Cognitive adaptation to nonmelanoma skin cancer

Development of an evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework

PURPOSE

To design and develop a complex, evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention (CSI) for breast cancer patients, following the Medical Research Council (MRC) framework.

METHODS

From 2018 September to 2020 November, a complex intervention perspective was adopted. The rationale, methods, and processes employed in carrying out the study were reported. The acceptability and feasibility of intervention program were evaluated as a part of subsequent pilot study. Based on piloting, a refined and optimized definitive intervention was obtained. The development of the intervention is an iterative process involving input from three key stakeholders: experts, medical staff, and patient representatives.

RESULTS

The systematic review revealed CSIs were effective and the selected theory served as a guide and indicated theory-inspired modifications. A representative team of breast cancer patients and oncology nurses collaboratively developed and tailored the intervention content and format with attention to the acceptability and feasibility. Five main strategies, including peripheral, evidential, linguistic, constituent-involving, and sociocultural strategies, were used to achieve and strengthen the cultural appropriateness. After the pilot phase, several refinements were made on the CSI program, such as editorial changes in the booklet or alternative suggestions for difficult strengths-based activities (e.g., outdoor activities). All participants not only expressed satisfaction with the program in process evaluation, but also reported perceived benefits such as enjoyable and sociable experience, better well-being, and increased confidence.

CONCLUSION

Consideration of the MRC framework, theory guidance, and suggestions from stakeholders during intervention development can optimize uptake and sustainability in the clinical setting. It is recommended that randomized controlled trial be used in future studies to assess the intervention, the process and the mechanisms of the intervention. Our approach may offer implications for the design and implementation of similar initiatives to support cancer patients.

TRIAL REGISTRATION

ClinicalTrials.gov Register Identifier: NCT04219267, 07/01/2020, retrospectively registered.

Early development of a novel scale to measure adaptation in people diagnosed with inflammatory bowel disease - the A-inflammatory bowel disease

Objective

To undergo the preliminary development of a new measure of patient adaptation to Inflammatory Bowel Disease (IBD): A-IBD.

Design

Based on a prior conceptualisation of adaptation, a 40-item scale was generated and completed by 304 people diagnosed with IBD.

Main outcome measures

Psychometric analysis of the measure. Association with the Brief Illness Perception Questionnaire (Brief IPQ) and the Inflammatory Bowel Disease Questionnaire (IBDQ).

Results

The 18-item scale consisted of four subscales (patient identity, person identity, acceptance, expectations). Weak to moderate correlations were found between subscales of the A-IBD and the Brief IPQ and IBDQ.

Conclusion

The A-IBD shows potential for assessing adaptation. Further analysis could confirm its usefulness.

Quality of Life in Patients with Non-melanoma Skin Cancer: Implications for Healthcare Education Services and Supports

Non-melanoma skin cancer (NMSC) is the most prevalent type of cancer among Caucasian populations worldwide. The purpose of this work was to measure quality of life (QOL) of the patients with diagnosis of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) who were referred to our cancer clinic. During 1 year, 95 patients were selected and asked to complete Dermatology Life Quality Index (DLQI) questionnaires. Ninety-five patients with NMSC (74 men and 21 women) with mean age of 64.6 ± 12.5 participated in this cross-sectional study. From 95 patients, 75 had BCC, 15 had SCC, and 5 patients had both SCC and BCC. The total DLQI scores of the all participants were between 0 and 16; the mean was 4.1 ± 4.25 and median was 2. Variables which were associated with impaired QOL were marital status (P = 0.03) and tumor location (P = 0.02). By using general dermatology QOL questionnaire, it had been demonstrated that patients with NMSC faced with minimal QOL impairment; also, this handicap was more pronounced in younger patients and singles and patients with tumors located in exposed areas. Our findings demonstrated a need to educate our patients to improve patients' knowledge about different aspects of disease.

Nonmelanoma skin cancer: disease-specific quality-of-life concerns and distress

PURPOSE/OBJECTIVES

To provide a better understanding of the disease-specific quality-of-life (QOL) concerns of patients with nonmelanoma skin cancer (NMSC).

DESIGN

Cross-sectional.

SETTING

Skin cancer clinic of Jewish General Hospital in Montreal, Quebec, Canada.

SAMPLE

56 patients with basal cell carcinoma and/or squamous cell carcinoma.

METHODS

Descriptive and inferential statistics applied to quantitative self-report data.

MAIN RESEARCH VARIABLES

Importance of appearance, psychological distress, and QOL.

FINDINGS

The most prevalent concerns included worries about tumor recurrence, as well as the potential size and conspicuousness of the scar. Skin cancer-specific QOL concerns significantly predicted distress manifested through anxious and depressive symptomology. In addition, the social concerns related to the disease were the most significant predictor of distress.

CONCLUSIONS

The findings of this study provide healthcare professionals with a broad picture of the most prevalent NMSC-specific concerns, as well as the concerns that are of particular importance for different subgroups of patients.

IMPLICATIONS FOR NURSING

Nurses are in a position to provide pivotal psychosocial and informational support to patients, so they need to be aware of the often-overlooked psychosocial effects of NMSC to address these issues and provide optimal care.