Concept analysis of cancer survivorship and contributions to oncological nursing

The experience of health-related quality of life in extended and permanent cancer survivors: A qualitative systematic review

OBJECTIVE

This qualitative systematic review aims to synthesize qualitative evidence from primary studies on experiencing health-related quality of life (HRQoL) in extended and permanent cancer survivors.

METHODS

A systematic literature search was performed in PubMed, CINAHL, LILACS, PsycINFO, Scopus, and Web of Science. It followed guidelines from the statement in the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). A quality appraisal of each study was undertaken using the Critical Appraisal Skills Programme. Data synthesis was conducted according to the thematic synthesis approach. Confidence in each review finding was assessed using the Confidence in the Evidence from Reviews of Qualitative research (Grade-CERQual).

RESULTS

Twenty-four studies from nine countries were selected for the final sample. Analysis of the studies' results allowed for the construction of nine descriptive themes that were interpreted into three analytical themes: "The body as a representation of HRQoL," "Living through and beyond cancer: the re-signification of HRQoL," and "Employing resources to improve HRQoL." According to the CERQual approach, moderate confidence estimations were achieved for the results.

CONCLUSIONS

The themes reflect that the HRQoL experience is re-signified by survivors from the privilege of being alive. This process happens with the support of social resources, family, hope, and spirituality. Based on the findings, it is suggested that health staff should be able to recognize the impact that cancer survival has on HRQoL and develop a care plan that addresses needs to sustain health in these survivors.

Interventions for Managing a Symptom Cluster of Pain, Fatigue, and Sleep Disturbances During Cancer Survivorship: A Systematic Review

PROBLEM IDENTIFICATION

More than 40% of cancer survivors experience a symptom cluster of pain, fatigue, and sleep disturbances, which can greatly reduce quality of life.

LITERATURE SEARCH

A literature search was performed using CINAHL®, Google ScholarTM, PubMed®, PsycINFO®, and Web of Science. Articles included randomized controlled trials of interventions aimed at managing a symptom cluster of pain, fatigue, and sleep disturbances.

DATA EVALUATION

11 studies were assessed for quality, risk of bias, cancer type, sample size, intervention type, duration, and setting. For an intervention to be considered effective, the reduction of symptom severity or distress had to be statistically significant.

SYNTHESIS

Data from the 11 studies were summarized. Four interventions were found to be effective in managing the symptom cluster, but evidence on long-term effectiveness was insufficient.

IMPLICATIONS FOR NURSING

Oncology nurses can assess the patterns and characteristics of simultaneous symptoms experienced by cancer survivors and administer interventions to relieve symptom burden and improve quality of life.

"What I was and what I am": A qualitative study of survivors' experience of urological cancer

PURPOSE

Most qualitative studies do not explore experience throughout the urologic cancer survival trajectory. Moreover, the evidence of the experience of cancer survivors that focuses on the contextual aspects of culture is scarce in oncology literature. This study aimed to analyze the survival experience of urological cancer from the perspective of men.

METHOD

This was a narrative research based on the concepts of culture derived from the interpretative medical anthropologic approach. Semi-structured interviews were conducted with 10 male survivors of urological cancer at different survival seasons. Seven participants agreed to a second interview, which resulted in 17 interviews. The data were analyzed using a five-phase thematic analysis approach. The findings are presented as narrative syntheses. The standards for reporting qualitative research (SPQR) was used in this study.

RESULTS

Two narrative syntheses were constructed: "The journey of urological cancer: discovering oneself as a survivor" and "What I was and what I am today": the disruption on the body and life. The narrative synthesis shows that survivors undergo transitions of identity from being healthy men to wrecked men. The survivors tried to present themselves as normal men to keep their masculinity intact. However, the experience of survival constituted a process of liminality and biographical disruption.

CONCLUSION

The experience of surviving urological cancer has highlighted the physical, emotional, and social challenges experienced by these male survivors. It is recommended to oncology nurses that nursing care should be planned along survival seasons considering the survivors' individual and subjective experiences.

Reintegration for Post-treatment Cancer Survivors: A Concept Analysis

Background: Cancer survivors who have completed active treatments experience challenges in the survivorship phase of cancer care. Survivors transitioning through an illness experience negotiate former roles and relationships and reevaluate their self-identity. Reintegration of post-treatment cancer survivors has not been analyzed; however, nurses with a clear understanding of reintegration influence holistic care. Purpose: The goal of this artricle is to provide a theoretical definition of the concept of reintegration for cancer survivors post-treatment. The definition is derived and supported from a multidisciplinary literature review. Method: The discussion was organized using the Walker and Avant approach to concept analysis. Findings: This concept analysis defined reintegration as a dynamic process involving the reorganization of former performance roles concurrent with the reevaluation of personal abilities. Survivors are involved in creating a new normal and post-treatment cancer survivor identity. Reintegration is characterized by transitional phases that may be cyclical and evolve with time. Finally, desired outcomes are based on perceived subjective and objective criteria of importance and are strengthened through multidimensional supportive networks. Conclusion: Incorporating the physical, social, emotional, spiritual, and community/environmental aspects of the cancer survivorship experience enhances reintegration.

Patient, cured, victim or survivor of urological cancer? A qualitative study

PURPOSE

to describe the meanings that patients attribute to the term cancer survivor and to analyze the identities assumed by them according to their experience with the disease.

METHODS

qualitative study with a narrative method, theoretical framework of the medical anthropology and identity concept. The study included 14 participants, men and women, diagnosed with urologic cancer. The semi-structured interviews were performed at the individual's home, after confirming participation.

RESULTS

eight participants assumed to be survivors, but five also assumed at least one other identity, in addition to cancer survivor. In contrast, among the six who defined themselves as cured, only one indicated another identity. Four considered themselves as victims and only two as cancer patients. However, the latter - cancer patient and victim - assumed at least one other associated identity.

CONCLUSIONS

allowing patients to reflect on themselves and their experience with the disease, as well as attributing themselves a new identity, will be directly related to the wellbeing and momentum the survivor is going through. Therefore, it can direct care in the cancer survivorship phase according to each survivor's individual context.