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Rizvi-Toner A, Coe AB, Friese CR, Manojlovich M, Wallner L, Farris KB. Patient symptoms, self-management, and unscheduled healthcare use during the first 6 months of targeted oral anticancer agent therapy: protocol for a mixed-methods US study. BMJ Open 2024; 14:e081375. [PMID: 38355181 PMCID: PMC10868296 DOI: 10.1136/bmjopen-2023-081375] [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] [Received: 10/25/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Targeted oral anticancer agents (OAAs) are increasingly used to treat cancer, including haematological malignancies and ovarian cancer, but they can cause serious symptomatic side effects such as arrhythmias, hypertension, and hyperglycaemia. Unaddressed OAA symptoms or inadequately managed symptoms may also lead to unnecessary and unscheduled healthcare use that decreases patient quality of life and financially burdens both patients and the healthcare system. Limited information is available about patient symptoms, self-management behaviours, and use of healthcare services over time while taking targeted OAAs, but is needed to ensure successful OAA therapy. The primary objective is to understand patient experiences and behaviours on initiating targeted OAA, and elicit cancer care clinicians' (ie, physicians, advanced practice practitioners, nurses, and pharmacists) perspectives on supporting patients during therapy. Study results will inform comprehensive and realistic interventions that minimise disruptions to therapy while maximising quality of life. METHODS AND ANALYSIS We will conduct a remote single-arm, convergent-parallel mixed-methods cohort study within a large academic medical centre. A minimum of 60 patients will be enrolled. Patients will complete several validated patient-reported outcome measures at six timepoints over 6 months. Mixed-effects logistic regression will be used to predict the primary binary outcome of unscheduled healthcare use by patient self-efficacy for symptom self-management. Semistructured interviews will be conducted with patients and clinicians and thematically analysed. Triangulated quantitative and qualitative results will be reported using cross-case comparison joint display. ETHICS AND DISSEMINATION This study protocol is approved by the Institutional Review Board of University of Michigan Medical School (IRBMED). Study results will be published in peer-reviewed journals, presented at conferences, and disseminated to study participants.
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Affiliation(s)
- Amna Rizvi-Toner
- Clinical Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | - Antoinette B Coe
- Clinical Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Lauren Wallner
- Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Karen B Farris
- Clinical Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
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Dürsch H, Boltenhagen U, Mahler C, Joos S, Joachim S, Klafke N. A Qualitative Investigation of Factors Influencing the Integration of Complementary and Integrative Healthcare Recommendations in the Daily Lives of Patients with Cancer. Integr Cancer Ther 2024; 23:15347354241252195. [PMID: 38812440 PMCID: PMC11143848 DOI: 10.1177/15347354241252195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/14/2024] [Accepted: 04/14/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Many patients diagnosed with cancer use complementary and integrative healthcare (CIH) approaches to manage their cancer- and treatment-related symptoms and improve their well-being. Evidence suggests that counseling on CIH can improve health outcomes and decrease healthcare costs by increasing patient activation. This qualitative study explores the experiences of cancer patients who underwent interprofessional counseling on CIH to gain insights into how these patients were able to integrate recommended CIH measures into their daily lives while undergoing conventional cancer treatment. METHODS Forty semi-structured interviews were conducted with cancer patients participating in the CCC-Integrativ study and its process evaluation. The interviews were audio-recorded, transcribed verbatim, and analyzed using content analysis following Kuckartz and Rädiker. A purposeful sampling strategy was used to achieve a balanced sample regarding gender, age, cancer diagnosis, and treatment approach. RESULTS Most patients with cancer reported largely implementing the CIH recommendations. Participants acknowledged the efficacy of CIH recommendations in managing their symptoms. They felt strengthened and empowered to actively take part in their healthcare decisions. However, the patients encountered obstacles in incorporating the recommended CIH applications into their daily routines. These challenges encompassed the effort required for treatment application (e.g., baths, compresses), limitations imposed by the cancer disease (e.g., fatigue, pain), difficulties acquiring necessary materials, associated costs, and lack of infrastructure for CIH. Facilitators of CIH implementation included the availability of easily manageable CIH measures (e.g., herbal teas), informative materials on their application, distribution of samples, family support, and a high level of self-efficacy. The patient-centered approach and strong patient-provider partnership within the counseling context were perceived as empowering. Participants expressed a desire for a consistent point of contact to address their CIH concerns. CONCLUSIONS The findings underscore the benefits of CIH counseling for cancer patients' symptom management and overall well-being. Healthcare professionals providing CIH counseling to patients with cancer may recognize the barriers identified to better support their patients in the regular use of CIH.
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Affiliation(s)
- Helena Dürsch
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Ursula Boltenhagen
- Department of Nursing Science, Institute of Health Sciences, University Hospital Tuebingen, Tuebingen, Germany
| | - Cornelia Mahler
- Department of Nursing Science, Institute of Health Sciences, University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Joos
- Institute of General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - Szecsenyi Joachim
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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Nelleke Seghers PAL, Hamaker ME, O'Hanlon S, Portielje JEA, Wildiers H, Soubeyran P, Coolbrandt A, Rostoft S. Self-reported electronic symptom monitoring in older patients with multimorbidity treated for cancer: Development of a core dataset based on expert consensus, literature review, and quality of life questionnaires. J Geriatr Oncol 2024; 15:101643. [PMID: 37979368 DOI: 10.1016/j.jgo.2023.101643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 05/18/2023] [Accepted: 10/02/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION In cancer care, symptom monitoring during treatment results in improved clinical outcomes such as improved quality of life, longer survival, and fewer hospital admissions. However, as the majority of patients with cancer are older and have multimorbidity, they may benefit from monitoring of additional symptoms. The aim of this study was to identify a core set of symptoms to monitor in older patients with multimorbidity treated for cancer, including symptoms caused by treatment side effects, destabilization of comorbidities, and functional decline. MATERIALS AND METHODS During a scoping literature search, 17 quality of life questionnaires were used to select 53 possible symptoms to monitor. An expert panel of cancer and geriatrics specialists was asked to participate in multiple online surveys to indicate whether these symptoms were not relevant to monitor, only relevant to monitor in a specific patient group, or relevant to monitor in all patients. In a subsequent round the list was reduced and the panel indicated how frequently these symptoms should be monitored during cancer treatment and after cancer treatment completion. Finally, a digital consensus meeting was organised to decide when symptoms had to trigger a recommendation to the patient to get in touch with their medical team. RESULTS In total, 30 healthcare professionals participated in the online surveys. After two rounds, a dataset of 19 symptoms related to cancer, cancer treatment, functional decline, and destabilization of comorbidities was agreed upon for monitoring. Five symptoms were selected for daily monitoring during treatment, seven for weekly, and seven for monthly. After treatment completion, the panel agreed upon less frequent reporting. Additionally, nine symptoms to be monitored only in patients with specific cancer types or treatment types were chosen, such as "cough up blood" in lung cancer. DISCUSSION This study is the first to identify a core set of symptoms to monitor in older patients with multimorbidity treated for cancer. Future research is needed to investigate whether the monitoring of these symptoms is feasible and improves clinical outcomes in older patients with multimorbidity treated for cancer.
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Affiliation(s)
- P A L Nelleke Seghers
- Department of Geriatric Medicine, Diakonessenhuis, 3582, KE, Utrecht, the Netherlands.
| | - Marije E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis, 3582, KE, Utrecht, the Netherlands.
| | - Shane O'Hanlon
- Department of Geriatric Medicine, St Vincent's University Hospital, D04 T6F4 Dublin, Ireland; Department of Geriatric Medicine, University College Dublin, D04 V1W8 Dublin, Ireland.
| | - Johanneke E A Portielje
- Department of Medical Oncology, Leiden University Medical Center-LUMC, 2333, ZA, Leiden, the Netherlands.
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
| | - Pierre Soubeyran
- Department of Medical Oncology, Institut Bergonié, Inserm U1312, SIRIC BRIO, Université de Bordeaux, 33076 Bordeaux, France.
| | - Annemarie Coolbrandt
- Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
| | - Siri Rostoft
- Department of Geriatric Medicine, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway.
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Suhail M, Saulat F, Khurram H, Fatima F, Zenab A, Wasim M, Sadia NUA, Afzaal F, Latif H, Nasrullah M. Knowledge, Attitude and Practice Related to Chemotherapy Among Cancer Patients. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241246460. [PMID: 38616652 PMCID: PMC11017809 DOI: 10.1177/00469580241246460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/11/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
Cancer is a leading cause of death, with a rapidly increasing global burden. Chemotherapy is the most effective cancer treatment, and with its benefits, there exist potential problems. The present study assesses cancer patients' knowledge, attitude, and practice toward chemotherapy use. A descriptive cross-sectional study was conducted in the oncology wards of various tertiary care hospitals and cancer care centers in Lahore, Pakistan. Patients were included in the study based on convenient sampling. A structured questionnaire with 25 (close-ended) questions and a demographic profile was used to collect data. Descriptive statistics was used to analyze frequencies and percentages. Independent sample t-test and ANOVA were used to calculate the mean and standard deviation. Most patients were females (54%) and married (52.6%), with an unemployment rate of 39%. Patients with higher education depicted significantly higher scores in knowledge (9.61 ± 2.65), attitude (19.37 ± 2.70), and practice (3.89 ± 1.03) domains. Surprisingly, throughout the whole KAP domain, the patient's attitude (18.42 ± 3.31) toward chemotherapy use, showed higher values, as compared to their knowledge (7.78 ± 3.26) and practice (3.66 ± 1.08) scores. The majority of the study participants had a positive attitude toward chemotherapy use, with limited knowledge, and practice.
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Affiliation(s)
- Muzna Suhail
- Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | - Fabeha Saulat
- Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | - Hira Khurram
- Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | - Farzeen Fatima
- Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | - Atia Zenab
- Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | - Mehak Wasim
- Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | | | - Fasiha Afzaal
- Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | - Hamid Latif
- Akhtar Saeed Medical and Dental College, Lahore, Pakistan
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Yenson VM, Amgarth-Duff I, Brown L, Caperchione CM, Clark K, Cross A, Good P, Landers A, Luckett T, Philip J, Steer C, Vardy JL, Wong AK, Agar MR. Defining research priorities and needs in cancer symptoms for adults diagnosed with cancer: an Australian/New Zealand modified Delphi study. Support Care Cancer 2023; 31:436. [PMID: 37395859 DOI: 10.1007/s00520-023-07889-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE This study asked consumers (patients, carers) and healthcare professionals (HCPs) to identify the most important symptoms for adults with cancer and potential treatment interventions. METHODS A modified Delphi study was conducted involving two rounds of electronic surveys based on prevalent cancer symptoms identified from the literature. Round 1 gathered information on participant demographics, opinions and/or experience on cancer symptom frequency and impact, and suggestions for interventions and/or service delivery models for further research to improve management of cancer symptoms. In Round 2, respondents ranked the importance of the top ten interventions identified in Round 1. In Round 3, separate expert panels of consumers and healthcare professionals (HCPs) attempted to reach consensus on the symptoms and interventions previously identified. RESULTS Consensus was reached for six symptoms across both groups: fatigue, constipation, diarrhoea, incontinence, and difficulty with urination. Notably, fatigue was the only symptom to reach consensus across both groups in Round 1. Similarly, consensus was reached for six interventions across both groups. These were the following: medicinal cannabis, physical activity, psychological therapies, non-opioid interventions for pain, opioids for breathlessness and cough, and other pharmacological interventions. CONCLUSIONS Consumers and HCPs prioritise differently; however, the symptoms and interventions that reached consensus provide a basis for future research. Fatigue should be considered a high priority given its prevalence and its influence on other symptoms. The lack of consumer consensus indicates the uniqueness of their experience and the need for a patient-centred approach. Understanding individual consumer experience is important when planning research into better symptom management.
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Affiliation(s)
- Vanessa M Yenson
- University of Technology Sydney, Sydney, NSW, Australia.
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia.
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia.
| | - Ingrid Amgarth-Duff
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Linda Brown
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Cristina M Caperchione
- University of Technology Sydney, Sydney, NSW, Australia
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Katherine Clark
- University of Technology Sydney, Sydney, NSW, Australia
- Northern Sydney Local Health District Supportive and Palliative Care Network, St Leonards, Sydney, NSW, Australia
- Northern Clinical School, The University of Sydney, St Leonards, Sydney, NSW, Australia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
| | - Andrea Cross
- Consumer Advocate, Cancer Symptom Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Phillip Good
- University of Technology Sydney, Sydney, NSW, Australia
- Palliative and Supportive Care, Mater Misericordiae, South Brisbane, QLD, Australia
- Department of Palliative Care, St Vincent's Private Hospital, Brisbane, QLD, Australia
- Mater Research - University of Queensland, South Brisbane, QLD, Australia
| | - Amanda Landers
- University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care, Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Tim Luckett
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Jennifer Philip
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of Melbourne, Palliative Medicine, Melbourne, VIC, Australia
- Peter MacCallum Cancer Centre, Palliative Care, Melbourne, VIC, Australia
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Christopher Steer
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of New South Wales Rural Clinical Campus, Albury-Wodonga, NSW, Australia
- Border Medical Oncology, Albury-Wodonga Regional Cancer Centre, Albury-Wodonga, NSW, Australia
| | - Janette L Vardy
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Aaron K Wong
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of Melbourne, Palliative Medicine, Melbourne, VIC, Australia
- Peter MacCallum Cancer Centre, Palliative Care, Melbourne, VIC, Australia
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Meera R Agar
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
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Panjwani AA, Southward MW, Fugate-Laus K, Carpenter KM. Coping self-efficacy, perceived helpfulness of coping, and distress: a longitudinal investigation of breast and gynecologic cancer patients undergoing chemotherapy. J Behav Med 2022; 45:868-881. [DOI: 10.1007/s10865-022-00345-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 06/27/2022] [Indexed: 10/15/2022]
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Christiansen MG, Jarden M, Bager L, Mirza MR, Pappot H, Piil K. SystematiC nurse-led cONsultations based oN Electronic patient-reported outcome among women with ovarian- or endometrial Cancer during chemoTherapy - protocol for the CONNECT study. Acta Oncol 2022; 61:602-607. [PMID: 35311443 DOI: 10.1080/0284186x.2022.2046850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 02/22/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Mille Guldager Christiansen
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Mary Jarden
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Louise Bager
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Mansoor Raza Mirza
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Faculty of Health, University of Aarhus, Aarhus, Denmark
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Kwekkeboom KL, Wieben A, Stevens J, Tostrud L, Montgomery K. Guideline-Recommended Symptom Management Strategies That Cross Over Two or More Cancer Symptoms. Oncol Nurs Forum 2021; 47:498-511. [PMID: 32830800 DOI: 10.1188/20.onf.498-511] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Patients with cancer experience multiple symptoms, but current practice is driven by guidelines that address single symptoms. Identifying symptom management strategies recommended across two or more symptoms could relieve multiple symptoms and reduce patient burden. LITERATURE SEARCH The Oncology Nursing Society, National Comprehensive Cancer Network, and American Society of Clinical Oncology websites were searched to identify management guidelines for 15 symptoms. DATA EVALUATION The authors extracted symptom management strategies and recommendations. Recommendations were synthesized by symptom across the guidelines, and recommended strategies were compared across symptoms. SYNTHESIS Among 32 guidelines reviewed, a total of 88 symptom management strategies (41 pharmacologic, 47 nonpharmacologic) were recommended across two or more symptoms. IMPLICATIONS FOR PRACTICE Findings support the potential for coordinated selection of symptom management strategies that cross over multiple symptoms in a patient. Investigators should test these symptom management strategies in the context of co-occurring symptoms and develop guidelines that address multiple symptoms.
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Farzi S, Taleghani F, Yazdannik A, Esfahani MS. Communication culture in cancer nursing care: an ethnographic study. Support Care Cancer 2021; 30:615-623. [PMID: 34357456 DOI: 10.1007/s00520-021-06388-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/21/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE This study aimed to explore the communication culture in nursing care of patients with cancer. METHODS This ethnographic study was conducted in 2018-2019. Data were collected through participatory observation (318 h of observing nurses, patients, and family behaviors), semi-structured interviews (8 interviews with nurses), and informal interactions. Data were analyzed using Spradley's framework. RESULTS The study results in five cultural components of "communication determinants," "experimental acquisition of communication skills," "gradual empathetic communication," "avoidant communication with patient," and "communication with family as caregiver." "Communication between nurse, patient and family is an experimental, gradual and avoidant relationship" was the study's cultural statement. CONCLUSION In this study, the nurse-patient communication was influenced by factors related to the patient, the nurse and the care environment, and nurses acquired communication skills experimentally. There were two patterns of empathetic and avoidant communication between the nurse and the patient. For having high-quality care, nurses' behavioral patterns must be improved and changed in some cases. Nursing professors, managers, and nurses can use these results in training, hiring, orienting novice nurses, and empowering oncology nurses. Training communication skills to nurses and changing managers and nurses' approach to move from task-oriented care to holistic care help improve nurses' communication patterns.
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Affiliation(s)
- Saba Farzi
- Student Research Center, school of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing & Midwifery Care Research Center, School of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ahmadreza Yazdannik
- Nursing & Midwifery Care Research Center, School of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehran Sharifi Esfahani
- Department of Internal Medicine, School of Medicine, Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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The Effects of a Tripod Approach for Cancer Patients on Illness Stress, Health-Promoting Lifestyle, Hope, and Resilience. Cancer Nurs 2021; 44:125-135. [PMID: 31743151 DOI: 10.1097/ncc.0000000000000746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Health-related exercise and education program for cancer patients are necessary to provide physical and emotional support to enable efficient and appropriate self-management at home. OBJECTIVE This study aimed to investigate the effects of a tripod approach including physical exercise, education, and emotional support program on illness stress, health promotion lifestyle, hope, and resilience in cancer patients. INTERVENTIONS/METHODS This was a quasi-experimental repeated-measures study using a pre-post design with a nonhomogeneous control group. A total of 72 cancer patients (experimental group = 37, control group = 35) who were currently receiving treatment and staying at home were enrolled. RESULTS The experimental group showed significantly lower illness stress scores (F = 17.35, P < .001) and increase in health promotion lifestyle scores (F = 4.05, P = .048) compared with the control group, especially social relationships (t = 1.85, P = .073) and stress management (t = 2.30, P = .027). However, there were no effects on hope and resilience. Also, illness stress showed significant changes after 6 weeks (t = -3.35, P = .001) and after 10 weeks (t = -5.04, P < .001). Overall health promotion lifestyle showed changes after 10 weeks (t = 2.25, P = .030), with meaning of life (t = 2.57, P = .014), stress management (t = 2.30, P = .027), and medical behaviors (t = 2.46, P = .019) especially showing significant changes. CONCLUSIONS The results showed that the tripod approach had positive effects on illness stress and health promotion lifestyle of cancer patients staying at home. Further study to improve positive emotions such as hope and resilience is needed. IMPLICATIONS FOR PRACTICE Based on our findings, combining nursing intervention with physical exercise, education, and emotional support could be incorporated into cancer patients in community and early survivorship care plans in clinical practice.
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Koppel PD, De Gagne JC. Exploring Nurse and Patient Experiences of Developing Rapport During Oncology Ambulatory Care Videoconferencing Visits: Protocol for a Qualitative Study. JMIR Res Protoc 2021; 10:e27940. [PMID: 34125073 PMCID: PMC8240804 DOI: 10.2196/27940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 01/23/2023] Open
Abstract
Background Telehealth videoconferencing has largely been embraced by health care providers and patients during the COVID-19 pandemic; however, little is known about specific techniques for building rapport and provider-patient relationships in this care environment. Although research suggests that videoconferencing is feasible and can be effective for some types of care, concerns about the impact of technology on provider-patient relationships exist across health disciplines. Suggestions for adapting some in-person rapport techniques, such as the use of small talk, eye contact, and body language to facilitate trust, personal connection, and communication during videoconferencing encounters, have been discussed in the popular press and clinical commentaries. Notably, evidence regarding the effects of these strategies on rapport and clinical care outcomes is lacking. Understanding how to establish rapport in videoconferencing visits is especially important in oncology nursing, where rapport with patients enables nurses to become a source of emotional support, helping patients adapt and navigate the cancer journey. Objective This study aims to investigate the nature of nurse-patient rapport in ambulatory cancer care videoconferencing visits. The objectives include exploring how patients with cancer and nurses describe experiences of rapport and strategies for cultivating rapport in videoconferencing visits and similarities and differences identified by patients with cancer and nurses between experiences of rapport in videoconferencing and in-person visits. Methods Semistructured narrative interviews of patients with cancer and nurses will be conducted to understand the experience of rapport building in videoconferencing visits. Nurses and patients will be interviewed separately to facilitate an understanding of the perspectives of both types of participants. Interviews will be conducted on a secure videoconferencing platform. This qualitative descriptive study will describe participant experiences in a manner that, although not without interpretation, is as close to the data as possible. The research team will meet regularly to discuss, define, and document codes, categories, and themes, and the team will maintain a detailed audit trail of analytical decisions. In addition, member checking will enhance the rigor of the study. Nurse and patient interviews will be analyzed separately using identical procedures and may be explored side by side in the final analysis to provide a comparative analysis. Data management and analysis will be performed using NVivo 12. Results Data collection will begin during summer 2021, with results from the data analysis anticipated by winter 2021. A research team trained in qualitative methodology will use conventional content analysis to analyze the data using first- and second-level codes derived directly from the transcribed text data. Conclusions This study aims to determine what behaviors, communication techniques, and relational practices need to be adapted in videoconferencing telehealth visits, setting the foundation for future development of interventions and evidence-based practice guidelines for relationship building during videoconferencing telehealth visits. International Registered Report Identifier (IRRID) PRR1-10.2196/27940
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Affiliation(s)
- Paula D Koppel
- Duke University School of Nursing, Durham, NC, United States
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12
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Experience of women with breast cancer undergoing chemotherapy: a systematic review of qualitative research. Qual Life Res 2021; 30:1249-1265. [DOI: 10.1007/s11136-020-02754-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 01/26/2023]
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13
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ÇAVUŞOĞLU F, AYDIN AVCI İ, ÇAL A. Kolorektal kanser hastalarının kanserle yaşam ve tıbbi bakımla ilgili deneyimleri. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.733414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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14
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Li Z, Jiang S, Xu C, Lu F, He R, Pan Z, Zhang P, Zhang L. Determinants of place of death for end-stage cancer patients: evidence from China. Int J Qual Health Care 2020; 32:41-47. [PMID: 31297534 DOI: 10.1093/intqhc/mzz064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/13/2019] [Accepted: 06/19/2019] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To determine factors influence place of death (POD) for end-stage cancer patients and investigate how the healthcare utilization mediates on the effect of socioeconomic status (SES) on POD. DESIGN A population-based, retrospective study from July 2015 to June 2017. SETTING Yichang, China. PARTICIPANTS 894 end-stage cancer patients. MAIN OUTCOME MEASURE POD. RESULTS Patients of hospital death experience more inpatient hospitalization services (IHS) and emergency department visits. Patients enrolled in the New Rural Cooperative Medical Scheme (OR = 7.60, P < 0.001) and Urban Employee Basic Medical Insurance (OR = 28.0, P < 0.001) have higher rates of hospital death than those in the Urban Resident-based Basic Medical Insurance. Living with spouse (OR = 1.72, P = 0.019) and receiving higher education (OR = 1.92, P = 0.004), increase the likelihood of hospital death by 72% and 92%, respectively. The probability of hospital death will increase by 14% and decrease by 4% per IHS and outpatient services occur, respectively. Outpatient services (Z = -2.28, P < 0.001), and IHS (Z = 2.17, P < 0.001) mediate 1.81% and 1.89%, respectively, of the effect of health insurance on POD. The overall effect of the mediators is non-statistically significant (Z = 0.09, P = 0.825). CONCLUSION POD is mainly driven by SES. The relationship between health insurance and POD is partly mediated by outpatient services and IHS, respectively. The results corroborated that hospital and home services should be coherently bridged. Furthermore, benefit packages for end-stage cancer patients could be redesigned.
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Affiliation(s)
- Zhong Li
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei, China
| | - Shan Jiang
- School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chengzhong Xu
- Yichang Center for Disease Control and Prevention, Yichang, Hubei, China
| | - Fangfang Lu
- Yichang Center for Disease Control and Prevention, Yichang, Hubei, China
| | - Ruibo He
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei, China
| | - Zijin Pan
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei, China
| | - Pei Zhang
- Yichang Center for Disease Control and Prevention, Yichang, Hubei, China
| | - Liang Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei, China
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15
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Magalhães B, Fernandes C, Lima L, Martinez-Galiano JM, Santos C. Cancer patients’ experiences on self-management of chemotherapy treatment-related symptoms: A systematic review and thematic synthesis. Eur J Oncol Nurs 2020; 49:101837. [DOI: 10.1016/j.ejon.2020.101837] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 01/12/2023]
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16
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Patients' Experience of Communication During Their Course of Treatment in an Oncology Outpatient Clinic: Qualitative Study. Cancer Nurs 2020; 45:E187-E196. [PMID: 33038098 DOI: 10.1097/ncc.0000000000000891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Communication between patients and healthcare professionals becomes increasingly important as patients with cancer are primarily treated in outpatient settings, where the time to communicate is brief. There is a need to understand patients' experiences of communication to ensure person-centered communication during treatment. OBJECTIVE The aim of this study was to explore how patients experience communication with healthcare professionals during their course of treatment in an oncology outpatient clinic to elucidate how their needs for support are met. METHODS Data were generated through semistructured qualitative interviews in patients with cancer who received treatment in an oncology outpatient clinic (n = 18). Interpretive description methodology and symbolic interactionism inspired the analytical approach. RESULTS Three overarching communication categories were generated, namely, verbal practices, relational practices, and nonverbal practices, which reflect distinct characteristics and the quality of the communication. Communication was characterized as being informative, cheerful, and routinized, which the patients found supportive and, contrarily, superficial, task focused, lacking continuity in care, and missing existential dimensions. CONCLUSION The communication practice in the oncology outpatient clinic especially supported patients in managing their treatment and side effects. However, psychological, social, and existential concerns were rarely addressed, requiring the patient to self-manage these issues in everyday life while living with cancer. IMPLICATIONS FOR PRACTICE Patients are socialized by verbal and nonverbal communication practices in the outpatient clinic, which influences their expectations of what to talk about during their treatment. Methods are needed to support person-centered communication in outpatient settings, so patient care needs are met more broadly.
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17
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The Symptom Experience and Self-management Strategies of Women Undergoing Cervical Cancer Treatment: A Qualitative Study. Cancer Nurs 2020; 45:12-20. [PMID: 32675630 DOI: 10.1097/ncc.0000000000000843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cervical cancer treatment modalities, such as surgery, chemotherapy, radiation, and brachytherapy, often result in short- and long-term adverse effects such as nausea, fatigue, and sexual dysfunction. Chemotherapy and radiation are typically provided on an outpatient basis, requiring women to be more active in self-managing their symptoms at home. OBJECTIVE The aim of this study was to explore how women with cervical cancer experience symptoms and manage daily life during treatment. METHODS Individual interviews with 10 women diagnosed with cervical cancer and undergoing curative concurrent chemotherapy and radiation were carried out. Data analysis was conducted using a phenomenological-hermeneutic perspective, inspired by Ricoeur. RESULTS Three themes were identified based on the interviews: (1) new life perspectives, (2) suffering in silence, and (3) enhanced symptom self-management strategies. CONCLUSION Diagnosis and treatment create an opportunity for the women to critically reflect on their lives and to develop new life perspectives. During treatment, a mental transformation involving the use of various individual social, mental, and physical coping strategies allowed the women to manage their daily lives. This enabled self-management strategies, resulting in maintaining a sense of normalcy, trying to defy the adverse effects, and prioritizing themselves, their families, and the treatment. IMPLICATIONS FOR PRACTICE Women with cervical cancer undergoing oncological treatment need more specific and detailed information about the course of treatment, symptom management, adverse effects, and psychological reactions to better manage their daily lives. Healthcare professionals play a crucial role in supporting and guiding the women and in ensuring optimal symptom management.
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18
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Ala-Leppilampi K, Baker NA, McKillop C, Butler MO, Siu LL, Spreafico A, Abdul Razak AR, Joshua AM, Hogg D, Bedard PL, Leighl N, Oza AM, Parsons JA, Hansen AR. Cancer patients' experiences with immune checkpoint modulators: A qualitative study. Cancer Med 2020; 9:3015-3022. [PMID: 32119767 PMCID: PMC7196048 DOI: 10.1002/cam4.2940] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 12/17/2022] Open
Abstract
Background Minimal qualitative data exist on the experiences of cancer patients treated with immune checkpoint inhibitors or costimulatory antibodies. Understanding the day to day experiences of patients being treated with immune checkpoint modulators, and how these relate to their health‐related quality of life, can inform future research and lead to better clinical decision‐making and care. We report here the first in depth qualitative study to consider patients' diverse and complex experiences with immune checkpoint modulators, with a focus on side effects and how these impact daily life. Methods This single‐center qualitative study was based on focus groups and semistructured interviews. Patients who were being treated or who had been treated with immune checkpoint modulators within the last year for a range of cancer diagnoses were recruited. Interpretive description informed our inductive, iterative approach to analysis. Results Eight themes were identified, characterizing the complexity of these patients' lived experiences: major categories of side effects experienced and how they impacted patient well‐being; the heterogeneous nature of side effects experienced; living with uncertainty; reframing the meaning and severity of SEs; focus on survival, hope, and being positive; acceptance and adaptation; feeling supported; and faith in medical innovation. Throughout their accounts, participants highlighted the profound impact that immune checkpoint modulators had on their daily lives. Conclusion This is the first in‐depth qualitative study into patient accounts of their experiences of treatment with immune checkpoint modulators, related side effects, and how it impacted their daily lives. This research is an integral initial step in developing an instrument that will assess treatment‐related side effects in patients treated with this form of therapy.
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Affiliation(s)
- Kari Ala-Leppilampi
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
| | - Natalie A Baker
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
| | | | - Marcus O Butler
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Lillian L Siu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Anna Spreafico
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Albiruni R Abdul Razak
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Anthony M Joshua
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.,Department of Medical Oncology, Kinghorn Cancer Centre, St Vincents Hospital and Garvan Institute of Medical Research, Sydney, Australia
| | - David Hogg
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Philippe L Bedard
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Natasha Leighl
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Amit M Oza
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Janet A Parsons
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.,Department of Physical Therapy and the Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Aaron R Hansen
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada
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19
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Jernigan C, Johnson T, Varghese S, Fellman B. Evaluating the Feasibility of a Nurse-Driven Telephone Triage Intervention for Patients With Cancer in the Ambulatory Setting. Oncol Nurs Forum 2020; 47:E44-E54. [DOI: 10.1188/20.onf.e44-e54] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Bana M, Ribi K, Kropf-Staub S, Näf E, Schramm MS, Zürcher-Florin S, Peters S, Eicher M. Development and implementation strategies of a nurse-led symptom self-management program in outpatient cancer centres: The Symptom Navi© Programme. Eur J Oncol Nurs 2020; 44:101714. [PMID: 31954227 DOI: 10.1016/j.ejon.2019.101714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The Symptom Navi© Programme (SN©P) is a structured nurse-led intervention supporting symptom self-management in cancer patients. We describe the development and evaluation of the intervention, implementation strategy, and the evaluation of nurse training for the Symptom Navi© Pilot Study. METHODS The intervention was developed using multiple methods (e.g. literature synthesis, focus groups) to produce SN©P information leaflets (SN©Flyers in French and German) and standardised training for nurses to deliver semi-structured consultations. We evaluated the SN©P using online surveys, focus groups, interviews, and the Item-Content Validity Index (I-CVI). Nurse training was evaluated in relation to content, acceptability, and confidence in implementing the SN©P. We examined the association between scored on the Work-related Sense of Coherence (Work-SoC) scale and nurses' confidence in implementing the SN©P. Thematic analysis was used to analyse qualitative data. Quantitative data was descriptively analysed and the Kendall Tau test was employed for correlations. RESULTS Patients and health care professionals confirmed that SN©Flyers and semi-structured consultations facilitated symptom self-management. Nurses considered training content/format acceptable and appropriate and felt confident in implementing the SN©P. Overall Work-SoC scores were correlated with nurses' confidence in implementing the SN©P (rπ = .47, p = .04). CONCLUSIONS Health care professionals and cancer patients perceived the SN©P as a useful support. Successful implementation of the SN©P depends on centre-specific factors including time, resources and workflow. CLINICAL TRIAL REGISTRY NCT03649984 and SNCTP000002381.
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Affiliation(s)
- Marika Bana
- University of Applied Sciences and Arts Western Switzerland HES-SO, School of Health Sciences, Route des Arsenaux 16a, CH-1700, Fribourg, Switzerland; Institute of Higher Education and Research in Health Care IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010, Lausanne, Switzerland.
| | - Karin Ribi
- Institute of Higher Education and Research in Health Care IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010, Lausanne, Switzerland; International Breast Cancer Study Group (IBCSG), Effingerstrasse 40, CH-3008, Bern, Switzerland.
| | - Susanne Kropf-Staub
- Hospital Group Lindenhof, Lindenhof, Bremgartenstrasse 117, Postfach, CH-3001, Bern, Switzerland.
| | - Ernst Näf
- Department of Practice Development in Nursing, Solothurner Spitäler, Kantonsspital Olten, Baslerstrasse 150, CH-4601, Olten, Switzerland.
| | - Monique Sailer Schramm
- University of Applied Sciences and Arts Western Switzerland HES-SO, School of Health Sciences, Route des Arsenaux 16a, CH-1700, Fribourg, Switzerland.
| | - Sabin Zürcher-Florin
- Hospital Group Lindenhof, Lindenhof, Bremgartenstrasse 117, Postfach, CH-3001, Bern, Switzerland.
| | - Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 21, CH-1011, Lausanne, Switzerland.
| | - Manuela Eicher
- Institute of Higher Education and Research in Health Care IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010, Lausanne, Switzerland; Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 21, CH-1011, Lausanne, Switzerland.
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21
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Bana M, Ribi K, Kropf-Staub S, Zürcher-Florin S, Näf E, Manser T, Bütikofer L, Rintelen F, Peters S, Eicher M. Implementation of the Symptom Navi © Programme for cancer patients in the Swiss outpatient setting: a study protocol for a cluster randomised pilot study (Symptom Navi© Pilot Study). BMJ Open 2019; 9:e027942. [PMID: 31289075 PMCID: PMC6615799 DOI: 10.1136/bmjopen-2018-027942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Self-management interventions show promising results on symptom outcomes and self-management behaviours. The Symptom Navi© Programme (SN©P) is a nurse-led intervention supporting patients' symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi© Flyers (SN©Flyers)), semistructured consultations and a training manual for nurses. METHODS AND ANALYSIS This pilot study will evaluate the implementation of the SN©P based on the Reach Effectiveness-Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the intervention clusters will provide at least two semistructured consultations with the involvement of SN©Flyers. Outcomes include patients' accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses' fidelity of providing the intervention as intended, and patients' safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be analysed by thematic analysis. ETHICS AND DISSEMINATION The Symptom Navi© Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017-00020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences. TRIAL REGISTRATION NUMBER NCT03649984; Pre-results.
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Grants
- Swiss Cancer League, Bern, Switzerland
- Lindenhofgruppe, Bern, Switzerland
- CHUV, Departement of Oncology, Lausanne, Switzerland
- Heds-FR, School of Health Sciences, Fribourg, Switzerland
- Dr. Hans Altschüler Stiftung, St. Gallen, Switzerland
- Institute of Higher Education and Research in Health Care, Faculty of Biology and Medicine, University of Lausanne, Switzerland
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Affiliation(s)
- Marika Bana
- HedS-FR School of Health Sciences, University of Applied Science and Arts Western Switzerland, Fribourg, Switzerland
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
| | - Karin Ribi
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
- Quality ofLife Office, International Breast Cancer Study Group, Bern, Switzerland
| | | | | | - Ernst Näf
- Department of Practice Development in Nursing, Solothurner Spitaler AG, Solothurn, Switzerland
| | - Tanja Manser
- FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | | | | | | | - Manuela Eicher
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
- Departement of Oncology, CHUV, Lausanne, Switzerland
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Klafke N, Mahler C, von Hagens C, Uhlmann L, Bentner M, Schneeweiss A, Mueller A, Szecsenyi J, Joos S. The effects of an integrated supportive care intervention on quality of life outcomes in outpatients with breast and gynecologic cancer undergoing chemotherapy: Results from a randomized controlled trial. Cancer Med 2019; 8:3666-3676. [PMID: 31115192 PMCID: PMC6639168 DOI: 10.1002/cam4.2196] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 04/01/2019] [Accepted: 04/10/2019] [Indexed: 12/12/2022] Open
Abstract
The aim of the Complementary Nursing in Gynecologic Oncology study was to investigate the effects of a complex, nurse‐led, supportive care intervention using Complementary and Integrative Medicine (CIM) on patients’ quality of life (QoL) and associated patient‐reported outcomes. In this prospective, pragmatic, bicentric, randomized controlled trial, women with breast or gynecologic cancer undergoing a new regimen of chemotherapy (CHT) were randomly assigned to routine supportive care plus intervention (intervention group, IG) or routine care alone (control group, CG). The intervention consisted of CIM applications and counseling for symptom management, as well as CIM information material. The primary endpoint was global QoL measured with the EORTC‐QLQ‐C30 before and after CHT. Mixed linear models considering fixed and random factors were used to analyze the data. In total, 126 patients were randomly assigned into the IG and 125 patients into the CG (median age 51 years). The patients’ medical and socio‐demographic characteristics were homogenous at baseline and at follow‐up. No group effects on QoL were found upon completion of CHT (estimate −1.04 [−4.89; 2.81]; P = 0.596), but there was a significant group difference in favor of the IG 6 months later (estimate 6.643 [1.65; 11.64]; P = 0.010). IG patients did also experience significant better emotional functioning (P = 0.007) and less fatigue (P = 0.027). The tested supportive intervention did not improve patients’ QoL outcomes directly after CHT (T3), but was associated with significant QoL improvements when considering the change from baseline to the time point T4, which could be assessed 6 months after patients’ completion of CHT. This delayed effect may have resulted due to a strengthening of patients’ self‐management competencies.
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Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Cornelia Mahler
- Department of Nursing, Institute for Health Sciences, University Hospital Tuebingen, Tuebingen, Germany
| | - Cornelia von Hagens
- Division of Naturopathy and Integrative Medicine, Department of Gynaecological Endocrinology and Reproductive Medicine, University Womens' Hospital Heidelberg, Heidelberg, Germany
| | - Lorenz Uhlmann
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Martina Bentner
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Schneeweiss
- Division Gynaecologic Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Mueller
- Womens' Clinic, Community Hospital Karlsruhe, Karlsruhe, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefanie Joos
- Institute of General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
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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.
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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
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24
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Prip A, Pii KH, Møller KA, Nielsen DL, Thorne SE, Jarden M. Observations of the communication practices between nurses and patients in an oncology outpatient clinic. Eur J Oncol Nurs 2019; 40:120-125. [PMID: 31229201 DOI: 10.1016/j.ejon.2019.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/04/2019] [Accepted: 03/19/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Effective communication in cancer care and treatment is linked to better health outcomes, improved treatment adherence, and improved quality of life for cancer patients. While the characteristics of effective communication have been identified, there is sparse knowledge about the current conditions for providing effective communication especially within the outpatient clinical context, where the majority of cancer patients are currently being treated. This study aimed to explore communication practices between nurses and patients undergoing chemotherapy in an outpatient clinic to gain insight into how patients are supported in this setting. METHODS Data were collected through 70 h of participant observations of nurse-patient interactions supplemented with ad hoc interviews with nurses in an oncology outpatient clinic. The methodology and data analysis are guided by interpretive description, thematic analysis and symbolic interactionism. RESULTS Three themes were generated that characterised communication in the outpatient clinic: Treatment-centred communication, efficient communication and spatially-bound communication. While there was good opportunity for patients to learn about treatment and side effects during cancer treatment, psychosocial concerns were rarely addressed. CONCLUSIONS The outpatient setting influences the type and quality of communication between nurses and patients. Improvement of communication should include not only verbal and written information, but focus on the importance of nonverbal communication in the oncology outpatient clinic. Furthermore, there is a need to make environmental adjustments that can facilitate the opportunity for patients to express their needs and for nurses to respond to them.
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Affiliation(s)
- Anne Prip
- Department of Nursing and Nutrition, University College Copenhagen, Tagensvej 86, 2200 Copenhagen N, Denmark.
| | - Kathrine H Pii
- Department of Nursing and Nutrition, University College Copenhagen, Tagensvej 86, 2200 Copenhagen N, Denmark.
| | - Kirsten A Møller
- Department of Nursing and Nutrition, University College Copenhagen, Tagensvej 86, 2200 Copenhagen N, Denmark.
| | - Dorte Lisbet Nielsen
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730 Herlev, Denmark.
| | - Sally E Thorne
- School of Nursing, University of British Columbia, Canada.
| | - Mary Jarden
- Department of Hematology and Oncology, Copenhagen University Hospital, Rigshospitalet & Department of Public Health, University of Copenhagen, Denmark.
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Coolbrandt A, Wildiers H, Aertgeerts B, Dierckx de Casterlé B, van Achterberg T, Milisen K. Systematic development of CHEMO-SUPPORT, a nursing intervention to support adult patients with cancer in dealing with chemotherapy-related symptoms at home. BMC Nurs 2018; 17:28. [PMID: 29983638 PMCID: PMC6020323 DOI: 10.1186/s12912-018-0297-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 06/18/2018] [Indexed: 11/22/2022] Open
Abstract
Background Given the great symptom burden associated with chemotherapy on the one hand and generally poor self-management of symptoms by cancer patients on the other hand, our aim was to develop a nursing intervention to reduce symptom burden in adult cancer patients treated with chemotherapy and to support them in dealing with their various symptoms at home. Methods Development of the intervention was guided by the Intervention Mapping Approach and included following steps: needs assessment, formulation of proximal programme objectives, selection of methods and strategies, production of programme components, and planning for implementation and evaluation of the intervention. A panel of multidisciplinary healthcare professionals (n = 12) and a panel of patients and family caregivers (n = 7) were actively involved developing the intervention at each stage. Results For the intervention, four patient performance objectives relating to self-management were advanced. Self-efficacy and outcome expectations were selected as key determinants of dealing with chemotherapy-related symptoms. As methods for supporting patients, motivational interviewing and tailoring were found to fit best with the change objectives and determinants. Existing patient information materials were re-designed after panel input to reinforce the new intervention approach. Conclusion The intervention mapping approach, including active involvement of the intervention providers and receivers, informed the design of this nursing intervention with two or more contacts. Further evaluation is needed to gain insight into the potential effects, feasibility and mechanisms of this complex intervention. Electronic supplementary material The online version of this article (10.1186/s12912-018-0297-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Annemarie Coolbrandt
- 1Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.,2Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Hans Wildiers
- 3Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Bert Aertgeerts
- 4Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | | | - Theo van Achterberg
- 2Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Koen Milisen
- 2Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
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Coolbrandt A, Milisen K, Wildiers H, Aertgeerts B, van Achterberg T, Van der Elst E, Dierckx de Casterlé B. A nursing intervention aimed at reducing symptom burden during chemotherapy (CHEMO-SUPPORT): A mixed-methods study of the patient experience. Eur J Oncol Nurs 2018; 34:35-41. [DOI: 10.1016/j.ejon.2018.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
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27
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Mardani-Hamooleh M, Heidari H. Living with cancer challenges: a qualitative analysis of cancer patients’ perceptions in Iran. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-017-0844-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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28
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Coolbrandt A, Wildiers H, Laenen A, Aertgeerts B, Dierckx de Casterlé B, van Achterberg T, Milisen K. A Nursing Intervention for Reducing Symptom Burden During Chemotherapy. Oncol Nurs Forum 2018; 45:115-128. [DOI: 10.1188/18.onf.115-128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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29
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Coolbrandt A, Steffens E, Wildiers H, Bruyninckx E, Verslype C, Milisen K. Use of a symptom diary during chemotherapy: A mixed-methods evaluation of the patient perspective. Eur J Oncol Nurs 2017; 31:37-45. [DOI: 10.1016/j.ejon.2017.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 09/23/2017] [Accepted: 09/25/2017] [Indexed: 01/17/2023]
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30
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Cooley ME, Nayak MM, Abrahm JL, Braun IM, Rabin MS, Brzozowski J, Lathan C, Berry DL. Patient and caregiver perspectives on decision support for symptom and quality of life management during cancer treatment: Implications for eHealth. Psychooncology 2017; 26:1105-1112. [PMID: 28430396 DOI: 10.1002/pon.4442] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 03/03/2017] [Accepted: 04/14/2017] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Adequate symptom and quality-of-life (SQL) management is a priority during cancer treatment. eHealth is a timely way to enhance patient-engagement, facilitate communication, and improve health outcomes. The objectives of this study were to describe patient and caregivers' perspectives for providing, processing, and managing SQL data to enhance communication and identify desired components for decision support. METHODS Data were collected from 64 participants through questionnaires and focus groups. Analysis was conducted using NVivo. Open and axial coding was completed, grouping commonalities and large constructs into nodes to identify and synthesize themes. RESULTS Face-to-face meetings with clinicians were the prime time to communicate, and patients strove to understand treatment options and the effect on SQL by bringing caregivers to their visits, taking notes, tracking symptoms, and creating portable health records. Patients/caregivers struggled to self-manage their symptoms and were uncertain when to contact clinicians when experiencing uncontrolled symptoms. Most participants identified eHealth solutions for decision support. However, 38% of participants (n = 24) rarely used computers and identified non-eHealth options for decision support. Core components for both eHealth and non-eHealth systems were access to (1) cancer information, (2) medical records, (3) peer support, and (4) improved support and understanding on when to contact clinicians. CONCLUSIONS Patients were faced with an overwhelming amount of information and relied on their caregivers to help navigate the complexities of cancer care and self-manage SQL. Health technologies can provide informational support; however, decision support needs to span multiple venues to avoid increasing disparities caused by a digital divide.
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Affiliation(s)
| | | | | | | | | | - Jane Brzozowski
- Independent Clinical Informatics Consultant, Boston, MA, USA
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31
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Lai XB, Ching SSY, Wong FKY. A qualitative exploration of the experiences of patients with breast cancer receiving outpatient-based chemotherapy. J Adv Nurs 2017; 73:2339-2350. [DOI: 10.1111/jan.13309] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Xiao Bin Lai
- School of Nursing; Fudan University; Shanghai China
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32
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Szalai M, Szirmai A, Füge K, Makai A, Erdélyi G, Prémusz V, Bódis J. Special aspects of social support: Qualitative analysis of oncologic rehabilitation through a belly dancing peer support group. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28194904 DOI: 10.1111/ecc.12656] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 11/29/2022]
Abstract
Tumour-related peer support groups (PSGs) show long-term development in quality of life and coping, and decrease distress in cancer care. To clarify channels of social support in oncologic rehabilitation by combined exercise and psychosocial therapy, individual semi-structured interviews were conducted after 1 year additional belly dance rehabilitation in a closed PSG among 51 patients with malignant tumour diagnosis in Budapest, Hungary. Interview data were transcribed and analysed using qualitative content analysis (ATLAS.ti 6 Win). Results suggest that group experience provides emotional-, practical- and informational support. We could point out specific social effects of "role model" function and extend the coping model. The group dispose all the features of effective suggestion and may be effectively applied as additional therapy for patients with malignancies. The extended coping model and the introduction of "role model" function could be useful for PSGs' efficacy assessment.
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Affiliation(s)
- M Szalai
- Department of Head and Neck Surgery, National Institute of Oncology, Budapest, Hungary.,Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - A Szirmai
- Doctoral School of Psychology, Faculty of Humanities, Eötvös Loránd University, Budapest, Hungary
| | - K Füge
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - A Makai
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - G Erdélyi
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - V Prémusz
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - J Bódis
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.,Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary
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Weller D. Screening, resilience, patient navigation and information needs--key areas in cancer control. Eur J Cancer Care (Engl) 2017; 25:3-5. [PMID: 26768700 DOI: 10.1111/ecc.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 12/31/2022]
Affiliation(s)
- D Weller
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Cal A, Avci IA, Cavusoglu F. Experiences of Caregivers with Spouses Receiving Chemotherapy for Colorectal Cancer and their Expectations from Nursing Services. Asia Pac J Oncol Nurs 2017; 4:173-179. [PMID: 28503652 PMCID: PMC5412157 DOI: 10.4103/apjon.apjon_11_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The purpose of this study was to reveal experiences of caregivers whose spouses were receiving chemotherapy for colorectal cancer and their expectations from nursing services. METHODS This is a qualitative study. The caregivers were interviewed at their home. Sampling criteria were volunteering to participate in the study, being able to understand Turkish, not having speech or hearing problems and offering care to spouses with primary colorectal cancer. The interviews continued until concepts likely to be responses to research questions repeatedly appeared. Fourteen caregivers with spouses receiving chemotherapy for colorectal cancer comprised the study sample. Data were collected with a descriptive characteristics form and a semi-structured interview at in-depth interviews after making appointments with the caregivers on the phone. The steps followed in the content analysis were coding data, an organization of codes and themes, description of findings and evaluation of findings. RESULTS Experiences of the caregivers whose spouses were receiving chemotherapy for colorectal cancer and their expectations from nursing services were found to comprise the following themes "Facing the Disease," "Difficulties Encountered," "Continuing to Live," and "Provision of Health Care Services." CONCLUSIONS The results of the study revealed that cancer and its treatment affected not only cancer patients but also their spouses offering care. Nurses giving care at oncology clinics, public health centers, and home can make care plans based on the four themes emerging in this study and can detect problems earlier and create appropriate solutions to them. They will contribute to the literature revealing needs of people offering care to oncology patients as well.
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Affiliation(s)
- Ayse Cal
- Department of Public Health Nursing, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Ilknur Aydin Avci
- Department of Public Health Nursing, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Figen Cavusoglu
- Department of Public Health Nursing, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
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Mardani-Hamooleh M, Heidari H. Cancer patients' effort to return to normal life: a hermeneutic study. Scand J Caring Sci 2016; 31:351-358. [DOI: 10.1111/scs.12354] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/19/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Marjan Mardani-Hamooleh
- School of Nursing and Midwifery; Department of Nursing; Iran University of Medical Sciences; Tehran Iran
| | - Haydeh Heidari
- Faculty of Nursing and Midwifery; Modeling in Health Research Center; Shahrekord University of Medical Sciences; Shahrekord Iran
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Traeger L, McDonnell TM, McCarty CE, Greer JA, El-Jawahri A, Temel JS. Nursing intervention to enhance outpatient chemotherapy symptom management: Patient-reported outcomes of a randomized controlled trial. Cancer 2015; 121:3905-13. [PMID: 26194461 DOI: 10.1002/cncr.29585] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/14/2015] [Accepted: 06/16/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND The authors conducted a randomized controlled trial to evaluate a nurse practitioner (NP)-delivered symptom management intervention for patients initiating chemotherapy for nonmetastatic cancer. The aim was to reduce patient-reported symptom burden by facilitating patient-NP collaboration and the early management of symptoms. METHODS At the time of the first chemotherapy visit, adult participants with nonmetastatic breast, colorectal, or lung cancer (120 participants) completed self-report measures and were then randomly assigned to standard care plus the intervention or standard care alone. Intervention participants received proactive telephone calls from their oncology team NP during the week after each of the first 2 chemotherapy administration visits. Measures were repeated at the second and third chemotherapy visits. Group differences were analyzed with regard to patient-reported symptoms (Memorial Symptom Assessment Scale-Short Form items), satisfaction with care (Family Caregiver Satisfaction-patient scale), and the likelihood of depression or anxiety symptoms (Patient Health Questionnaire-4). RESULTS At the time of the first visit, 50.8% of participants reported ≥1 physical symptom, most commonly lack of energy (35.8%) and drowsiness (30.8%). The number of symptoms (gamma coefficient [γ] = 0.16; P<.001), symptom distress (γ = 0.45; P<.001), and satisfaction with care (γ = 0.24; P = .004) increased whereas the likelihood of anxiety symptoms decreased (γ = -0.19; P = .02) and the likelihood of depression symptoms did not change (γ = 0.01; P = .91). Outcomes did not differ by randomized group. Randomized group interacted with emetogenic potential in predicting symptom distress (γ = 0.43; P = .03) and satisfaction with care (γ = -0.45; P = .045). CONCLUSIONS The intervention did not appear to reduce symptom burden compared with standard care. Early symptoms highlight the importance of continuing to examine strategies to improve symptom management during chemotherapy for nonmetastatic disease.
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Affiliation(s)
- Lara Traeger
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Caitlin E McCarty
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Joseph A Greer
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Areej El-Jawahri
- Hematology Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jennifer S Temel
- Hematology Oncology, Massachusetts General Hospital, Boston, Massachusetts
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