1
|
Andersson J, Angenete E, Gellerstedt M, Haglind E. Developing a multivariable prediction model of global health-related quality of life in patients treated for rectal cancer: a prospective study in five countries. Int J Colorectal Dis 2024; 39:35. [PMID: 38441657 PMCID: PMC10914847 DOI: 10.1007/s00384-024-04605-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Rectal cancer and its treatment have a negative impact on health-related quality of life (HRQoL). If risk factors for sustained low HRQoL could be identified early, ideally before the start of treatment, individualised interventions could be identified and implemented to maintain or improve HRQoL. The study aimed to develop a multivariable prediction model for global HRQoL 12 months after rectal cancer treatment. METHODS Within COLOR II, a randomised, multicentre, international trial of laparoscopic and open surgery for rectal cancer, a sub-study on HRQoL included 385 patients in 12 hospitals and five countries. The HRQoL study was optional for hospitals in the COLOR II trial. EORTC QLQ-C30 and EORTC QLQ-CR38 were analysed preoperatively and at 1 and 12 months postoperatively. In exploratory analyses, correlations between age, sex, fatigue, pain, ASA classification, complications, and symptoms after surgery to HRQoL were studied. Bivariate initial analyses were followed by multivariate regression models. RESULTS Patient characteristics and clinical factors explained 4-10% of the variation in global HRQoL. The patient-reported outcomes from EORTC QLQ-C30 explained 55-65% of the variation in global HRQoL. The predominant predictors were fatigue and pain, which significantly impacted global HRQoL at all time points measured. CONCLUSION We found that fatigue and pain were two significant factors associated with posttreatment global HRQoL in patients treated for rectal cancer T1-T3 Nx. Interventions to reduce fatigue and pain could enhance global HRQoL after rectal cancer treatment. TRIAL REGISTRATION This trial is registered with ClinicalTrials.gov No. NCT00297791.
Collapse
Affiliation(s)
- John Andersson
- Department of General and Orthopaedic Surgery, Alingsås Hospital, Alingsås, Sweden
- Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Angenete
- Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | | | - Eva Haglind
- Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
| |
Collapse
|
2
|
Diez-Martínez M, Perpiñá-Galvañ J, Fernández-Alcántara M, García-Rodríguez G, Carreres M, Portilla J, Cabañero-Martínez MJ. Knowledge and Perceived Emotions Regarding an Anal Cancer Preventive Program in People Diagnosed With HIV: A Qualitative Study. Cancer Nurs 2024; 47:E18-E27. [PMID: 35984921 DOI: 10.1097/ncc.0000000000001156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To the best of our knowledge, no studies have yet examined the emotional repercussions of the care processes among people infected with the human immunodeficiency virus who participate in preventive anal cancer screening programs. OBJECTIVE This study aimed to explore the knowledge, emotions, sexuality, barriers, and facilitators perceived by this patient group during the process of anal cancer screening and diagnosis. METHODS Detailed, semistructured, qualitative interviews were completed with 17 men and 3 women to explore their knowledge, experiences, and emotions regarding the screening process. Purposive sampling was conducted on the basis of age, gender, and type of lesion diagnosed in the anal biopsy. RESULTS Four major themes were identified: 1) knowledge of the disease and its treatment, 2) emotions perceived by the patients, 3) the influence of screening on sexual practices, and 4) facilitators and obstacles during the care provision process. Patients reported appropriate knowledge of anal cancer and human papillomavirus. Predominant emotions were worry and fear with avoidance as one of the coping strategies. CONCLUSION These results suggest that communication of information and clinical results can be improved. IMPLICATION FOR PRACTICE Understanding the facilitators and barriers to the program will allow the integration of interventions designed to improve healthcare provision into direct care.
Collapse
Affiliation(s)
- Marcos Diez-Martínez
- Author Affiliations: Infectious Diseases Unit, Alicante University General Hospital (Mr Diez-Martínez, Mrs García-Rodríguez, Mrs Carreres, and Dr Portilla); Alicante Institute for Health and Biomedical Research (ISABIAL); Spanish AIDS Research Network, Carlos III Health Institute (Mr Diez-Martínez, Mrs García-Rodríguez, Mrs Carreres, and Dr Portilla), Madrid; Nursing Department, University of Alicante (Drs Perpiñá-Galvañ and Cabañero-Martínez); Department of Health Psychology, University of Alicante (Dr Fernández-Alcántara); and Department of Clinical Medicine, Miguel Hernandez University (Dr Portilla), Elche, Alicante, Spain
| | | | | | | | | | | | | |
Collapse
|
3
|
González-Herrera A, Pujol-Ribera E, Esteva M, Ruiz-Marcos L, March S. Colorectal cancer: a qualitative study of coping strategies used by survivors, with associated social determinants. Arch Public Health 2023; 81:111. [PMID: 37331995 DOI: 10.1186/s13690-023-01104-4] [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: 08/12/2022] [Accepted: 05/06/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Colorectal cancer survivors have to develop coping strategies during the diagnosis and survivorship period. This study aims to identify coping strategies in patients with colorectal cancer, in particular the differences between coping strategies during the disease and throughout survival. It also aims to investigate the impact of some social determinants on coping strategies and critically reflect on the influence of positive psychology. METHODS Qualitative study with in-depth interviews of a purposive sample of 21 colorectal cancer survivors in Majorca (Spain), developed between 2017-2019. Data was analysed using interpretive thematic analysis. RESULTS We observed different coping strategies during the stages of disease and survival. However, striving toward acceptance and adaptation when facing difficulties and uncertainty, predominate in both stages. Confrontational attitudes are also considered important, as well as encouraging positive rather than negative feelings, which are considered unhelpful and to be avoided. CONCLUSIONS Although coping during illness and survival can be classified into common categories (problem and emotion-centred strategies), the challenges of these stages are faced differently. Age, gender and the cultural influence of positive psychology strongly influence both stages and strategies.
Collapse
Affiliation(s)
| | - Enriqueta Pujol-Ribera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Gerència Territorial de Barcelona, Institut Català de La Salut, Barcelona, Spain
| | - Magdalena Esteva
- Primary Care Research Unit, Majorca Department of Primary Care, Baleares Health Service (IbSalut), Palma, Majorca, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Majorca, Spain.
| | - Lorena Ruiz-Marcos
- Faculty of Political Sciences and Sociology, Complutense University of Madrid, Pozuelo de Alarcón, Madrid, Spain
| | | |
Collapse
|
4
|
Ketlogetswe TS, Van Rensburg JJJ, Maree JE. The experiences of caregivers of patients living with cancer admitted to a hospice in South Africa. Int J Palliat Nurs 2022; 28:164-171. [PMID: 35465701 DOI: 10.12968/ijpn.2022.28.4.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Caregivers share cancer experiences with patients, but little is known about their own experiences in the end-of-life phase, the most difficult phase in the caregiving journey. AIMS To describe the experiences of caregivers of cancer patients admitted to a hospice in South Africa. METHODS A qualitative design was used; 22 (n=22) participants were purposively selected and in-depth interviews were conducted. Analysis of the data was by qualitative content analysis. FINDINGS A total of three themes arose from the data: emotional responses towards the caregiver role, personal cost of caregiving and spiritual issues relating to caregiving. CONCLUSION Caring for cancer patients during the last phase of life was not easy. Responsibilities overwhelmed the participants and they were emotionally exhausted. They lacked knowledge of how to care and experienced a heavy financial burden. Despite the challenges that they faced, faith and religious practices served as a coping mechanism and kept some going.
Collapse
Affiliation(s)
- Tinalipi S Ketlogetswe
- MSc candidate, Department of Nursing Education, University of the Witwatersrand, South Africa
| | | | - Johanna Elizabeth Maree
- Associate Professor, Department of Nursing Education, University of the Witwatersrand, South Africa
| |
Collapse
|
5
|
Wan SW, Chong CS, Jee XP, Pikkarainen M, He HG. Perioperative experiences and needs of patients who undergo colorectal cancer surgery and their family caregivers: a qualitative study. Support Care Cancer 2022; 30:5401-5410. [PMID: 35298716 PMCID: PMC8929239 DOI: 10.1007/s00520-022-06963-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/07/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Colorectal cancer (CRC) surgeries are major, complex, and often associated with debilitating symptoms or significant deconditioning that may impair patients' quality of life. Little is known about how patients and family caregivers cope and their unmet needs during this daunting perioperative phase. This study aimed to explore the experiences and needs of CRC patients who undergo surgery and their family caregivers. METHODS An exploratory qualitative design was adopted. A total of 27 participants comprising fifteen outpatients who had undergone colorectal cancer surgery and twelve family caregivers were recruited through purposive sampling from a public tertiary hospital in Singapore between December 2019 and November 2020. Individual, audio-recorded, semi-structured interviews were conducted, transcribed verbatim, and analyzed using thematic analysis. RESULTS Four themes emerged: initial reactions to the diagnosis, impact of the illness and surgery, personal coping, and external support. The lack of apparent assessments on the psychological well-being of patients was found despite several participants exhibiting early signs of distress. Access to psychological support provided by healthcare professionals or peers was selective, and knowledge deficit was prevalent, especially in the preoperative stage. CONCLUSION Psychological priming and strengthening are important for CRC patients' and their caregivers' adaptive coping throughout the treatment continuum. Technology-based, dyadic psychoeducation should be offered preoperatively to ease CRC patients' acceptance of their diagnosis and adjustment to life after surgery while at the same time reduce the burden of family carers.
Collapse
Affiliation(s)
- Su Wei Wan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 1, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597 Singapore
| | - Choon Seng Chong
- Division of Colorectal Surgery and Surgical Oncology, Department of Surgery, National University Cancer Institute, National University Hospital, Singapore, Singapore ,Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Xin Pei Jee
- Division of Colorectal Surgery, Department of Nursing, National University Hospital, Singapore, Singapore ,National University Health System, Singapore, Singapore
| | - Minna Pikkarainen
- Martti Ahtisaari Institute, Oulu Business School, Oulu University, Oulu, Finland ,Oslomet, Oslo Metropolitan University, Oslo, Norway
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 1, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597 Singapore
| |
Collapse
|
6
|
Brincat A, Vella Bonanno P, Stewart D, Weidmann AE. Patients’ experiences of medicines on initiation of antineoplastic agents for the treatment of colorectal cancer: a qualitative study. BMJ Open 2021. [PMCID: PMC8719168 DOI: 10.1136/bmjopen-2020-047749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective To explore the patients’ experiences on initiation of treatment with antineoplastic medicines for colorectal cancer. Design A qualitative study using semistructured, face-to-face interviews based on the adapted patients’ lived experience with medicines conceptual model was conducted. Ethics approval was granted. Interviews took place while eligible patients were receiving their first cycle of antineoplastic medicines, audiorecorded and transcribed verbatim. Interpretative phenomenological analysis was used. Setting National oncology hospital in Malta. Participants Adult patients over 18 years, newly diagnosed with colorectal cancer and initiating treatment with 5-fluorouracil/folinic acid and oxaliplatin (FOLFOX) or capecitabine plus oxaliplatin (XELOX) between October 2018 and September 2019 were recruited. Patients were included if fully aware of their diagnosis and the treatment being received. A purposive sample of 16 patients participated in the study. Results Five themes emerged from our analysis: (1) beliefs and knowledge on cancer and treatment; (2) healthcare system in relation to treatment; (3) medicine-taking practice; (4) medicine-related impact and (5) personal support structure. In addition, 16 subthemes were identified to describe the interplay of all aspects of the patients’ experiences on initiation of treatment with antineoplastic medicines. Conclusion This qualitative study illustrated that the patients find themselves in a complex situation on initiation of treatment with antineoplastic medicines. The patients’ knowledge on their specific treatment and active participation in making an informed decision need to be addressed. The healthcare system should develop tailored patient-centred services that specifically address the lack of patient empowerment and patient’s concern about treatment specific information.
Collapse
Affiliation(s)
- Alison Brincat
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
| | - Patricia Vella Bonanno
- Department of Health Systems Management and Leadership, University of Malta, Msida, Malta
| | - Derek Stewart
- Department of Clinical Pharmacy and Practice, Qatar University, Doha, Qatar
| | - Anita E Weidmann
- Department of Clinical Pharmacy, University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
7
|
Mlaba PC, Ginindza TG, Hlongwana KW. The social burden experienced by families caring for members living with cancer in KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med 2021; 13:e1-e10. [PMID: 34797113 PMCID: PMC8603144 DOI: 10.4102/phcfm.v13i1.2955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Cancer is a global public health problem and it affects people in different ways. Family caregivers (FCs) play an essential role in caring for patients with cancer, and thus, they experience many caregiver burdens that go unnoticed. AIM This research study explored the social burden that families experience in providing care to their family members living with cancer. SETTING This study was conducted in Durban and Pietermaritzburg, cities located in KwaZulu-Natal, South Africa. METHODS This was a qualitative study using the interpretative phenomenological approach that was ideal for understanding FCs subjective perspectives on their cancer caregiving experience. Data saturation were reached at 20 in-depth interviews. RESULTS Two major themes culminated from the data analysis; dynamics of a cancer diagnosis and psychosocial impact of a cancer diagnosis with respective sub-themes. Themes centred around the relational impact of a cancer diagnosis with FCs experiencing a shift in this dynamic and a disturbance to normality in social life. Social support systems were found to play a meaningful role in mitigating the impact of a cancer diagnosis with financial, psychosocial and educational support considered essential needs. CONCLUSION Cancer caregiving is a challenging task that also presents opportunities for strengthening family bonds as they evolve in new paths. A family-centred care approach is recommended as a form of social support with further collaboration with health care providers for guided patient care. If the needs of FCs are addressed accordingly through health care policies and interventions, FCs may be able to provide better care and support for their family members with cancer and thus positively impact cancer survivorship.
Collapse
Affiliation(s)
- Phindile C Mlaba
- Department of Public Health Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban.
| | | | | |
Collapse
|
8
|
Cuthbert CA, Farragher JF, Farrer CL, Cheung WY. Living with paradox: A qualitative study of colorectal cancer patients' experiences in managing their health after cancer treatment. Eur J Cancer Care (Engl) 2021; 30:e13416. [PMID: 33506569 DOI: 10.1111/ecc.13416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/09/2020] [Accepted: 01/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Managing one's health after colorectal cancer may present specific challenges given long-term impacts to biopsychosocial functioning. Understanding experiences of managing one's health post-treatment is important to informing patient-centred supportive care. METHODS A qualitative study with 19 patients who had completed treatment for colorectal cancer to explore the experience of managing one's health. Following Thorne's Interpretive Description, we conducted interviews using either focus groups or individual interviews. Transcribed data were analysed following Thorne's approach. Sociodemographic and clinical characteristics were also collected. RESULTS The metaphor of living with paradox was the main theme characterising the experiences of managing one's health in the post-treatment period. Participants described the ambiguity of health, their need to accept the new normal, losing control and taking back control, experiencing positive and negative life changes, and the need to continually reframe their perspectives to focus on the positives. CONCLUSION Our findings suggest that providing patient-centred care to colorectal cancer survivors post-treatment involves recognising their changing and sometimes conflicting experiences. Their ability to manage their health may fluctuate and their supportive care needs may not fit with a particular trajectory. Cancer care systems should strive for flexibility in the structure and timing of support available.
Collapse
Affiliation(s)
- Colleen A Cuthbert
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.,Division of Medical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Janine F Farragher
- Department of Occupational Science and Occupational Therapy, University of Toronto, Calgary, Alberta, Canada
| | - Christie L Farrer
- Division of Medical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Winson Y Cheung
- Division of Medical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,CancerControl, Alberta Health Services, Calgary, Alberta, Canada
| |
Collapse
|
9
|
Son H, Kang Y. Coping Processes of Patients with Ostomies in South Korea: A Focus Group Study. Healthcare (Basel) 2020; 9:healthcare9010021. [PMID: 33375414 PMCID: PMC7824537 DOI: 10.3390/healthcare9010021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022] Open
Abstract
Despite the adverse effects of negative coping after receiving a stoma, there is a lack of information on how patients cope with ostomies and on their families' experiences throughout the coping process. We aimed to explore the coping experiences of individuals with ostomies throughout their illness, applying the Corbin and Strauss Chronic Illness Trajectory Framework, using exploratory qualitative methods involving focus group interviews. Purposive sampling was utilized to recruit 19 participants (split across three groups) through an ostomy association in South Korea. Two focus group interviews were separately conducted from March through to May 2017 until data saturation was achieved. Using qualitative content analysis, we analyzed the transcribed interviews and identified words and themes to interpret the results. The coping experiences of patients with ostomies were expressed through three interrelated themes: struggling and suffering, learning how to live with ostomy, and living with ostomy. We found gender differences in spousal support and a struggle among older patients regarding social coping. The themes identified suggest that gender should be considered when designing interventions to help patients cope with ostomies.
Collapse
Affiliation(s)
- Heesook Son
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea;
| | - Youngmi Kang
- East-West Nursing Research Institute, College of Nursing Science, Kyung Hee University, Seoul 02447, Korea
- Correspondence: ; Tel.: +82-2-961-9175
| |
Collapse
|
10
|
Olsen A, Keogh J, Sargeant S. Investigating How Bowel Cancer Survivors Discuss Exercise and Physical Activity Within Web-Based Discussion Forums: Qualitative Analysis. J Med Internet Res 2019; 21:e13929. [PMID: 31841117 PMCID: PMC6937542 DOI: 10.2196/13929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 01/29/2023] Open
Abstract
Background Online cancer support group discussions enable patients to share their illness experience with others. The sharing of technical and emotional support information and the ability to ask for advice are some of the primary discussions shared online. People with bowel cancer can also use these forums to support each other by sharing information based on personal experiences. This type of support provides newly diagnosed patients with advice about several topics, including exercise from those who have been there. Information gathered from online discussion boards may complement the advice received by health professionals. Objective This study aimed to explore the nature of information related to exercise and physical activity exchanged online for cancer survivors. Methods A public open access bowel cancer discussion board was searched for threads containing information related to physical activity or exercise. Keywords such as exercise, physical activity, moving, walking, lifting, weights training, and resistance were used to search for threads (online conversations) related to exercise or physical activity. Only threads initiated by bowel cancer patients or survivors were included. From more than 6000 posts, the inclusion criteria yielded 75 threads for analysis. Inductive thematic analysis was conducted across all included threads. Results Analysis yielded 3 main themes: level of exercise competence, beneficial dimensions of exercise, and faith in the knowledge. Level of exercise competence illustrated the varying definitions of exercise that members of the forum discussed in the forum. Beneficial dimensions of exercise revealed that forum members shared both the spiritual benefits associated with exercise as well as the physical benefits or goodness that they feel exercise or physical activity provides them. Faith in the knowledge of exercise demonstrated that forum members were aware of the general benefits of exercise but felt disappointed that it did not keep the cancer at bay. However, members also had faith that exercise would keep them healthy after diagnosis and treatment. Conclusions The analysis revealed that people with bowel cancer discuss exercise and physical activity online and that they view exercise as having a mostly positive influence on their cancer journey. However, personal definitions of exercise became a source of conflict within the group. People with bowel cancer seeking information about exercise may benefit from participating in online support groups as it appears that there are many similar others willing to share their personal experiences with exercise. In addition, health care professionals responsible for caring for people with bowel cancer may use these findings to discuss exercise with their patients while being mindful of how they may view exercise.
Collapse
Affiliation(s)
- Alicia Olsen
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia.,Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Australia.,Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sally Sargeant
- School of Health and Human Sciences, Southern Cross University, Bilinga, Australia
| |
Collapse
|
11
|
Sharour LA, Omari OA, Malak MZ, Salameh AB, Yehia D, Subih M, Alrshoud M. Using Mixed-Methods Research to Study Coping Strategies among Colorectal Cancer Patients. Asia Pac J Oncol Nurs 2019; 7:81-87. [PMID: 31879688 PMCID: PMC6927164 DOI: 10.4103/apjon.apjon_20_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/09/2019] [Indexed: 12/04/2022] Open
Abstract
Objective: The objective was to identify and understand the coping strategies of colorectal cancer (CRC) patients. Methods: A mixed-methods approach including quantitative and qualitative methods was used to collect data from Jordanian patients. In the quantitative phase, we aimed to determine the coping strategies employed in a representative sample (n = 200) of Jordanian adult patients with CRC using the Jalowiec Coping Scale. In the qualitative phase, we aimed to understand these coping strategies through an in-depth and detailed exploration. A sample of ten participants was chosen purposefully based on their coping score in the quantitative phase, and interviews were conducted. Quantitative data were analyzed using SPSS software version 23. Qualitative data were analyzed using directed content analysis. Results: Results from the quantitative phase indicated that evasive coping strategies were used predominantly, followed by confrontive coping strategies and optimistic coping strategies. In contrast, fatalistic and emotive coping strategies had the lowest scores. In addition, the results indicated that the total scores for the effectiveness of coping strategies ranged from 42 to 143, with a mean of 93.45 (standard deviation 13.67); higher scores reflected greater effectiveness. Content analysis in the qualitative phase identified three themes, and subcategories emerged, including perceived collaborative support, increased awareness of treatment, and internal power. Conclusions: CRC patients used different coping strategies to face the new challenge. Oncology nurses can play a pivotal role in enhancing these coping strategies through implementing multidisciplinary programs.
Collapse
Affiliation(s)
- Loai Abu Sharour
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Omar Al Omari
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Malakeh Z Malak
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Ayman Bani Salameh
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Dalal Yehia
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Maha Subih
- Nursing Department, Faculty of Nursing, AL-Zaytoonah University of Jordan, Amman, Jordan
| | - Mohammad Alrshoud
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Amman, Jordan
| |
Collapse
|
12
|
Kristanti MS, Effendy C, Utarini A, Vernooij-Dassen M, Engels Y. The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach. Palliat Med 2019; 33:676-684. [PMID: 30916614 PMCID: PMC6537031 DOI: 10.1177/0269216319833260] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Strong family bonds are part of the Indonesian culture. Family members of patients with cancer are intensively involved in caring, also in hospitals. This is considered "normal": a societal and religious obligation. The values underpinning this might influence families' perception of it. AIM To explore and model experiences of family caregivers of patients with cancer in Indonesia in performing caregiving tasks. DESIGN A grounded theory approach was applied. The constant comparative method was used for data analysis and a paradigm scheme was employed for developing a theoretical model. SETTING/PARTICIPANTS The study was conducted in three hospitals in Indonesia. The participants were family caregivers of patients with cancer. RESULTS A total of 24 family caregivers participated. "Belief in caregiving" appeared to be the core phenomenon. This reflects the caregivers' conviction that providing care is an important value, which becomes the will power and source of their strength. It is a combination of spiritual and religious, value and motivation to care, and is influenced by contextual factors. It influences actions: coping mechanisms, sharing tasks, and making sacrifices. Social support influences the process of the core phenomenon and the actions of the caregivers. Both positive and negative experiences were identified. CONCLUSION We developed a model of family caregivers' experiences from a country where caregiving is deeply rooted in religion and culture. The model might also be useful in other cultural contexts. Our model shows that the spiritual domain, not only for the patient but also for the family caregivers, should be structurally addressed by professional caregivers.
Collapse
Affiliation(s)
- Martina Sinta Kristanti
- Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
- School of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Christantie Effendy
- School of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Adi Utarini
- Department of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
13
|
Kaufmann-Molnàr I, Hofmann Checchini H, Fringer A. [Chemotherapeutic side effects in colon cancer. A qualitative study from the point of view of those affected]. Pflege 2019; 32:129-136. [PMID: 30961434 DOI: 10.1024/1012-5302/a000676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Chemotherapeutic side effects in colon cancer. A qualitative study from the point of view of those affected Abstract. Background: Colon cancer is a common disease in industrialized countries. The combination of surgery, chemo- and / or target therapies leads to physical, psychological and social changes in everyday life. Those affected are confronted with uncertainty, transience and loss of control. It is not clear which strategies are used by those affected to promote self-management. Objective: To identify coping strategies that individuals with stage III and IV colon cancer develop in dealing with the disease and its symptoms as well as the side effects of chemotherapy. Methods: A qualitative-descriptive design with guideline-based interviews was chosen. Data analysis was performed inductively by means of "initial coding" using four process steps for category development. Results: Eleven people affected report the loss of autonomy and control in everyday life. They experience their own finiteness and personal limits. Those affected develop strategies to compensate for the increasing loss of control and dependency. They look for expertise and try to maintain normality and everyday life. Their experience oscillates between "fear and hope". Conclusions: For people with colon cancer, hope is an important coping strategy. Person-centred counselling throughout the treatment process help people cope with their chronic condition.
Collapse
Affiliation(s)
| | - Hedi Hofmann Checchini
- 2 Fachbereich Gesundheit, Hochschule für Angewandte Wissenschaften, Fachhochschule St. Gallen
| | - André Fringer
- 2 Fachbereich Gesundheit, Hochschule für Angewandte Wissenschaften, Fachhochschule St. Gallen.,3 Institut für Pflege, Zürcher Hochschule für Angewandte Wissenschaften ZHAW, Winterthur
| |
Collapse
|
14
|
Puchalski CM, Sbrana A, Ferrell B, Jafari N, King S, Balboni T, Miccinesi G, Vandenhoeck A, Silbermann M, Balducci L, Yong J, Antonuzzo A, Falcone A, Ripamonti CI. Interprofessional spiritual care in oncology: a literature review. ESMO Open 2019; 4:e000465. [PMID: 30962955 PMCID: PMC6435249 DOI: 10.1136/esmoopen-2018-000465] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 01/08/2023] Open
Abstract
Spiritual care is recognised as an essential element of the care of patients with serious illness such as cancer. Spiritual distress can result in poorer health outcomes including quality of life. The American Society of Clinical Oncology and other organisations recommend addressing spiritual needs in the clinical setting. This paper reviews the literature findings and proposes recommendations for interprofessional spiritual care.
Collapse
Affiliation(s)
- Christina M Puchalski
- George Washington Institute for Spirituality and Health, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Andrea Sbrana
- Department of Translational Research, Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Betty Ferrell
- Division of Nursing Research and Education City of Hope, Duarte, California, USA
| | - Najmeh Jafari
- George Washington Institute for Spirituality and Health, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Stephen King
- Spiritual Health, Child Life, and Clinical Patient Navigators, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Tracy Balboni
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Initiative on Health, Religion, and Spirituality–Harvard University, Boston, Massachusetts, USA
| | - Guido Miccinesi
- Clinical Epidemiology Unit, Cancer Network, Prevention and Research Institute-ISPRO, Florence, Italy
| | - Anna Vandenhoeck
- European Research Institute for Chaplains in Healthcare, Theology and Religious Studies KU Leuven, Leuven, Belgium
| | | | - Lodovico Balducci
- Moffitt Cancer Center, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Julianna Yong
- College of Nursing, WHO Collaborating Centre for Training in Hospice and Palliative Care, The Catholic University of Korea, Seoul, Korea
| | - Andrea Antonuzzo
- Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Alfredo Falcone
- Department of Translational Research, Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Carla Ida Ripamonti
- Oncology-Supportive Care Unit, Department of Oncology-Haematology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| |
Collapse
|
15
|
Abelson JS, Chait A, Shen MJ, Charlson M, Dickerman A, Yeo H. Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: A qualitative study. Surgery 2019; 165:461-468. [DOI: 10.1016/j.surg.2018.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/09/2018] [Accepted: 06/05/2018] [Indexed: 10/28/2022]
|
16
|
Calderón C, Jimenez-Fonseca P, Jara C, Hernández R, Martínez de Castro E, Varma S, Ghanem I, Carmona-Bayonas A. Comparison of Coping, Psychological Distress, and Level of Functioning in Patients With Gastric and Colorectal Cancer Before Adjuvant Chemotherapy. J Pain Symptom Manage 2018; 56:399-405. [PMID: 29775693 DOI: 10.1016/j.jpainsymman.2018.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/28/2022]
Abstract
CONTEXT Patients with gastrointestinal cancers are at high risk for functional problems that are generally accompanied by a decline in their overall status and intense psychological distress. OBJECTIVES This study compares the level of functioning in individuals with gastric cancer (GC) and colorectal cancer (CRC) and analyzes whether improved functioning can be explained by patients' psychological status and coping strategies. METHODS This is a prospective, transversal, multicenter study in patients with nonmetastatic GC and CRC before initiating adjuvant chemotherapy. Participants answered questionnaires evaluating quality of life, including functioning (European Organization for Research and Treatment of Cancer Quality of Life questionnaire), coping strategies (Mini-Mental Adjustment to Cancer), and psychological distress (Brief Symptom Inventory-18). RESULTS Between December 2015 and July 2017, 266 patients with CRC and 69 patients with GC were consecutively recruited. A pathological level of functioning was more prevalent in people with GC than in those with CRC (20% vs. 5%). Individuals with GC presented worse functioning and more psychological distress and displayed more hopelessness, anxious preoccupation, and cognitive avoidance as coping strategies than those with CRC. Psychological distress and fighting spirit accounted for 40% of the functional status in GC patients, whereas psychological distress and hopelessness represented 58% of CRC patients' functional status. CONCLUSION Our findings suggest that level of functioning affects many subjects with GC and reveals the importance of developing interventions targeted at enhancing adaptive coping strategies before initiating adjuvant cancer treatment.
Collapse
Affiliation(s)
- Caterina Calderón
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Carlos Jara
- Department of Medical Oncology, Hospital Universitario Fundación Alcorcón, University Rey Juan Carlos, Madrid, Spain
| | - Raquel Hernández
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Eva Martínez de Castro
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Sonal Varma
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Ismael Ghanem
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | | |
Collapse
|
17
|
Potgieter T, Maree JE. The palliative chemotherapy decision and experiences of South African patients and their families. Int J Palliat Nurs 2018; 24:272-280. [PMID: 29932835 DOI: 10.12968/ijpn.2018.24.6.272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS To describe what motivates cancer patients, treated at a private cancer care centre in Port Elizabeth, South Africa, to undergo palliative chemotherapy and how the patients and their families experienced this treatment. METHODS A descriptive qualitative design was used. Researchers conducted 22 in-depth interviews with 11 purposively selected patients and 11 family members nominated by the patients. Qualitative content analysis was used to analyse the data. FINDINGS The patient participants consisted of two males and nine females between the ages 40 and 79, who had been diagnosed with various cancers. The family members consisted of six husbands, two wives and three sons, with ages ranging from 20 to 79. Three themes arose from the patient data and three from the family data. CONCLUSION Hope informed the palliative treatment decision. Despite being told that the chemotherapy would not cure them, patients hoped for additional time and even a cure. The families supported the patient's decision and shared their hopes. The family members were aware of the side effects their loved ones were experiencing, but still experienced the treatment as positive. Giving and receiving support was important and religion, the families and staff and fellow patients at the cancer care centre were identified as sources of support.
Collapse
Affiliation(s)
- Theola Potgieter
- Nursing Student, Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| | - Johanna E Maree
- Head of Department, Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
18
|
Maree JE, Moshima D, Ngubeni M, Zondi L. On being a caregiver: The experiences of South African family caregivers caring for cancer patients. Eur J Cancer Care (Engl) 2017; 27:e12801. [PMID: 29265503 DOI: 10.1111/ecc.12801] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2017] [Indexed: 12/26/2022]
Abstract
The purpose of our study was to describe the experiences of family caregivers of cancer patients using the public healthcare system in South Africa. We used a qualitative descriptive design and conducted in-depth interviews with 20 purposively selected family caregivers. Data saturation determined the sample size, and qualitative content analysis was used to analyse the data. Three themes arose from the data: emotional responses and feelings towards the cancer diagnosis, fulfilling the role of the caregiver and living and coping with a changed life and a changed person. Caring for a person with cancer was not easy. Participants were overwhelmed with the care responsibilities, which were aggravated by poverty. Some felt emotionally broken and alone in this journey and experienced the rest of their family as uncaring. The lives the participants knew changed and they had to put their own lives on hold and make sacrifices involving their children, work, possible relationships and their normal activities to care for the sick person. For some, the sick person they cared for changed and became a person they did not know. Most participants used religious practices to cope with their situation; however, some used other coping mechanisms, such as recreation and even smoking.
Collapse
Affiliation(s)
- J E Maree
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - D Moshima
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - M Ngubeni
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - L Zondi
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
19
|
Brandenbarg D, Roorda C, Stadlander M, de Bock GH, Berger MY, Berendsen AJ. Patients' views on general practitioners' role during treatment and follow-up of colorectal cancer: a qualitative study. Fam Pract 2017; 34:234-238. [PMID: 27920118 DOI: 10.1093/fampra/cmw124] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE To clarify experiences and preferences of patients regarding the current and future role of GPs during treatment and follow-up care of colorectal cancer (CRC). METHODS Qualitative semi-structured, audio-recorded, face-to-face interviews in patients' homes in the north of the Netherlands were performed. Patients were sampled purposively on age, gender, time since diagnoses and primary health care use. Data were transcribed verbatim and analysed thematically by two independent researchers until saturation was reached. RESULTS Twenty-two patients were interviewed. GPs played a significant and highly valued role directly after surgery by proactively contacting their patients and offered support in clarification of medical issues, lifestyle advice and care for treatment-related side effects. During follow-up, GPs provided psychosocial support for patients and family members, besides routine health care. Concerning the organization of future follow-up care, most patients expressed a preference for specialist-led services; some said that primary care-led care would be more accessible and less expensive. CONCLUSION Although at present patients perceived their GP is involved in CRC care, they would prefer their follow-up care in a hospital setting. If, in line with recent insights, future follow-up care might become more relying on testing for markers instead of imaging, there may be scope for incorporating this care in current GP routines.
Collapse
Affiliation(s)
- Daan Brandenbarg
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Carriene Roorda
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michelle Stadlander
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marjolein Y Berger
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette J Berendsen
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
20
|
Selman L, Beynon T, Radcliffe E, Whittaker S, Orlowska D, Child F, Harding R. ‘We're all carrying a burden that we're not sharing’: a qualitative study of the impact of cutaneous T-cell lymphoma on the family. Br J Dermatol 2015; 172:1581-1592. [DOI: 10.1111/bjd.13583] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2014] [Indexed: 11/30/2022]
Affiliation(s)
- L.E. Selman
- Department of Palliative Care, Policy and Rehabilitation; Cicely Saunders Institute; King's College London; Bessemer Rd London SE5 9PJ U.K
| | - T. Beynon
- Department of Palliative Care, Policy and Rehabilitation; Cicely Saunders Institute; King's College London; Bessemer Rd London SE5 9PJ U.K
| | - E. Radcliffe
- Department of Palliative Care, Policy and Rehabilitation; Cicely Saunders Institute; King's College London; Bessemer Rd London SE5 9PJ U.K
| | - S. Whittaker
- St. John's Institute of Dermatology; Guy's and St. Thomas' NHS Foundation Trust; London U.K
| | - D. Orlowska
- St. John's Institute of Dermatology; Guy's and St. Thomas' NHS Foundation Trust; London U.K
| | - F. Child
- St. John's Institute of Dermatology; Guy's and St. Thomas' NHS Foundation Trust; London U.K
| | - R. Harding
- Department of Palliative Care, Policy and Rehabilitation; Cicely Saunders Institute; King's College London; Bessemer Rd London SE5 9PJ U.K
| |
Collapse
|