Lived Experiences of “Illness Uncertainty” of Iranian Cancer Patients: A Phenomenological Hermeneutic Study

The impact of an integrated early palliative care telehealth intervention on the quality of life of heart failure patients: a randomized controlled feasibility study

BACKGROUND

While palliative care for patients with heart failure has gained global attention, in Iran most palliative care interventions have focused only on cancer patients. The purpose of this study is to determine the feasibility and acceptability of a telehealth palliative care intervention to improve the quality of life in patients with heart failure in Iran.

METHODS

This single-site, pilot randomized controlled trial of a telehealth palliative care intervention versus usual care was conducted on patients with New York Heart Association class II/III heart failure recruited from a heart failure clinic in Iran. Under the supervision of a nurse interventionist, intervention participants received 6 weekly educational webinars and concurrent WhatsApp® group activities, with 6 weeks of follow-up. Feasibility was assessed by measuring recruitment, attrition, and questionnaire completion rates; acceptability was assessed via telephone interviews asking about satisfaction and attitudes. Secondary outcomes measured at baseline and 6 weeks included quality of life (PKCCQ and FACIT-Pal-14), anxiety and depression (HADS), and emergency department visits.

RESULTS

We recruited and randomized 50 patients (mean age 47.5 years, 60% men). Among those approached for consent, 66% of patients agreed to participate and total study attrition was 10%. Also 68% of patients successfully completed at least 4 out of the 6 webinar sessions. Acceptability: 78% of patient participants expressed willingness to participate in the present study again or recommend other patients to participate. There was a trend towards improvement in anxiety and depression scores in the intervention group though the study was not powered to detect a statistical difference.

CONCLUSION

This nurse-led, early telehealth-palliative care intervention demonstrated evidence of feasibility, acceptability, and potential improvement on quality of life in patients with heart failure in Iran.

TRIAL REGISTRATION

The study was registered at the Iranian Registry of Clinical Trials (IRCT) at 14 November, 2021, and can be found on the Iranian Registry of Clinical Trials Platform. IRCT registration number: IRCT20100725004443N29.

Factors influencing the supportive care needs of female patients with genital cancer in South Korea

Genital cancers are particularly important compared to other cancers because of the psychological impact they have on the individual. This study investigated the complexity in illness and quality of life among female genital cancer patients and determined the effects of these factors on supportive care needs to provide evidential data for the development of nursing intervention strategies to reduce supportive care needs in female genital cancer patients. This cross-sectional study collected data from July 22 to August 17, 2021. The study subjects were 103 female outpatients and inpatients aged 19 years or older who were treated for cervical cancer, endometrial cancer, ovarian cancer, or other female genital cancers such as vulvar cancer and vaginal cancer in a university hospital in Korea. The data were analyzed with t-tests and Scheffé's test using SPSS 26.0. The factors affecting supportive care needs were examined using hierarchical regression. The average age of the subjects was 56.41 (±9.91) years. Cervical cancer was the most common diagnosis at 42.7%, followed by ovarian cancer at 34.0%, and endometrial cancer at 21.4%. The factors affecting supportive care needs included a middle school education or below (β = 0.21, P = .028), unemployment (β = 0.23, P = .018), complexity in illness (β = 0.32, P < .001), and quality of life (β = -0.68, P < .001). Developing a strategy for managing the complexity in illness and quality of life caused by various variables including disease stage and type of treatment is necessary to reduce the supportive care needs of female genital cancer patients. Improving their quality of life through effective communication with healthcare providers is essential.

Relationship between self-disclosure and anticipatory grief in patients with advanced lung cancer: the mediation role of illness uncertainty

Objective

To study the relationship between self-disclosure, illness uncertainty (IU) and anticipatory grief (AG) in patients with advanced lung cancer.

Methods

This is a cross-sectional study using convenience sampling method, in which 316 patients with advanced lung cancer who were hospitalized in a tertiary hospital in Wuxi City, China, from November 2022 to April 2023 were sampled. The Preparatory Grief in Advanced Cancer Patients, Mishel Uncertainty in Illness Scale, and the Distress Disclosure Index Scale (DDI) were selected to analyse the status quo, correlations, and the mediating effect of illness uncertainty on the relationship between self-disclosure and anticipatory grief in advanced lung cancer patients.

Results

The total self-disclosure score of advanced lung cancer patients was (36.35 ± 9.25), the total score of IU was (56.92 ± 15.65), and the score of AG was (52.29 ± 9.08); the results of correlation analyses showed that IU was negatively correlated with self-disclosure in advanced lung cancer patients (p < 0.05) and positively correlated with AG (p < 0.05), and self-disclosure was negatively correlated with AG (p < 0.05);the mediating effect rate of IU between self-disclosure and AG in advanced lung cancer patients was 49%.

Conclusion

The AG of advanced lung cancer patients was at a medium-high level, and IU had a significant mediating effect between self-disclosure and AG of advanced lung cancer patients; by increasing the level of patients' self-disclosure, IU could be effectively alleviated, and ultimately the AG of the patients could be reduced.

Supportive care needs of breast cancer survivors with different levels of fear of cancer recurrence: A cross-sectional survey study

PURPOSE

To examine the supportive care needs of breast cancer survivors with nonclinical, subclinical, or clinical fear of cancer recurrence.

METHODS

In this cross-sectional study, 385 breast cancer survivors consented and completed a set of online questionnaires. Supportive care needs were assessed by using the 34-item Supportive Care Needs Survey. Fear of cancer recurrence was assessed by using the Fear of Cancer Recurrence Inventory.

RESULTS

One hundred eighty-four (47.8%) participants reported nonclinical fear of cancer recurrence, 147 (38.2%) reported subclinical fear of cancer recurrence, and 54 (14.0%) reported clinical fear of cancer recurrence. Higher levels of fear of cancer recurrence were associated with higher levels of supportive care needs in five domains (β = 0.30-0.60, P < 0.001) after adjusting for places of residence, education, motherhood, and time since diagnosis. Among participants with nonclinical fears of cancer recurrence, the most common needs were in the 'Health care system/Information' domain (50.5%). Among participants with subclinical or clinical fear of cancer recurrence, the most common needs were in the 'Psychological' domain (85.7% and 96.3%, respectively).

CONCLUSION

Fear of cancer recurrence was associated with supportive care needs. The most common needs among participants with subclinical or clinical fears of cancer recurrence were psychological needs.

Caring ability and its related factors in the family caregivers of patients with cancer

BACKGROUND

Caregivers of cancer patients experience a variety of challenges caused by the prolonged burden of care. Many of these caregivers do not have the necessary knowledge, skills and caring ability to fulfil their caring role. Therefore, healthcare providers should support them in learning to provide high-quality care. Evaluating caregivers' ability will be the first step of this supportive programme.

AIM

The aim of this study was to determine the caring ability of the caregivers of cancer patients and its related factors.

METHODS

This descriptive correlational study was performed with 271 caregivers of cancer patients who were selected through convenience sampling conducted from July to December 2021 in selected hospitals in Tehran, the capital city of Iran. The data were collected using the caring ability of family caregivers of patients with cancer scale (CAFCPCS), which was developed by Nemati et al (2020). In addition, the stability reliability coefficient was calculated to be ICC=0.93. Data analysis was performed through Statistical Package for the Social Sciences (version 26), using descriptive and inferential statistics and correlation coefficient tests at a significance level of 0.05.

RESULTS

The mean score for the caring ability of the family caregivers of cancer patients in this study was 91.86±7.59. The mean total score of caring ability scale had a statistically significant correlation with the type of cancer and the duration of patient care (P-value=0.05).

CONCLUSION

The results of the study demonstrated that the family caregivers of cancer patients do not have the necessary knowledge and awareness to perform their caring role effectively. Therefore, it is recommended to empower caregivers and use strategies to improve their trust, especially in caregivers who oversee patient care for a significant period of time.

Psychosocial experiences of caring by family caregivers of patients living with prostate cancer in a teaching hospital: A descriptive phenomenological study

AIM

This study explored the psychosocial experience of caregiving on the family caregiver of patients with prostate cancer in the Cape Coast metropolis of Ghana.

DESIGN

A descriptive phenomenological study was conducted through in-depth face-to-face semi-structured interviews. Twelve family caregivers of prostate cancer patients were selected through purposive sampling. Interviews were conducted until data saturation. All interviews were taped, transcribed verbatim and analysed thematically.

RESULTS

The family caregiver's psychosocial experience associated with caregiving uncovered two significant themes with 13 sub-themes. 'Psychological impact' emerged as the first central theme, with anxiety, care as an obligation and feelings of inadequacy, hopelessness, uncertainty, denial and concealment as the sub-themes. The second central theme was 'Social impact' with sexual concerns, role adjustment, loss of livelihood, turmoil and reduced leisure activities emerging as sub-themes.

CONCLUSION

The findings demonstrated that caring significantly impacts the psychological and social well-being of the caregivers of prostate cancer patients. Therefore, there is a need for holistic assessment to include the psychosocial well-being of family caregivers to improve quality of life. Therefore, psychiatric nurses support family caregivers through education and psychosocial interventions to improve their quality of life and enable them to care for their loved ones more effectively.

Fear of Cancer Recurrence and Coping Strategies among Prostate Cancer Survivors: A Qualitative Study

BACKGROUND

Fear of cancer recurrence (FCR), as a commonly reported problem among prostate cancer survivors, has not been fully understood. This study aimed to explore the experience of FCR and relevant coping strategies among Iranian prostate cancer survivors.

METHODS

Qualitative research was conducted on 13 men who completed treatments for prostate cancer in the last 24 months. The participants were selected through purposeful sampling, and in-depth semi-structured interviews were used for data collection. Conventional content analysis was used for data analysis.

RESULTS

Data analysis led to the emergence of three themes. "Living with insecurity" describes the participants' experiences regarding what triggers FCR with two categories, including "fear of incomplete cure" and "fear of cancer return." In addition, "struggling to cope" with two categories, including "psychological strategies" and "spiritual coping," presents coping strategies used by the participants for reducing FCR. Furthermore, "trying to prevent cancer recurrence" with two categories, "seeking health" and "lifestyle modification," indicates coping strategies used by the participants to prevent cancer recurrence.

CONCLUSIONS

Healthcare providers need to consider the cultural characteristics of prostate cancer survivors when assessing their FCR, encourage them to disclose their concerns and fears, and provide tailored interventions in order to reduce FCR among them.

The predictors of spiritual dryness among Iranian cancer patients during the COVID-19 pandemic

Background

Spiritual struggles affect the wellbeing of religious people. Among them are strugglers with God which is perceived as non-responsive and distant. These perceptions were so far analyzed predominantly in Western societies with a Christian background, but not in Muslims from Iran. The aim of this study was to determine the predictors of spiritual dryness among cancer patients in Iran during the COVID-19 pandemic.

Methods

Cross-sectional study with standardized questionnaires (i.e., Spiritual Dryness Scale, WHO-5, BMLSS-10, Awe/Gratitude Scale) among 490 cancer patients (mean age 49.50 ± 14.92 years) referring to the selected educational hospitals in Tehran (the capital of Iran), who were selected through convenience sampling and based on the inclusion criteria, enrolled between December 2020-May 2021. Data analysis was done using SPSS software version 26 and the statistical methods including calculating the mean and the standard deviation, correlation coefficients, as well as regression analysis.

Results

The overall experience of spiritual dryness was perceived regularly in 10.2% of Iranian cancer patients, sometimes in 22.9%, rarely in 22.9%, and never in 43.3%. The mean ± SD was 25.66 ± 5.04, and the scores ranged from 10 to 55. A higher score means greater spiritual dryness. The strongest predictors of spiritual dryness were praying activities Furthermore, the perception of burden due to the pandemic was positively correlated with spiritual dryness. Moreover, each 1 unit increase in its score changed the spiritual dryness score by 0.2 units. The regression of spirituality-related indicators, demographic-clinical variables, and health-related behaviors accounted for 21, 6, and 4% of the total SDS variance, respectively. These findings show that with an increase in praying, performing daily prayers, and the indicators related to spirituality, spiritual dryness will decrease. Most patients were able to cope with these phases often or even regularly, while 31.1% were never or rarely only able to cope.

Conclusion

The results of this study showed that in times of crisis, cancer patients' faith and confidence in God could be challenged. It is not the disease itself which seems to be associated with this form of crisis, but their religious practices. Therefore, it is necessary to support these patients during their struggle, especially as spirituality is one of the best approaches to cope with the disease.

The Mediating Role of Spiritual Health in Adherence to Treatment in Patients with Cancer

Background: Adherence to the treatment regimen is among the behaviors, which predict the successful control of the disease and decrease its intensity and negative consequences, which is influenced by several factors. The patient's beliefs and attitudes toward the disease are effective factors in disease management and adherence to treatment, and spiritual health is one of these influential variables. Objectives: The aim of this study was to determine the mediating role of spiritual health in adherence to treatment in patients with cancer. Methods: In this descriptive correlational study, the participants were 234 Iranian patients with cancer, who were selected through convenience sampling, admitted to the oncology wards of 9 selected teaching hospitals in the northern, southern, eastern, and western provinces of the country, as well as the capital in 2021. The research instruments included the Demographic and Clinical Information Questionnaire, Spiritual Well-Being Scale, and Morisky Medication Adherence Scale-8. The path analysis was done to determine the factors related to the degree of adherence to treatment, taking into account the mediating role of spiritual health. Results: The mean age of the participants in the study was 47.27 ± 15.36. The mean scores for spiritual health and adherence to treatment were 76.70 ± 13.75 and 6.47 ± 2.1, respectively. A positive and significant relationship was found between spiritual health and adherence to treatment (P-value < 0.05). The variables of marital status, the time of diagnosis, and being a religious person had a direct effect on spiritual health, and the time of diagnosis indirectly affected treatment adherence. Conclusions: According to the results, the level of spiritual health and adherence to the treatment in patients with cancer was moderate. In addition, the variable of diagnostic time affected adherence to treatment indirectly. Besides, in examining the factors affecting spiritual health, the findings indicated the effect of the variables “being religious”, “marital status”, and “the time of diagnosis”. In addition to strengthening spiritual health, it is necessary to highlight the need to follow therapeutic diets in these patients. Therefore, it is suggested to consider a program to meet the patients with cancer spiritual needs along with the physical care program.

Challenges encountered by family caregivers of prostate cancer patients in Cape Coast, Ghana: a descriptive phenomenological study

Background

In Ghana, prostate cancer is more prevalent than all other cancers, with a mortality rate of 75% partly due to late presentation to the health care facilities. Limited health services provision across the country and shortages of skilled nurses place a significant demand on family caregivers who are often ill-equipped for the caring role, resulting in many challenges. As they are expected to provide complex care at home with little resources, information, and support, the healthcare system rarely addresses the challenging needs of these family caregivers. This study explored the challenges encountered by family caregivers of people with prostate cancer.

Methods

We conducted interviews using a descriptive phenomenological approach. Twelve family caregivers of prostate cancer patients were selected through a purposive sampling technique at the Cape Coast Teaching Hospital. All interviews were recorded, transcribed, and analysed using Colaizzi’s (1978) data analysis approach.

Results

Three main themes were identified as critical challenges: education and training needs, resources and caregiver-nurse relationship issues. Under the three main themes emerged seven sub-themes that collectively hindered the family caregiver’s ability to meet the care demands. Sub-themes that emerged were; lack of preparedness towards the caring role, lack of knowledge about condition/ treatment, misconception about the condition, lack of accommodation facilities, financial constraints, poor communication, and poor staff attitude.

Conclusion

Caregiving is associated with significant challenges that hinder the family caregiver’s ability to care for the patient effectively, further diminishing the caregiver’s quality of life and patient care. Therefore, healthcare professionals, especially nurses, should consider these challenges family caregivers face and take measures to obviate them through education, preparation and support.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-022-00993-6.

The Psychological Experiences of Using Islamic Philosophy Approach among Women’s with Advanced Breast Cancer in Indonesia

BACKGROUND: Breast cancer turns a person’s life upside down, affecting every aspect of an individual including the psychological domain, such as feelings of phobia, isolation, anger, irritability, confusion, and most frequently anxiety. Some studies reported that rituals practice in Islam have an impact on the psychological health breast cancer patient. AIM: The aim of the study was to explore the experience of psychological alteration among patients with advanced breast cancer. METHODS: A qualitative study utilizing the content analysis approach was organized. Twenty Muslims with breast cancer during chemotherapy treatment with a mean age of 47.1 years who dealt with their psychological responses during treatment were invited to participate in a semi-structured interview, before and after applying Islamic-based practice therapy. This study conducted between February and June 2018 in the outpatient unit of chemotherapy in one of the Indonesia’s teaching hospitals. The generated data were transcribed verbatim and the content analysis approach was used for data reduction, data names, obtaining analytical code, and determining categories and themes. RESULTS: Four themes emerged from the data analysis before the researchers using the Islamic-based practice therapy: (1) Self-blaming, (2) feeling sad, (3) feeling fear and uncertain, and (4) living with a new body. However, the results after applying the Islamic-based practice therapy emerged three themes: (1) Closer to God, (2) peace of mind, and (3) inner strength. CONCLUSION: Overall, in the view of breast cancer patients, the psychological experience of using the Islamic-based practice therapy could change to positive responses by making them feel closer to God, having good inner strength, and a peaceful mind in dealing with their day-to-day conditions. Hence, understanding the patient’s experience will assist the nurses to promote professional abilities and improve nursing care delivery related to different cultural backgrounds and spiritual dimensions of Muslims patients.

Life experiences and disease trajectories in women coexisting with ovarian cancer

OBJECTIVE

This study investigated the lived experiences of ovarian cancer survivors amid the disease trajectory and psychosocial adaptation.

MATERIALS AND METHODS

Twenty-one women, all of whom were ovarian cancer survivors, were recruited from medical centers in Taiwan. In-depth, face-to-face, semi-structured interviews were conducted and transcribed verbatim from audio recordings. The sample size was determined by information saturation during data collection. The steps of data process and analysis were performed using Giorgi's phenomenology.

RESULTS

Three themes and 12 subthemes were extracted: (1) a depressed state, as if facing a fierce enemy: being sentenced to a death penalty like facing an insurmountable challenge; contradictory information and helplessness; turnaround for treatment decision; and facing stigmatization from society; (2) shadow of cancer recurrence: side-effects of cancer treatment; falling into desperation and frustration; worrying about cancer recurrence; and continuing to fight cancer; (3) a change of mindset to move forward: experiencing changes in outlook on life; activating the self-healing process; coexisting with cancer and treating it as a chronic disease; and experiencing physical and mental purification and enhancement.

CONCLUSION

The conventional models caring for patients with ovarian cancer are based on disease and unable to meet their needs because the lengthy rehabilitation journey. Therefore, medical personnel should emphasize patients' medical autonomy and combine professional care and social resources to help patients developing adjustment strategies and establishing support systems in timely manner for body, mind, and soul of these patients.

Experience of Uncertainty in Patients with Thalassemia Major: A Qualitative Study

Background: Uncertainty leads to a stressful situation in patients with thalassemia major that can dramatically affect their psychosocial coping ability, treatment process and disease outcomes, and reduce patients' quality of life. As one of the important factors affecting the health of thalassemia patients, understanding the concept of uncertainty is of major importance to health care providers especially nurses as the first line of exposure to these patients. The present study aimed to explore the experiences of uncertainty in patients with thalassemia major.

Materials and Methods: The present qualitative study was conducted through in-depth face-to-face semi-structured interviews held with 18 patients with major thalassemia selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed with conventional content analysis method of Landman and Graneheim using MAXQDA10 software.

Results: Two main themes, including 'living in the shadow of anxiety' and 'coping with uncertainty' emerged from patients’ experiences of illness uncertainty of thalassemia. 'Living in the shadow of anxiety' included four categories of 'fear of complications', 'contradictory views on treatment', 'unknown future' and 'stigma'. 'Coping with uncertainty' included three categories of 'spiritual coping', 'psychosocial coping' and 'knowledge acquisition'.

Conclusion: According to the results of this study, uncertainty is a major psychological stress in patients with thalassemia major. Healthcare providers should therefore consider the challenges and concerns faced by patients and, through utilizing appropriate training and communicational practices, plan interventions and strategies to empower patients for coping with uncertainty.

Using Liminality and Subjunctivity to Better Understand How Patients With Cancer Experience Uncertainty Throughout Their Illness Trajectory

Uncertainty is a central theme in the illness experiences of older cancer patients throughout their illness trajectory. Mishel's popular theory on uncertainty during illness approaches uncertainty as an outcome and is characterized by the patient's inability to find meaning in illness events. This study used the concepts of liminality and subjunctivity to explore uncertainty throughout the illness trajectory of cancer patients. We interviewed 18 older (age range = 57-92 years) patients with breast cancer or gastro-intestinal cancer 3 to 4 years post diagnosis. Our analysis is based on the QUAGOL guide that draws on elements of grounded theory such as constant comparison. We found that liminality and subjunctivity provide a useful frame for understanding uncertainty with a specific focus on its productive potential and meaning making. Health care professionals should be open to acquiring a complete picture of patients' diverse and dynamic experiences of uncertainty in the different stages of their illness trajectory.

Uncertainty and unmet care needs before and after surgery in patients with gastric cancer: A survey study

Uncertainty and unmet care needs constantly change in patients with cancer. However, there is a lack of information regarding the changing pattern of these variables. This study aimed to examine the changes in uncertainty and unmet care needs at diagnosis and after surgery among patients with gastric cancer. In total, 86 individuals completed a self-reported questionnaire. Data were collected twice - to measure uncertainty and unmet care needs at cancer diagnosis (T1), and after surgery (T2) - and analyzed using descriptive analysis and a dependent t-test. Uncertainty was moderate at both periods but significantly higher at T1. Unmet care needs were highest in the information domain and lowest in the sexuality domain at both T1 and T2. Only the physical/daily living domain were significantly higher at T2, whereas the information, psychological, and patient care/support domains were significantly higher at T1. Different levels of uncertainty and unmet needs were identified at T1 and T2. Healthcare providers should assess changing unmet care needs at each stage of the cancer trajectory and provide related nursing care and information to this population, even immediately after diagnosis.

[Experiences of Ego Integrity Recovery in Elderly Cancer Patients: Grounded Theory Approach]

PURPOSE

This study was conducted to derive a substantive theory on lived experiences of elderly cancer patients.

METHODS

The data were collected from February to March 2018 through in-depth personal interviews with 14 elderly cancer patients. The collected data were analyzed based on Corbin and Strauss's grounded theory.

RESULTS

The core category was "the journey to find balance in daily lives as a cancer patient by recovering disturbed ego integrity." The core phenomenon was "shattered by suffering from cancer," and the causal conditions were "physical change" and "limitations in daily life." The contextual conditions were "decreased self-esteem," "feelings of guilt toward the family," and the sense of "economic burden." The participants' action and interaction strategies were "maintaining or avoiding social relations," "seeking meaning of the illness," "falling into despair," and "strengthening the willingness to battle the cancer." The intervening conditions were "support from health care providers and family," "dissatisfaction with health care providers," "spiritual help from religion," and "the improvement or worsening of health conditions." The consequences were "having a new insight for life," "living positively along with cancer illness," and "the loss of willingness to live." A summary of the series of processes includes the "crisis stage," "reorganizing stage," and the "ego integration stage."

CONCLUSION

This study explored the holistic process of ego integrity impairment and the recovery experience of elderly cancer patients. This study is expected to be used as a basis for the development of nursing interventions that can support patients when coping with all stages of their cancer illness trajectory.

INCERTIDUMBRE FRENTE AL DIAGNÓSTICO DE CÁNCER

RESUMEN Objetivo: describir el significado de la experiencia frente al diagnóstico de cáncer en la construcción de la realidad individual y subjetiva desarrollada. Método: estudio cualitativo con enfoque fenomenológico hermenéutico, desarrollado en una unidad de cáncer, en cuatro mujeres y dos hombres, con diferentes diagnósticos de cáncer. Las entrevistas, recogidas entre enero y marzo de 2016, fueron grabadas y para el análisis se empleó el Análisis de la Fenomenología Interpretativa y la Teoría de la Incertidumbre de Mishel. Resultados: la incertidumbre es una vivencia que invade a la persona con enfermedad crónica. Emergen temas acerca del Desconocimiento/conocimiento; El personal de salud y familiar, un soporte para enfrentar el diagnóstico y no desfallecer; Actitud positiva; Sufrimiento ante la adversidad; Aferrándose a Dios y La adversidad del sistema de salud. Conclusión. todos los pacientes vivieron el período de incertidumbre en un principio como peligro, pero, emprendieron esfuerzos de afrontamiento manifestadas por sentimientos de optimismo y actitud positiva, dirigida a reducir la incertidumbre y a controlar la excitación emocional generada por su diagnóstico.

A Global Perspective on Publishing in Oncology

OBJECTIVES

To describe the discordance in contributions to the literature between developed and low- and middle-income countries (LMICs); identify global challenges in accessing the literature, publishing, and conducting research; and describe successful collaborative publishing models.

DATA SOURCES

Published literature; survey data; personal experience.

CONCLUSION

There is a scarcity of literature written by nurse authors in LMICs. Limited support for nursing research, inconsistent internet access, workforce shortages, and language barriers are significant barriers to publishing success.

IMPLICATIONS FOR NURSING PRACTICE

Nurses from developed countries can build relationships with global partners from LMICs to increase dissemination capacity. Mentorship programs and academic partnerships are two possible solutions for increasing publications from nurses in LMICs.

Palliative Care Policy Analysis in Iran: A Conceptual Model

BACKGROUND

Palliative care programs are rapidly evolving for patients with life-threatening illnesses. Increased and earlier access for facilities is a subject of growing importance in health services, policy, and research.

AIM

This study was conducted to explain stakeholders' perceptions of the factors affecting the design of such a palliative care system and its policy analysis.

METHODOLOGY

Semi-structured in-depth interviews conducted following purposive sampling of the participants. Twenty-two participants were included in the study. The interviews were analyzed using qualitative-directed content analysis based on "policy analysis triangle" framework.

RESULTS

The findings showed the impact of four categories, namely context (political, social, and structural feasibility), content (target setting), process (attracting stakeholder participation, the standardization of care, and education management), and actors (the Ministry of Health and Medical Education, health-care providers, and volunteers) in the analysis of the palliative care policies of Iran.

CONCLUSION

In the past 6 years, attention to palliative care has increased significantly as a result of the National Cancer Research Network with the support of the Ministry of Health. The success of health system plan requires great attention to its aspects of social, political, and executive feasibility. Careful management by policymakers of different stakeholders is vital to ensure support for any national plan, but this is challenging to achieve.

Perceptions of family caregivers of cancer patients about the challenges of caregiving: a qualitative study

BACKGROUND

The experience of caring for a family member with cancer is associated with several care-related problems and challenges for the caregiver. The comprehensive and in-depth understanding of the trials and tribulations of caregiving can be a step towards resolving the problems faced by family caregivers of these patients.

AIM

The present study aimed to explore challenges faced by Iranian family caregivers of cancer patients.

MATERIALS AND METHODS

The present qualitative study was conducted through in-depth semi-structured interviews held with 21 family caregivers of cancer patients selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analysed through conventional content analysis.

FINDING

The codes extracted from interviews produced four main themes, including 'confusion', 'uncertainty', 'disintegration' and 'setback', which collectively caused suffering for family caregivers.

CONCLUSION

Care provided in an atmosphere of suffering and discontent diminishes caregiver's quality of life and quality of patient care. Health planners should therefore consider the challenges and sufferings faced by family caregivers and should seek to obviate them through appropriate plans.