough times in life, and receiving support from healthcare professionals. CONCLUSIONS The stories of lymphoma survivors in early aftercare revealed their experiences of how they coped with a range of challenges in their personal lives. Choosing an aftercare trajectory based on an aftercare consultation that encourages patients to think about their issues, goals, and possible aftercare options may be useful for their transition from treatment to survivorship. IMPLICATIONS FOR PRACTICE Survivors' social support and self-management capabilities are important aspects to be addressed in cancer care. An aftercare consultation involving shared goal setting and care planning may help nurses provide personalized aftercare.
Collapse
|
13
|
Heveran L, Andrewes T. Nursing measures to support the needs of haematological cancer survivors post-treatment: a literature review. ACTA ACUST UNITED AC 2020; 29:S18-S24. [PMID: 32053451 DOI: 10.12968/bjon.2020.29.3.s18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Patients with haematological cancers are surviving longer due to increasingly effective treatments. Many patients continue to need support and advice after treatment ends. AIMS To review the support needs of patients after treatment for haematological cancer, in order to establish nursing measures for supporting them. Methods: A literature review and thematic analysis of six primary research articles. FINDINGS Three themes were identified: a sense of abandonment, education about late effects, and becoming a survivor. CONCLUSION Understanding an individual's support needs after treatment for haematological cancer enables nurses to offer sensitive, individualised care to patients. A tailored survivorship plan, led by a specialist nurse, helps to meet the ongoing holistic needs of haematological cancer patients.
Collapse
Affiliation(s)
- Laura Heveran
- Staff Nurse, University Hospitals Plymouth NHS Trust
| | | |
Collapse
|
14
|
Watts TE, Bower J. Still lost in transition: a qualitative descriptive study of people's experiences following treatment completion for haematological cancer in Wales, UK. Ecancermedicalscience 2019; 13:985. [PMID: 32010209 PMCID: PMC6974372 DOI: 10.3332/ecancer.2019.985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to explore Welsh adults' experiences of the transition into survivorship from initial active systemic anti-cancer treatments for haematological cancers. An exploratory, qualitative descriptive study consisting of in-depth, face-to-face interviews was designed. A convenience sample of adults in Wales, UK, who had completed their initial systemic anti-cancer treatment for haematological cancer was recruited from one University Health Board. Data were generated in digitally recorded, individual, face-to-face interviews during 2017. Interviews were fully transcribed and analysed using a qualitative thematic approach. Seven people participated in interviews. Thematic analysis revealed three themes: encountering ambiguity, the pursuit of normality and navigating treatment completion. The transition from patient to survivor was characterised by trepidation and uncertainty. While participants sought to resume a sense of normality in their lives, they were beset by enduring treatment effects. They felt insufficiently prepared for these effects and were uncertain about the availability of the ongoing supportive care which met their individual needs. Participants articulated that they desired much more from haematology providers in preparing them for life beyond initial SACT.
Collapse
Affiliation(s)
- Tessa E Watts
- School of Healthcare Sciences, Cardiff University, Cardiff CF10 3AT, UK
- https://orcid.org/0000-002-1201-5192
| | - Janet Bower
- Chemotherapy Day Unit, Hywel Dda University Health Board, Withybush General Hospital, Haverfordwest SA61 2PZ, UK
| |
Collapse
|
15
|
Hohmann NS, McDaniel CC, Mason SW, Cheung WY, Williams MS, Salvador C, Graves EK, Camp CN, Chou C. Patient perspectives on primary care and oncology care coordination in the context of multiple chronic conditions: A systematic review. Res Social Adm Pharm 2019; 16:1003-1016. [PMID: 31812499 DOI: 10.1016/j.sapharm.2019.11.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/12/2019] [Accepted: 11/24/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Patients' views on the optimal model for care coordination between primary care providers (PCPs) and oncologists in the context of cancer and multiple chronic conditions (MCC) are unclear. Thus, the purpose of this systematic review is to evaluate the perceptions of patients with both cancer and MCC regarding their care coordination needs. METHODS Following PRISMA guidelines, the literature was systematically searched through PubMed, CINAHL, and PsycINFO for articles pertaining to patients' perspectives, experiences, and needs regarding care coordination between PCPs and oncologists during the cancer care continuum, in the context of patients with cancer and MCC. English-language articles were included if they met the following criteria: 1) published between 2008 and 2018; 2) peer-reviewed study; 3) patients aged 18 years or older diagnosed with any type or stage of cancer; 4) patients have one or more chronic comorbid condition; 5) inclusion of patient perceptions, experiences, or needs related to care coordination between PCPs and oncologists; and 6) ability to extract results. Data extraction was performed with a standardized form, and themes were developed through qualitative synthesis. A grounded theory approach was used to qualitatively evaluate data extracted from articles and create a framework for providers to consider when developing patient-centered care coordination strategies for these complex patients. Risk of bias within each study was assessed independently by two authors using the Mixed Methods Appraisal Tool. RESULTS A total of 22 articles were retained, representing the perspectives of 8,114 patients with cancer and MCC. Studies were heterogeneous in the patients' respective phases of cancer care and study design. From qualitative synthesis, four themes emerged regarding patients' needs for cancer care coordination and were included as constructs to develop the Patient-centered Care Coordination among Patients with Multiple Chronic Conditions and Cancer (PCP-MC) framework. Constructs included: 1) Communication; 2) Defining provider care roles; 3) Information access; and 4) Individualized patient care. Care navigators served as a communication bridge between providers and patients. CONCLUSIONS Findings highlight the importance that patients with both cancer and MCC place on communication with and between providers, efficient access to understandable care information, defined provider care roles, and care tailored to their individual needs and circumstances. Providers and policymakers may consider the developed PCP-MC framework when designing, implementing, and evaluating patient-centered care coordination strategies for patients with both cancer and MCC.
Collapse
Affiliation(s)
- Natalie S Hohmann
- Auburn University, Harrison School of Pharmacy, Department of Pharmacy Practice, 4201 Walker Building, Auburn University, AL, 36849, USA
| | - Cassidi C McDaniel
- Auburn University, Harrison School of Pharmacy, Health Outcomes Research and Policy, 4306 Walker Building, Auburn University, AL, 36849, USA
| | - S Walker Mason
- University of North Carolina Medical Center, Department of Pharmacy, 101 Manning Dr, Chapel Hill, NC, 27514, USA
| | - Winson Y Cheung
- University of Calgary, Cumming School of Medicine, Department of Oncology: Tom Baker Cancer Centre, 1331 29th Street NW, Calgary, Alberta, T2N 4N2, Canada
| | - Michelle S Williams
- University of Mississippi Medical Center, Cancer Institute and Department of Population Health Science, 2500 North State Street, Jackson, MS, 39216, USA
| | - Carolina Salvador
- University of Alabama at Birmingham, School of Medicine, Division of Hematology/Oncology, 1720 2nd Avenue South, NP2540, Birmingham, AL, 35294, USA
| | - Edith K Graves
- Cancer Center of East Alabama Medical Center, Medical Oncology, 2501 Village Professional Dr, Opelika, AL, 36801, USA
| | - Christina N Camp
- Auburn University, Harrison School of Pharmacy, Health Outcomes Research and Policy, 4306 Walker Building, Auburn University, AL, 36849, USA
| | - Chiahung Chou
- Auburn University, Harrison School of Pharmacy, Health Outcomes Research and Policy, 4306 Walker Building, Auburn University, AL, 36849, USA; China Medical University Hospital, Department of Medical Research, No.2 Yude Road, North District, Taichung City, 40447, Taiwan.
| |
Collapse
|
16
|
Armoogum J, Harcourt D, Foster C, Llewellyn A, McCabe CS. The experience of persistent pain in adult cancer survivors: A qualitative evidence synthesis. Eur J Cancer Care (Engl) 2019; 29:e13192. [PMID: 31762169 DOI: 10.1111/ecc.13192] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 02/02/2023]
Affiliation(s)
| | | | | | - Alison Llewellyn
- University of the West of England Bristol UK
- Royal United Hospitals Bath NHS Foundation Trust Bath UK
| | - Candida S. McCabe
- University of the West of England Bristol UK
- Royal United Hospitals Bath NHS Foundation Trust Bath UK
- Florence Nightingale Foundation London UK
| |
Collapse
|
17
|
Chen L, Payne JB, Dance KV, Imbody CB, Ho CD, Ayers AA, Flowers CR. Priorities for Rural Lymphoma Survivors: A Qualitative Study. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 20:47-52.e3. [PMID: 31708453 DOI: 10.1016/j.clml.2019.09.599] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/23/2019] [Accepted: 09/21/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND We gathered rural patient perspectives on lymphoma care and unmet needs throughout the treatment course to better understand their attitudes toward treatment and their barriers to participating in clinical research studies. PATIENTS AND METHODS We conducted 12 individual semi-structured telephone interviews in the spring of 2018 with lymphoma survivors from rural counties in Georgia. Patients were identified by a residential address in counties classified as rural according to the Rural-Urban Commuting Areas codes. Participants were recruited from regional patient education conferences and from current research participants at a university research hospital in Georgia. The interviews were recorded and transcribed verbatim. Thematic analysis and MAXQDA, version 18.0.8, were used to facilitate a constant comparative coding process during theme development. RESULTS The greatest barrier to care was the travel distance. The participants described difficulty navigating between local clinics and larger cancer centers. The lack of communication between the local and specialized clinics complicated the process, and participants had difficulty contacting or seeking advice from the team at the larger cancer centers. Seeking treatment from specialized clinics farther away introduced additional barriers. Most participants agreed that the use of technology was important for improved communication. Participants described lymphoma etiology, subtype-specific studies, alternative therapies, and quality of life as key research priorities. CONCLUSION These findings suggest that targeted research and interventions are necessary to address the specific needs of rural patients with and survivors of lymphoma. To address the disparity in health outcomes within rural populations, healthcare professionals and investigators can use these data to engage rural patients in treatment decision-making and research planning.
Collapse
Affiliation(s)
- Lillian Chen
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Jackelyn B Payne
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA; Department of Psychology, Stony Brook University, Stony Brook, NY
| | - Kaylin V Dance
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Conner B Imbody
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA; Rollins School of Public Health, Emory University, Atlanta, GA
| | - Cathy D Ho
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Amy A Ayers
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Christopher R Flowers
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA.
| |
Collapse
|
18
|
Conway Keller M, Ruiz T, Needham A, King C, Hart L, Holden E, Lucas R. Development and Content Validation of End of Treatment Questionnaires for Children With Cancer. J Pediatr Oncol Nurs 2019; 37:128-135. [PMID: 31596172 DOI: 10.1177/1043454219878392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose: To describe the development and content validation of measures to assess the psychoeducational needs of children, adolescents/young adults (AYAs), and their parents at the end of successful treatment for cancer. Method: Professional experts, which included pediatric oncology nurses and advanced practice registered nurses, conducted a systematic review of the literature to determine specific end of treatment (EOT) needs of children and AYAs with cancer and their parents and evaluate available tools to measure these needs. From this review, two EOT questionnaires were initially developed. Oncology Family Advisory Board (FAB) members served as experiential experts in refining and validating these questionnaires. FAB members participated in a content validation process, rating questionnaires online, and subsequently participating in a focus group to establish content validity (n = 6). Results: Three EOT questionnaires were ultimately developed. The Child/AYA questionnaire was divided into two separate measures for developmental and literacy considerations. The Parent/Caregiver and the AYA questionnaires each contain 38 items with a content validity index score of 100%. The Child questionnaire contains 37 items with a content validity index score of 100%. Conclusion: Content validity was established for three EOT questionnaires, each of which has the potential to elicit information regarding needs and potential gaps in services perceived by childhood cancer survivors and their parents. Further psychometric testing is needed to determine stability (test-retest reliability) and construct validity of the questionnaires.
Collapse
Affiliation(s)
| | - Tiffany Ruiz
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Andrew Needham
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Courtney King
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - Leigh Hart
- Connecticut Children's Medical Center, Hartford, CT, USA
| | | | - Ruth Lucas
- University of Connecticut, Storrs, CT, USA
| |
Collapse
|
19
|
Raphael D, Frey R, Gott M. Maintaining psychosocial wellbeing for post-treatment haematological cancer survivors: Strategies and potential barriers. Eur J Oncol Nurs 2018; 38:36-41. [PMID: 30717934 DOI: 10.1016/j.ejon.2018.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE Haematological cancers often require aggressive treatment which can cause both late and long term physical and psychosocial effects that can appear years after treatment ends. However there is a paucity of studies that focus on psychosocial issues among post-treatment haematological cancer survivors. This research aimed to explore the strategies used by haematological cancer survivors to maintain psychosocial wellbeing in the post-treatment period, and examine the barriers they identify to maintaining wellbeing. METHOD This research utilised a qualitative research design. Participants were recruited through the New Zealand Cancer Registry. Semi-structured interviews were conducted with 23 post-treatment haematological cancer survivors. A thematic analysis was conducted to analyse the data. RESULTS The analysis identified three themes describing the strategies that enabled participants to maintain psychosocial wellbeing: inner strength; support from personal connections; support from health professionals/support organisations. Two themes were also identified describing the barriers to psychosocial wellbeing: barriers to utilising personal connections; barriers to utilising support from health professionals/support organisations. CONCLUSIONS Psychosocial support from others was essential in maintaining wellbeing for survivors. The participants who had ready support from family and friends reported needing less psychosocial support from other sources. However, those who needed more psychosocial support did not always receive it, or know where to find it. The key barriers to this type of support were informational gaps and not having a specific contact person to ask for help. Further research is needed to support the development of interventions to reduce psychosocial distress among this underserved group of cancer survivors.
Collapse
Affiliation(s)
- Deborah Raphael
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Rosemary Frey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
20
|
Raphael D, Frey R, Gott M. The nature and timing of distress among post-treatment haematological cancer survivors. Eur J Cancer Care (Engl) 2018; 28:e12951. [PMID: 30284333 DOI: 10.1111/ecc.12951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/19/2018] [Accepted: 09/12/2018] [Indexed: 11/26/2022]
Abstract
Many people with haematological cancers will not meet the diagnostic criteria for a psychological disorder, but will still suffer distress during treatment and beyond. The current study aimed to explore the nature and timing of psychosocial distress experienced by haematological cancer survivors. Twenty-three post-treatment haematological cancer survivors participated in a semi-structured interview. Data were analysed using thematic analysis which involved identifying, analysing and reporting themes. Four themes were identified: Apprehension about leaving the safety of the health care system comprises the struggles encountered when transitioning from patient to survivor, Uncertainty and life transitions in the post-treatment period encompasses the changes survivors face when attempting to re-enter their "normal" lives, Distress associated with ongoing physical problems or impairment describes issues associated with the ongoing physical sequelae, and Fear of recurrence encapsulates how the continuing threat of cancer recurrence impacted survivors. This study has found that distress is ongoing for many haematological cancer survivors in the post-treatment period. It is imperative that distress is identified and support offered to those in need to prevent further psychosocial issues. It is especially important to consider the psychosocial needs of survivors in the post-treatment stage who are discharged from the health system may be unsure where to seek help.
Collapse
Affiliation(s)
- Deborah Raphael
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Rosemary Frey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
21
|
Hackett F, Dowling M. Lymphoma survivors’ experiences at the end of treatment. J Clin Nurs 2018; 28:400-409. [DOI: 10.1111/jocn.14658] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 08/21/2018] [Accepted: 08/30/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Fidelma Hackett
- UL Hospitals Group University Hospital Limerick Dooradoyle, Limerick Ireland
| | - Maura Dowling
- School of Nursing and Midwifery National University of Ireland Galway Ireland
| |
Collapse
|
22
|
Rood JAJ, Lissenberg-Witte BI, Eeltink C, Stam F, van Zuuren FJ, Zweegman S, Verdonck- de Leeuw IM. The need for information among patients with hematological malignancies: Psychometric analyses of the 62-item Hematology Information Needs Questionnaire (HINQ-62). PLoS One 2018; 13:e0201699. [PMID: 30092035 PMCID: PMC6084926 DOI: 10.1371/journal.pone.0201699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/22/2018] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to investigate the psychometric characteristics (content validity, internal consistency, and subscale structure) of the Hematology Information Needs Questionnaire-62 (HINQ-62), a patient reported outcome measure (PROM) for assessing the need for information among patients with hematological malignancies (HM-patients). Baseline data were used from a prospective study on the need for information which 336 newly diagnosed HM-patients had completed. In phase 1 (design phase), data from the first 135 patients were used and in phase 2 (validation phase), data from the remaining 201 HM patients were used. Content validity was analyzed by examining irrelevance of items. Items were considered irrelevant if more than 10% of the patients scored totally disagree on that item. The subscale structure of the HINQ-62 was investigated with Factor analysis (FA) (exploratory FA in phase 1 and confirmatory FA in phase 2). Cronbach's α was computed for the different subscales and >.70 was considered as good internal consistency. None of the 62 HINQ-items were irrelevant. Exploratory FA identified five subscales: "Disease, symptoms, treatment and side-effects", "Etiology, sleep and physical changes", "Self-care", "Medical tests and prognosis", and "Psychosocial". Root Mean Square Error of Approximation (RMSEA) among patients was 0.037 in phase 1 and 0.045 in phase 2. The comparative fit index (CFI)/Tucker-Lewis index -non-normed fit index among patients was 0.984/0.983 and 0.948/0.946, in phase 1 and 2 respectively. The internal consistency of the subscales was good, with Cronbach's α 0.82-0.99. The HINQ is a valid PROM for assessing the need for information among Dutch HM-patients at diagnosis.
Collapse
Affiliation(s)
- Janneke A. J. Rood
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
- Department of Internal medicine, Northwest Clinics, Alkmaar, the Netherlands
- * E-mail:
| | | | - Corien Eeltink
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Frank Stam
- Department of Internal medicine, Northwest Clinics, Alkmaar, the Netherlands
| | | | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | | |
Collapse
|
23
|
Abstract
BACKGROUND Despite knowing the potential medical consequences of cancer treatment, little is known about how adolescents cognitively and emotionally frame, process, and manage in the early survivorship period. OBJECTIVE The specific aims were to describe the worries, perceived challenges, and ways of dealing with these issues for adolescent cancer survivors in the early period of survivorship. METHODS Twenty-nine adolescent survivors (12-18 years) completed a semistructured interview. Inductive coding methods adapted from grounded theory were used to analyze the data. RESULTS Seven domains and 18 categories organized the adolescent's experience with early posttreatment survivorship. The domains included getting back to school; relationships with parents, siblings, friends; feeling changed by the experience; and concerns about relapse. CONCLUSIONS This study contributes to our understanding of survivors' relationships with parents, siblings, and friends and survivors' models of the illness. Future studies are needed to understand how parents can help adolescents assume greater responsibility for their care, to understand what it is like for friends to have a peer with cancer and what behaviors by healthcare providers contribute to feelings of abandonment later in survivorship, and to better understand adolescent survivors' models of the illness and survivorship. IMPLICATIONS FOR PRACTICE Study results suggest that nurses are in an ideal position to begin and to continue discussions with adolescent survivors about the adolescent's view of medical follow- up, its purpose and importance, and ways in which the adolescent can begin, early on, to engage in planning their own health during survivorship.
Collapse
|
24
|
Strekalova YA, Hawkins KE, Drusbosky LM, Cogle CR. Using social media to assess care coordination goals and plans for leukemia patients and survivors. Transl Behav Med 2018; 8:481-491. [PMID: 29800400 DOI: 10.1093/tbm/ibx075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Care coordination has been shown to have a positive effect on the management of chronic disease. Specific to the management of leukemia, coordination may occur between primary care physician, medical and radiation oncologists, surgeons, cardiologists, and genetics specialists. Experiencing gaps in communication and care coordination, many health consumers seek instrumental support in their social circles, including online forums and networks. The goal of this theory-guided study was to provide an in-depth assessment of how individuals use online forums to deliberate about their goals and plans for leukemia care coordination. Guided by the planning theory of communication, the data were collected from the American Cancer Society Cancer Survivors Network and included 125 original posts and 1,248 responses. Thematic analysis and axial coding were applied to analyze the data. Goal-related themes included overcoming the diffusion of care coordination and achieving health management cohesion. Planning themes included social health management, communication self-efficacy, and role deliberation. Online patient forums provide an interactive platform for patients and caregivers to engage in active conversations, which in turn can serve as identifiers of care coordination needs. Communication with those who share similar experiences allows cancer patients and survivors to accumulate functional health literacy, gain communication self-efficacy, and articulate a care coordination role acceptable to them.
Collapse
Affiliation(s)
- Yulia A Strekalova
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Kimberly E Hawkins
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Leylah M Drusbosky
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Cristopher R Cogle
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| |
Collapse
|
25
|
Hebdon M, Abrahamson K, Griggs R, McComb S. Shared mental models of cancer survivorship care. Eur J Cancer Care (Engl) 2018; 27:e12831. [PMID: 29419945 DOI: 10.1111/ecc.12831] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 11/28/2022]
Affiliation(s)
- M.C. Hebdon
- Radford University School of Nursing; Radford VA USA
| | - K. Abrahamson
- Purdue University School of Nursing; West Lafayette IN USA
| | - R.R. Griggs
- Purdue University School of Nursing; West Lafayette IN USA
| | - S.A. McComb
- Purdue University Schools of Nursing and Industrial Engineering; West Lafayette IN USA
| |
Collapse
|
26
|
Brauer ER, Pieters HC, Ganz PA, Landier W, Pavlish C, Heilemann MV. "From Snail Mode to Rocket Ship Mode": Adolescents and Young Adults' Experiences of Returning to Work and School After Hematopoietic Cell Transplantation. J Adolesc Young Adult Oncol 2017; 6:551-559. [PMID: 28594579 PMCID: PMC5725632 DOI: 10.1089/jayao.2017.0025] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Resuming normal activities, such as work and school, is an important dimension of psychosocial recovery in cancer survivorship. Minimal data exist regarding adolescents or young adults' experiences of returning to school or work after cancer. The purpose of this study was to explore the processes of resuming work and school among adolescents and young adults after hematopoietic cell transplantation (HCT). METHODS In-depth interviews were conducted with 18 adolescents and young adults, who were 15-29 years when they underwent HCT and 6-60 months post-transplant at study enrollment. Interview transcripts were systematically analyzed using Grounded Theory methodology. RESULTS Participants described the context in which they attempted to return to work or school, specific challenges they faced, and strategies they developed in these environments. Feeling left behind from their peers and their pre-diagnosis selves, participants described "rushing" back to school and work impulsively, taking on too much too quickly while facing overwhelming physical and cognitive demands. Factors motivating this sense of urgency as well as barriers to successful and sustainable reentry in these settings are also addressed. CONCLUSION Findings are discussed in the context of important opportunities for clinical management, age-appropriate interventions, and implications for future research. A better understanding of psychosocial late effects, specifically related to school and work trajectories after cancer, is critical to survivorship care for adolescent and young adult cancer survivors.
Collapse
Affiliation(s)
- Eden R. Brauer
- Center for Cancer Prevention & Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California
- UCLA Fielding School of Public Health, Los Angeles, California
| | | | - Patricia A. Ganz
- Center for Cancer Prevention & Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California
- UCLA Fielding School of Public Health, Los Angeles, California
| | - Wendy Landier
- University of Alabama at Birmingham Schools of Medicine and Nursing, Birmingham, Alabama
| | | | | |
Collapse
|
27
|
Chan RJ, Button E, Thomas A, Gates P, Yates P. Nurses attitudes and practices towards provision of survivorship care for people with a haematological cancer on completion of treatment. Support Care Cancer 2017; 26:1401-1409. [PMID: 29138956 DOI: 10.1007/s00520-017-3972-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/09/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of this study is to assess cancer nurses' perceptions of responsibility, confidence levels and practice in relation to survivorship care for people with a haematological malignancy on completion of treatment. METHODS A prospective cross-sectional survey was conducted. An online survey was distributed to members of two Australian professional bodies. RESULTS A total of 310 cancer nurses participated in the study, representing a response rate of 28%. The participants generally agreed that all survivorship care items were part of their role. Of the 17 survivorship care items, the three items receiving the lowest confidence scores were discussing fertility issues, discussing employment and financial issues and discussing how to identify signs of cancer recurrence. The least performed survivorship care items were discussing fertility issues, communicating survivorship care with primary healthcare team (i.e. general practitioners) and discussing sexuality issues. Older age, more years of experience, having a post-graduate qualification and working in non-metropolitan area were associated with higher levels of perception of responsibilities and confidence (p < 0.05). The top ranked barriers to survivorship care were reported to be lack of end-of-treatment consultation dedicated to survivorship care, time and an appropriate physical space for delivering care. CONCLUSIONS Cancer nurses perceive key aspects of survivorship care to be part of their role, however there remains variations in practice and confidence with respect to implementation of survivorship care practices. IMPLICATIONS FOR CANCER SURVIVORS Interventions that focus on enhancing the capability of cancer nurses and eliminating barriers identified in this study have the potential to improve quality survivorship care provision.
Collapse
Affiliation(s)
- Raymond Javan Chan
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. .,School of Nursing, Queensland University of Technology, Kelvin Grove Road, Kelvin Grove, Queensland, Australia. .,Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
| | - Elise Button
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,School of Nursing, Queensland University of Technology, Kelvin Grove Road, Kelvin Grove, Queensland, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Alison Thomas
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Priscilla Gates
- Olivia Newton-John Cancer and Wellness Centre, Austin Hospital, Heidelberg, Victoria, Australia
| | - Patsy Yates
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,School of Nursing, Queensland University of Technology, Kelvin Grove Road, Kelvin Grove, Queensland, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Centre for Palliative Care Research and Education, Herston, Queensland, Australia
| |
Collapse
|
28
|
Muskat B, Jones H, Lucchetta S, Shama W, Zupanec S, Greenblatt A. The Experiences of Parents of Pediatric Patients With Acute Lymphoblastic Leukemia, 2 Months After Completion of Treatment. J Pediatr Oncol Nurs 2017; 34:358-366. [DOI: 10.1177/1043454217703594] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Diagnosis and treatment of childhood acute lymphoblastic leukemia (ALL) can be a highly stressful time for the entire family. While completion of treatment may bring relief to some families, it may also bring about additional anxieties and fear. The primary objective of this article is to present an analysis of the experiences, emotional states, and support needs of parents of pediatric cancer patients 2 months after treatment completion for ALL. Using a qualitative interpretive description approach, transcripts from interviews with 17 parents from the leukemia/lymphoma program of a large urban pediatric cancer center were analyzed using N-Vivo 10 data analysis software. Parents reported simultaneous feelings of relief and apprehension, changing relationships with their health care team and the experience of returning to a life following treatment. Results highlight the need for support for parents on completion of treatment.
Collapse
Affiliation(s)
| | - Heather Jones
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Wendy Shama
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sue Zupanec
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | |
Collapse
|
29
|
Leach CR, Troeschel AN, Wiatrek D, Stanton AL, Diefenbach M, Stein KD, Sharpe K, Portier K. Preparedness and Cancer-Related Symptom Management among Cancer Survivors in the First Year Post-Treatment. Ann Behav Med 2017; 51:587-598. [DOI: 10.1007/s12160-017-9880-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
30
|
Raphael D, Frey R, Gott M. Psychosocial distress in haematological cancer survivors: An integrative review. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12640] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2016] [Indexed: 01/07/2023]
Affiliation(s)
- D. Raphael
- School of Nursing; Faculty of Medical and Health Sciences; The University of Auckland; Auckland New Zealand
| | - R. Frey
- School of Nursing; Faculty of Medical and Health Sciences; The University of Auckland; Auckland New Zealand
| | - M. Gott
- School of Nursing; Faculty of Medical and Health Sciences; The University of Auckland; Auckland New Zealand
| |
Collapse
|
31
|
Franco BB, Dharmakulaseelan L, McAndrew A, Bae S, Cheung MC, Singh S. The experiences of cancer survivors while transitioning from tertiary to primary care. ACTA ACUST UNITED AC 2016; 23:378-385. [PMID: 28050133 DOI: 10.3747/co.23.3140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE In current fiscally constrained health care systems, the transition of cancer survivors to primary care from tertiary care settings is becoming more common and necessary. The purpose of our study was to explore the experiences of survivors who are transitioning from tertiary to primary care. METHODS One focus group and ten individual telephone interviews were conducted. Data saturation was reached with 13 participants. All sessions were audio-recorded, transcribed verbatim, and analyzed using a qualitative descriptive approach. RESULTS Eight categories relating to the main content category of transition readiness were identified in the analysis. Several factors affected participant transition readiness: how the transition was introduced, perceived continuity of care, support from health care providers, clarity of the timeline throughout the transition, and desire for a "roadmap." Although all participants spoke about the effect of their relationships with health care providers (tertiary, transition, and primary care), their relationship with the primary care provider had the most influence on their transition readiness. CONCLUSIONS Our study provided insights into survivor experiences during the transition to primary care. Transition readiness of survivors is affected by many factors, with their relationship with the primary care provider being particularly influential. Understanding transition readiness from the survivor perspective could prove useful in ensuring patient-centred care as transitions from tertiary to primary care become commonplace.
Collapse
Affiliation(s)
- B B Franco
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | | | - A McAndrew
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | - S Bae
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | - M C Cheung
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | - S Singh
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| |
Collapse
|
32
|
Jones WC, Parry C, Devine S, Main DS, Okuyama S, Tran ZV. Prevalence and predictors of distress in posttreatment adult leukemia and lymphoma survivors. J Psychosoc Oncol 2015; 33:124-41. [PMID: 25581206 DOI: 10.1080/07347332.2014.992085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This paper examines predictors of cancer-specific distress among posttreatment adult leukemia and lymphoma survivors (LLS). Using a survey mailed to LLS in the Colorado Central Cancer Registry (N = 477), the authors developed a multivariable risk profile for distress. Thirty one percent of LLS reported indicators of distress. Significantly higher distress was associated with younger age (p < 0.001) in bivariate analyses. The risk profile included fear of recurrence, financial burden, and younger age. Distress did not attenuate based on time since treatment completion and may persist up to 4 years posttreatment, suggesting a need for intervention, particularly among high-risk LLS.
Collapse
Affiliation(s)
- Whitney C Jones
- a Colorado School of Public Health, University of Colorado Denver , Aurora , CO , USA
| | | | | | | | | | | |
Collapse
|
33
|
Langbecker D, Ekberg S, Yates P, Chan A, Chan RJ. What are the barriers of quality survivorship care for haematology cancer patients? Qualitative insights from cancer nurses. J Cancer Surviv 2015; 10:122-30. [PMID: 26024780 DOI: 10.1007/s11764-015-0458-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/19/2015] [Indexed: 01/03/2023]
Abstract
PURPOSE Many haematological cancer survivors report long-term physiological and psychosocial effects beyond treatment completion. These survivors continue to experience impaired quality of life (QoL) as a result of their disease and aggressive treatment. As key members of the multidisciplinary team, the purpose of this study is to examine the insights of cancer nurses to inform future developments in survivorship care provision. METHODS Open text qualitative responses from two prospective Australian cross-sectional surveys of nurses (n = 136) caring for patients with haematological cancer. Data were analysed thematically, using an inductive approach to identify themes. RESULTS This study has identified a number of issues that nurses perceive as barriers to quality survivorship care provision. Two main themes were identified: the first relating to the challenges nurses face in providing care ('care challenges') and the second relating to the challenges of providing survivorship care within contemporary health care systems ('system challenges'). CONCLUSIONS Cancer nurses perceive the nature of haematological cancer and its treatment and of the health care system itself, as barriers to the provision of quality survivorship care. Care challenges such as the lack of a standard treatment path and the relapsing or remitting nature of haematological cancers may be somewhat intractable, but system challenges relating to clearly defining and delineating professional responsibilities and exchanging information with other clinicians are not. IMPLICATIONS FOR CANCER SURVIVORS Addressing the issues identified will facilitate cancer nurses' provision of survivorship care and help address haematological survivors' needs with regard to the physical and psychosocial consequences of their cancer and treatment.
Collapse
Affiliation(s)
- Danette Langbecker
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Stuart Ekberg
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Patsy Yates
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Cancer Nursing Professorial Precinct, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Alexandre Chan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, National Cancer Centre, Singapore, Singapore
| | - Raymond Javan Chan
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. .,Cancer Nursing Professorial Precinct, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. .,Centre for Research and Innovation, West Moreton Hospital and Health Service, Level 8, Tower Block, Ipswich Hospital, Ipswich, QLD, 4305, Australia.
| |
Collapse
|
34
|
Taylor K, Chan RJ, Monterosso L. Models of survivorship care provision in adult patients with haematological cancer: an integrative literature review. Support Care Cancer 2015; 23:1447-58. [PMID: 25691361 DOI: 10.1007/s00520-015-2652-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 02/08/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE Increasing numbers of haematology cancer survivors warrants identification of the most effective model of survivorship care to survivors from a diverse range of haematological cancers with aggressive treatment regimens. This review aimed to identify models of survivorship care to support the needs of haematology cancer survivors. METHOD An integrative literature review method utilised a search of electronic databases (CINAHL, Medline, PsycInfo, PubMed, EMBASE, PsycArticles, and Cochrane Library) for eligible articles (up to July 2014). Articles were included if they proposed or reported the use of a model of care for haematology cancer survivors. RESULTS Fourteen articles were included in this review. Eight articles proposed and described models of care, and six reported the use of a range of survivorship models of care in haematology cancer survivors. No randomised controlled trials or literature reviews were found to have been undertaken specifically with this cohort of cancer survivors. There was variation in the models described and who provided the survivorship care. CONCLUSION Due to the lack of studies evaluating the effectiveness of models of care, it is difficult to determine the best model of care for haematology cancer survivors. Many different models of care are being put into practice before robust research is conducted. Therefore, well-designed high-quality pragmatic randomised controlled trials are required to inform clinical practice.
Collapse
Affiliation(s)
- Karen Taylor
- Western Australia Cancer and Palliative Care Network, 189 Royal St., East Perth, WA, 6004, Australia,
| | | | | |
Collapse
|
35
|
Jones WC, Parry C, Devine S, Main DS, Okuyama S. Understanding distress in posttreatment adult leukemia and lymphoma survivors: a lifespan perspective. J Psychosoc Oncol 2015; 33:142-62. [PMID: 25671408 DOI: 10.1080/07347332.2014.1002658] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Using in-depth interviews, this paper explores the nature and sources of cancer-specific distress among 51 posttreatment adult leukemia and lymphoma survivors (LLS), focusing on the role of lifespan stage in shaping reported stressors. LLS (all ages) reported physical aftereffects of cancer treatment, with reported sources of emotional and financial distress varying by lifespan stage. Young adult survivors (18-39) reported a greater number of distress sources. Distress may persist up to 4 years posttreatment, particularly among younger LLS, who appear to be at greater risk of distress in multiple domains.
Collapse
Affiliation(s)
- Whitney C Jones
- a Colorado School of Public Health, University of Colorado Denver , Aurora , CO , USA
| | | | | | | | | |
Collapse
|
36
|
Tzelepis F, Sanson-Fisher RW, Hall AE, Carey ML, Paul CL, Clinton-McHarg T. The quality of patient-centred care: haematological cancer survivors' perceptions. Psychooncology 2014; 24:796-803. [PMID: 25504965 DOI: 10.1002/pon.3728] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 09/21/2014] [Accepted: 10/29/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Patient-reported outcome measures (PROMs) that assess the quality of patient-centred cancer care have failed to measure all six patient-centredness dimensions endorsed by the Institute of Medicine (IOM). This study is the first to use the Quality of Patient-Centered Cancer Care (QPCCC) measure that covers all six IOM patient-centredness dimensions to examine haematological cancer survivors' perceptions of care and characteristics associated with perceived quality of care. METHODS Haematological cancer survivors diagnosed in the last 6 years and aged 18-80 years were recruited from two Australian state population-based cancer registries. Survivors were mailed the 48-item QPCCC measure. RESULTS Overall, 545 haematological cancer survivors completed the measure. Areas of care most commonly identified as delivered were hospital staff showing respect to survivors (93%) and making sure the correct treatment was received (93%). Aspects of care most frequently nominated as not delivered were hospital staff helping family and friends (34%) or the survivor (32%) to find other people with similar experiences to talk to. Characteristics associated with survivors perceiving higher quality care was delivered included being employed, having private health insurance, being younger, a Non-Hodgkin lymphoma diagnosis and more recent diagnosis. Being depressed or stressed was associated with perceived lower quality of care. CONCLUSIONS Provision of peer support programs that allow haematological cancer survivors and families and friends to talk to others in similar situations could be improved. Using PROMs to identify areas where cancer survivors perceive improvements are needed is essential to quality improvement efforts.
Collapse
Affiliation(s)
- Flora Tzelepis
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Robert W Sanson-Fisher
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Alix E Hall
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Mariko L Carey
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Christine L Paul
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| |
Collapse
|
37
|
Hebdon M, Abrahamson K, McComb S, Sands L. Transitioning Patients to Survivorship Care: A Systematic Review. Oncol Nurs Forum 2014; 41:615-25. [DOI: 10.1188/14.onf.615-625] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
38
|
Keesing S, McNamara B, Rosenwax L. Cancer survivors' experiences of using survivorship care plans: a systematic review of qualitative studies. J Cancer Surviv 2014; 9:260-8. [PMID: 25343971 PMCID: PMC4441735 DOI: 10.1007/s11764-014-0407-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 10/07/2014] [Indexed: 01/16/2023]
Abstract
Purpose Cancer survivorship care plans (SCPs) are currently used in care settings to assist survivors during the transition from treatment to survivorship. In this paper, the experiences of cancer survivors are examined to provide their perspective of how survivorship care plans are used in practice. Methods A systematic review and critical review of the qualitative literature regarding the experiences of cancer survivors using survivorship care plans was completed. Databases reviewed included CINAHL, AMED, Embase, MEDLINE, Informit, ProQuest, PsycINFO, ScienceDirect, Wiley Online Library, Scopus and Web of Science from 2000 to 2014. Results Eleven qualitative studies were appraised for methodological quality and content. They revealed four key themes: stakeholders agreed that SCPs should be used as a key strategy for cancer survivors; there was a lack of consensus on the format, content and who should develop the SCP; cancer survivors do not consistently receive SCPs; and there was a lack of evidence to support the use of SCPs in practice. Conclusions There is great potential for SCPs to assist cancer survivors and this is supported by the range of qualitative literature examined in this study. Further research is required to examine the many practical issues relating to the delivery of SCPs and how they may be used across a variety of care contexts as well as providing further evidence to support their use. Implications for Cancer Survivors With further research, refinement and contributions made by survivors, health researchers and health care professionals, the survivorship care plan is proposed to be a useful and practical tool aimed at supporting the survivorship continuum of care.
Collapse
Affiliation(s)
- Sharon Keesing
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia,
| | | | | |
Collapse
|
39
|
Rood JAJ, Eeltink CM, van Zuuren FJ, Verdonck-de Leeuw IM, Huijgens PC. Perceived need for information of patients with haematological malignancies: a literature review. J Clin Nurs 2014; 24:353-69. [DOI: 10.1111/jocn.12630] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Janneke AJ Rood
- Department of Haematology (pk 2 br 018); VU University Medical Center; Amsterdam The Netherlands
- Department of Internal Medicine; Medical Center; Alkmaar
| | - Corien M Eeltink
- Department of Haematology (pk 2 br 018); VU University Medical Center; Amsterdam The Netherlands
| | - Florence J van Zuuren
- Department of Clinical Psychology; University of Amsterdam; Amsterdam The Netherlands
| | | | - Peter C Huijgens
- Department of Haematology (pk 2 br 018); VU University Medical Center; Amsterdam The Netherlands
| |
Collapse
|
40
|
Nissim R, Rodin G, Schimmer A, Minden M, Rydall A, Yuen D, Mischitelle A, Fitzgerald P, Lo C, Gagliese L, Zimmermann C. Finding new bearings: a qualitative study on the transition from inpatient to ambulatory care of patients with acute myeloid leukemia. Support Care Cancer 2014; 22:2435-43. [PMID: 24705856 DOI: 10.1007/s00520-014-2230-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 03/21/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE Treatment of adult acute myeloid leukemia (AML) is intensive, with induction treatment initiated in an inpatient setting and subsequent consolidation therapy often conducted in an outpatient setting. The purpose of the present qualitative paper is to provide insight into the experience of patients in the transition from inpatient to ambulatory care. METHODS Participants were 35 AML patients who were interviewed about their experience of the illness and treatment. Utilizing the grounded theory method, we describe the adjustment of participants to the transition to ambulatory care. RESULTS As outpatients, participants described adjusting to the intensity of ambulatory treatment and to the need to assume greater responsibility for their care. They also expressed a growing desire to understand their long-term care plan, compared to their preference to focus on the present prior to discharge, and they were struggling to construct a new sense of identity. CONCLUSIONS AML patients are now leaving acute care settings sicker and earlier. Considering their perceptions can inform interventions to facilitate adjustment during the transition to outpatient care.
Collapse
Affiliation(s)
- Rinat Nissim
- Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, 610 University Ave, Toronto, ON, Canada,
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Högberg K, Sandman L, Nyström M, Stockelberg D, Broström A. Prerequisites required for the provision and use of web-based communication for psychosocial support in haematologic care. Eur J Oncol Nurs 2013; 17:596-602. [PMID: 23453568 DOI: 10.1016/j.ejon.2013.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/04/2013] [Accepted: 01/07/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to describe the prerequisites required for the provision and use of web-based communication for psychosocial support within a haematology clinic, from a patient and family perspective. METHOD A qualitative design using content analysis was used. A strategically selected sample of patients (n = 11) and family members (n = 6) were offered access to a web-based communication capability with a nurse. After four months, individual interviews were conducted with all participants, in order to identify necessary prerequisites. RESULTS Preferences and characteristics of the individual patient or family member are crucial as to whether web-based communication for support is perceived as useful. To feel comfortable with writing and to self-identify the need for support are fundamental in getting motivated to use web-based communication. An effective organization around psychosocial support in general is another prerequisite. Goals and responsibilities must be clearly defined for patients and family members to understand their rights and enable the transformation of opportunities into practice. The use of web-based communication must also be a convenient and naturally incorporated part of both individual and organizational use of the web in general. CONCLUSIONS Prerequisites of taking into account caretakers' different preferences and needs, providing highly structured psychosocial support activities and providing a congruent range of web services, are necessary for successful provision and use of web-based communication for psychosocial support.
Collapse
Affiliation(s)
- K Högberg
- School of Health Science, University of Borås, BOX 111, SE-501 90 Borås, Sweden; School of Health Science, Jönköping University, Sweden.
| | | | | | | | | |
Collapse
|
42
|
Urquhart R, Folkes A, Babineau J, Grunfeld E. Views of breast and colorectal cancer survivors on their routine follow-up care. Curr Oncol 2012; 19:294-301. [PMID: 23300354 PMCID: PMC3503661 DOI: 10.3747/co.19.1051] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Our understanding of optimum health care delivery for cancer survivors is limited by the lack of a patient-centred perspective. The objectives of the present study were to explore the views of breast and colorectal cancer survivors on their routine follow-up care, with respect to needs, preferences, and quality of follow-up, and their views on cancer specialist- compared with family physician (fp)-led follow-up care. METHODS In Nova Scotia, Canada, 23 cancer survivors (13 breast, 10 colorectal) participated in either a focus group or a one-on-one interview. Participants were asked to reflect upon their lives as cancer survivors and on the type and quality of care and support they received during the follow-up period. Each focus group or interview was transcribed verbatim, and the transcripts were audited and subjected to a thematic analysis. RESULTS SIX THEMES WERE IDENTIFIED: My care is my responsibilityHow I receive information on follow-up careI have many care needsI want to be prepared and informedThe role of my fp in my cancer experience and follow-up careThe role of media Survivors often characterized the post-primary treatment experience as lacking in information and preparation for follow-up and providing inadequate support to address many of the care needs prevalent in survivor populations. Despite valuing fp participation in follow-up care, many survivors continued to receive comfort and reassurance from specialist care. CONCLUSIONS Our findings point to the need to implement strategies that better prepare breast cancer and colorectal cancer survivors for post-treatment care and that reassure survivors of the ability of their fp to provide quality care during this period.
Collapse
Affiliation(s)
- R. Urquhart
- Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, NS
| | - A. Folkes
- Prevention and Early Detection, Cancer Care Nova Scotia, Halifax, NS
| | - J. Babineau
- Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, NS
| | - E. Grunfeld
- Ontario Institute for Cancer Research, Toronto, ON
- Department of Family and Community Medicine, University of Toronto, Toronto, ON
| |
Collapse
|
43
|
Parry C, Lomax JB, Morningstar EA, Fairclough DL. Identification and correlates of unmet service needs in adult leukemia and lymphoma survivors after treatment. J Oncol Pract 2012; 8:e135-41. [PMID: 23277776 PMCID: PMC3439239 DOI: 10.1200/jop.2011.000464] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2012] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To examine and characterize the psychosocial and health service needs of adult leukemia and lymphoma survivors who had completed active treatment within the past 4 years. METHODS Self-report surveys were completed by 477 survivors, age 18 to 85 years, to identify areas and correlates of unmet psychosocial, health, and instrumental service needs. Unmet service needs were rank ordered, and nonparametric tests were run to assess relationships. RESULTS The rate of unmet need was highest regarding sexual issues, handling medical and living expenses, emotional difficulties, employment, and health insurance. Women were more likely to report unmet child care needs than men; younger individuals were more likely to report needing help with emotional difficulties and family problems; and lower income was related to greater unmet need regarding medical and living expenses. Relationships were also observed among the service needs, suggesting overlapping areas of unmet need. CONCLUSION Adult leukemia and lymphoma survivors demonstrated a diverse range of needs, many of which were related to the psychosocial and physical sequelae of cancer. The findings suggest directions for service provision and development of standards for quality care in this underserved post-treatment population.
Collapse
Affiliation(s)
- Carla Parry
- University of Colorado Denver School of Medicine, Aurora, CO, USA.
| | | | | | | |
Collapse
|