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Egeler MD, Boomstra E, Rohaan MW, Van den Heuvel NMJ, Fraterman I, Delfos M, van de Poll-Franse LV, Borch TH, Svane IM, Haanen JBAG, Retèl VP, Boekhout AH. "One more chance to survive": the experiences of patients with advanced melanoma and their partners with tumor-infiltrating lymphocyte therapy-a qualitative study and recommendations for future care. J Cancer Surviv 2023:10.1007/s11764-023-01452-8. [PMID: 37606816 DOI: 10.1007/s11764-023-01452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE Patients with advanced melanoma refractory to first-line treatment have a need for effective second-line treatment options. A recent phase 3 trial showed promising results for adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) as second-line therapy in patients with advanced melanoma. However, it remains unknown how patients and their partners experience TIL therapy, which is key to evaluate and improve the quality of care. METHODS Semi-structured interviews about the experience of TIL therapy were conducted with patients with advanced melanoma and their partners 2-4 weeks post-treatment (short term) and >6 months after treatment (long term). RESULTS In total, 25 interviews were conducted with advanced melanoma patients treated with TIL (n=13) and their partners (n=12), with the majority being short-term interviews (n=17). Overall, patients and partners experienced TIL therapy as intense (uncertainty of successful TIL culture, multiple treatment-related toxicities, and extensive hospitalization). Patients and partners with young children or other caregiving responsibilities encountered the most challenges during TIL therapy. All patients, however, reported a recovery of all treatment-related toxicities within 2-4 weeks (except fatigue). CONCLUSION Clinical data justify the role of TIL therapy in the treatment of advanced melanoma. With the distinct nature of TIL therapy compared to the current standard of care, we have provided patient-centered recommendations that will further enhance the quality of TIL therapy. IMPLICATIONS FOR CANCER SURVIVORS As more patients with advanced melanoma are expected to receive TIL therapy in the future, our findings could be incorporated into survivorship care plans for this novel group of advanced melanoma survivors treated with TIL.
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Affiliation(s)
- M D Egeler
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | - E Boomstra
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M W Rohaan
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - N M J Van den Heuvel
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - I Fraterman
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M Delfos
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - L V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - T H Borch
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - I M Svane
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - J B A G Haanen
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Division of Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - V P Retèl
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - A H Boekhout
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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2
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Özden ZM, Kılıç M. The effect of self-efficacy levels of patients with intestinal stoma on stoma adaptation. Support Care Cancer 2023; 31:252. [PMID: 37036537 PMCID: PMC10088733 DOI: 10.1007/s00520-023-07702-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/20/2023] [Indexed: 04/11/2023]
Abstract
OBJECTION This study was conducted to examine the effect of self-efficacy levels on stoma adaptation in patients with intestinal stoma. METHODS The study was planned as descriptive and analytical and was carried out in the university adult hospital general surgery stoma and wound care unit. Sixty-two patients with intestinal stoma who met the admission criteria were included in the study. Ethics committee approval, institutional permission and patient consent were obtained for the study. Data were collected from June to September 2021 using the Descriptive Feature Information Form, the Self Efficacy Scale for Individuals with Ostomy, and the Ostomy Adjustment Inventory (OAI-23). Data were analyzed by number, percentage, mean, standard deviation, Mann Whitney U, t test, ANOVA, Pearson's correlation, and linear regression analysis tests. RESULTS The mean age of the patients with intestinal stoma who participated in our study was 53.12 ± 12.30 years; 71% of them were women, 83.9% were married, and 32.2% were primary and secondary school graduates. The duration of stoma was 8.45 ± 4.69 months, 80.6% of them were opened due to cancer, and 54.8% of them had temporary colostomy. There was a weak and significant correlation between the duration of stoma of the patients and their self-efficacy and stoma adaptation, and as their self-efficacy levels increased, their stoma adaptation increased (p < .05). CONCLUSIONS Self-efficacy is one of the important factors affecting patients' adaptation with the stoma. For this reason, it is recommended to plan trainings to support the self-efficacy levels of patients and to conduct interventional studies in this direction.
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Affiliation(s)
- Zeynep Melis Özden
- Institute of Health Sciences, SANKO University, İncili Pınar, Gazimuhtar Paşa Boulevard No: 36, 27090, Gaziantep, Turkey
| | - Meryem Kılıç
- Faculty of Health Sciences, Department of Nursing, SANKO University, İncili Pınar, Gazimuhtar Paşa Boulevard No: 36, 27090, Gaziantep, Turkey.
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3
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Cancer specialist nurses' experiences of supporting family members of persons diagnosed with colorectal cancer: A qualitative study. Eur J Oncol Nurs 2022; 61:102205. [DOI: 10.1016/j.ejon.2022.102205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/29/2022] [Accepted: 09/19/2022] [Indexed: 11/23/2022]
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Coenen P, Zegers AD, de Vreeze N, van der Beek AJ, Duijts SFA. 'Nobody can take the stress away from me': a qualitative study on experiences of partners of patients with cancer regarding their work and health. Disabil Rehabil 2022; 45:1696-1704. [PMID: 35604402 DOI: 10.1080/09638288.2022.2074547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To explore experienced health- and work-related problems of partners of patients with cancer, and their needs for support. MATERIALS AND METHODS Semi-structured interviews were conducted with Dutch partners of patients with cancer. Interviews were transcribed verbatim. Data were analysed thematically, following the six steps of Braun & Clarke. RESULTS Of 20 included partners (mean age: 50 years [31-63]), 60% was female. Five themes consistently emerged from the data: 1) overwhelming chaos calls for taking control; 2) impact of prolonged stress; 3) flexibility and support of the employer are crucial; 4) coping with family and friends is a delicate matter; and 5) support from healthcare professionals is needed, but not a given. CONCLUSIONS Findings from this study show that the burden on partners of patients with cancer is substantial and cannot be overlooked. The state of survival mode that partners get into during the diagnosis, treatment and follow-up of their loved ones can have various implications on their physical and mental health, and work situation. Given this high burden and as legislation for care leave from work and (health care) support for partners appear to be insufficiently in place in the Dutch context, there is a need for better-targeted support for partners of patients with cancer. Implications for RehabilitationThe survival mode that partners of patients with cancer get into during the diagnosis, treatment and follow-up of their loved ones can have various implications on their physical and mental health, and work situation.This study showed that the burden on partners of patients with cancer is substantial and cannot be overlooked.Given this high burden and because legislation for care leave from work and (health care) support for partners appears to be insufficiently in place in the Dutch context, there is a need for better-targeted support for partners of patients with cancer.
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Affiliation(s)
- Pieter Coenen
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Amber D Zegers
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Nadia de Vreeze
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Allard J van der Beek
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands.,The Netherlands Comprehensive Cancer Organization (IKNL), Research & Development, Utrecht, the Netherlands
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5
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The effect of caregiver educational program on caregiver reactions and lifestyle behaviors for caregivers of colorectal cancer patients: a quasi-experimental study. Support Care Cancer 2022; 30:4389-4397. [DOI: 10.1007/s00520-022-06862-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/24/2022] [Indexed: 12/22/2022]
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6
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Lim CYS, Laidsaar-Powell RC, Young JM, Kao SCH, Zhang Y, Butow P. Colorectal cancer survivorship: A systematic review and thematic synthesis of qualitative research. Eur J Cancer Care (Engl) 2021; 30:e13421. [PMID: 33733545 DOI: 10.1111/ecc.13421] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/06/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION With rapid changes in treatments for colorectal cancer (CRC), qualitative research into CRC survivorship requires greater synthesis. This paper aims to fill this gap through a systematic review (PROSPERO CRD42019131576) and thematic synthesis of the qualitative literature on survivorship experiences across early-stage and advanced CRC survivors. METHODS CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched for qualitative CRC survivorship papers. Titles, abstracts and full texts were screened. Included articles (n = 81) underwent data extraction, CASP qualitative bias ratings and thematic synthesis. RESULTS Bowel dysfunction caused functional limitations and negative quality of life (QoL), while stomas posed threats to body image and confidence. Physical symptoms hindered return to work, increasing financial burdens. Survivors' unmet needs included information regarding symptom expectations and management, and ongoing support throughout recovery. Advanced and early-stage survivors shared similar experiences. Advanced survivors struggled with fear of cancer recurrence/progression and feelings of powerlessness. Functional limitations, financial impacts and sexuality in advanced survivors were underexplored areas. CONCLUSION CRC and its treatments impact survivors' QoL in all areas. A coordinated supportive care response is required to address survivors' unmet needs. Future qualitative studies should explore advanced CRC subpopulations, treatment-specific impacts on QoL and long-term (>5 years) impacts on CRC survivors.
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Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Clare Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,RPA Institute of Academic Surgery (IAS) and Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia
| | - Steven Chuan-Hao Kao
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Australian National University Research School of Population Health, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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Informal caregiver well-being during and after patients' treatment with adjuvant chemotherapy for colon cancer: a prospective, exploratory study. Support Care Cancer 2020; 29:2481-2491. [PMID: 32935205 PMCID: PMC7981306 DOI: 10.1007/s00520-020-05738-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/04/2020] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Caring for a significant other during cancer treatment can be demanding. Little is known about the well-being of informal caregivers of patients with colon cancer. This study aims to examine informal caregiver well-being during adjuvant chemotherapy for colon cancer. MATERIAL AND METHODS This exploratory longitudinal, prospective study measured the course of informal caregiver burden (Self-Perceived Pressure of Informal Care), distress (Hospital Anxiety and Depression Scale), health-related quality of life (RAND-36), marital satisfaction (Maudsley Marital Questionnaire), social support (Social Support List - Discrepancies), fatigue (Abbreviated Fatigue Questionnaire), and self-esteem (Caregiver Reaction Assessment) before (T0), during (T1), and after (T2) patients' treatment. RESULTS Baseline data of 60 out of 76 eligible dyads (79%) were analyzed. Mean levels of informal caregiver burden and distress improved significantly over time, as did their health-related quality of life and perceived social support. At baseline, 30% and 26.7% of informal caregivers reported moderate-to-high levels of burden and clinically relevant levels of distress, respectively, which changed to 20% and 18.8% at T2. Informal caregiver burden and distress at baseline were the strongest predictors of informal caregiver burden and distress during and following patients' treatment, respectively. CONCLUSION When informal caregivers and patients experience problems before start of adjuvant chemotherapy, problems seem to improve over time. Approximately 20% of informal caregivers remain burdened and distressed after patients' end of treatment. Paying attention to baseline distress and burden seems indicated, as these were strong predictors of informal caregivers' well-being during and after treatment.
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Atlas A, Milanese S, Grimmer K, Barras S, Stephens JH. Sources of information used by patients prior to elective surgery: a scoping review. BMJ Open 2019; 9:e023080. [PMID: 31383690 PMCID: PMC6687002 DOI: 10.1136/bmjopen-2018-023080] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To describe the range and nature of available research regarding sources of information that patients access to inform their decisions about elective surgery. DESIGN Scoping review. DATA SOURCES Peer-reviewed studies published until February 2019 from the six scientific literature databases were searched and included in the study: Medline, PubMed, CINAHL, Academic Search Premier, EMBASE and SCOPUS. Web searches for grey literature were conducted in Google, South Australia Department of Health, Commonwealth Department of Health (Australia) and My Aged Care from the Department of Social Services (Australia). ELIGIBILITY CRITERIA Studies with a focus on elective surgery information sources oriented to patients were eligible for inclusion. Only studies written in English were sought and no publication date or study restrictions were applied. DATA EXTRACTION AND SYNTHESIS Included literature was described by National Health and Medical Council hierarchy of evidence, and data were extracted on country and year of publication, type of literature, who provided it and any information on end users. Information sources were categorised by type and how information was presented. RESULTS A pool of 1039 articles was reduced to 26 after screening for duplicates and non-relevant studies. Face-to-face exchanges were the most likely source of information prior to elective surgery (59.3%), printed information (55.6%) followed by e-learning (51.9%) and multimedia (14.8%). The face-to-face category included information provided by the physician/general practitioners/specialists, and family and friends. Printed information included brochures and pamphlets, e-learning consisted of internet sites or videos and the use of multimedia included different mixed media format. CONCLUSION There is considerable variability regarding the types of information patients use in their decision to undergo elective surgery. The most common source of health information (face-to-face interaction with medical personnel) raises the question that the information provided could be incomplete and/or biased, and dependent on what their health provider knew or chose to tell them.
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Affiliation(s)
- Alvin Atlas
- International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
- Health Market Quality Research, Capital Markets CRC Ltd, Sydney, New South Wales, Australia
| | - Steve Milanese
- International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - Karen Grimmer
- International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - Sarah Barras
- Australian Health Service Alliance, Camberwell, Victoria, Australia
| | - Jacqueline H Stephens
- Centre for Population Health Research, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
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10
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Hildebrandt C, Mayer H, Koller A. Experiences of patients with colorectal cancer from diagnosis until completion of treatment: A meta-ethnography approach. Psychooncology 2018; 28:219-227. [PMID: 30447170 DOI: 10.1002/pon.4946] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The purpose of this meta-synthesis was to explore the experience of living with symptoms caused by colorectal cancer (CRC) and its treatment from the perspectives of those affected. METHODS In a systematic search of qualitative studies published up to September 2017, 21 relevant papers were identified. The meta-ethnography followed the approach developed by Noblit and Hare. To relate key themes from one paper to similar themes of different papers, a "reciprocal translation" was carried out. RESULTS Through synthesis, a new model was developed during treatment ("lines-of-argument synthesis"). Two constructs of experiences took place before the illness. Six third-order constructs were developed to capture patients' experiences during treatment, including "disruption in life through CRC" as well as the complex and circular experiences summarized as "experiences of symptoms and challenges by CRC". In contrast, experiences in dealing with changes that CRC and the treatment imply were "making sense of the experience", "sharing the experience", "experiences with controlling ones' body", and "experiences with reforming life". CONCLUSIONS This meta-ethnography clarifies fundamental aspects of patients' experience in very different settings or starting points by specifying a more complete and holistic spectrum of experiences with CRC and its treatment.
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Affiliation(s)
| | - Hanna Mayer
- Department of Nursing ScienceUniversity of Vienna Vienna Austria
| | - Antje Koller
- Department of Nursing ScienceUniversity of Vienna Vienna Austria
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11
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Pettersson ME, Öhlén J, Friberg F, Hydén L, Wallengren C, Sarenmalm EK, Carlsson E. Prepared for surgery – Communication in nurses' preoperative consultations with patients undergoing surgery for colorectal cancer after a person‐centred intervention. J Clin Nurs 2018; 27:2904-2916. [DOI: 10.1111/jocn.14312] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Monica E Pettersson
- Institute of Health and Care Sciences and Centre for Person‐Centred Care Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
- The Vascular Department Sahlgrenska University Hospital Gothenburg Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences and Centre for Person‐Centred Care Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Febe Friberg
- Department of Health studies Faculty of Social sciences University of Stavanger Stavanger Norway
- Centre for Person‐Centred Care Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Lars‐Christer Hydén
- Department of Health and Medical Sciences Linköping University Linköping Sweden
| | - Catarina Wallengren
- Institute of Health and Care Sciences and Centre for Person‐Centred Care Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Elisabeth Kenne Sarenmalm
- Research and Development Skaraborg Hospital Skövde and Institute of Health and Care Sciences Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Eva Carlsson
- Institute of Health and Care Sciences and Centre for Person‐Centred Care Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
- The Colorectal Unit Sahlgrenska University Hospital Gothenburg Sweden
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12
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Reinwalds M, Blixter A, Carlsson E. Living with a resected rectum after rectal cancer surgery—Struggling not to let bowel function control life. J Clin Nurs 2017; 27:e623-e634. [DOI: 10.1111/jocn.14112] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2017] [Indexed: 01/16/2023]
Affiliation(s)
- Maria Reinwalds
- Department of Surgery Institute of Clinical Sciences Sahlgrenska University Hospital/Östra Gothenburg Sweden
| | - Andrea Blixter
- Department of Surgery Angered Hospital Gothenburg Sweden
- Department of Surgery Kungälv Hospital Kungälv Sweden
| | - Eva Carlsson
- Department of Surgery Institute of Clinical Sciences Sahlgrenska University Hospital/Östra Gothenburg Sweden
- Institute of Health and Care Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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Wide-ranging impacts reported by NZ cancer survivors: is supporting cancer survivor resilience a health sector role? Support Care Cancer 2017; 26:1207-1213. [DOI: 10.1007/s00520-017-3943-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
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14
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Improving Experience of Patients With Rectal Cancer: A National Quality Improvement Project. J Wound Ostomy Continence Nurs 2017; 44:387-389. [PMID: 28549052 DOI: 10.1097/won.0000000000000341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Reed SC, Bell JF, Whitney R, Lash R, Kim KK, Bold RJ, Joseph JG. Psychosocial outcomes in active treatment through survivorship. Psychooncology 2017; 27:279-285. [PMID: 28429466 DOI: 10.1002/pon.4444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 02/26/2017] [Accepted: 04/14/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of the study is to understand potential differences in psychosocial outcomes from active treatment to survivorship. METHODS Using the Medical Expenditure Panel Survey Experiences with Cancer Survivorship Supplement (n = 1360), we examined and compared psychosocial outcomes among respondents in active treatment with survivors by year(s) since treatment ended. Survey-weighted regression models were used to test associations between year(s) since treatment and depressive symptoms (Patient Health Questionnaire-2), psychological distress (K6), and cancer-specific worry related to recurrence. RESULTS Unadjusted estimates showed no significant differences in depressive symptoms or psychological distress between those in active treatment and cancer survivors at any time posttreatment. In contrast, the prevalence of cancer-specific worry was lowest among survivors more than 5 years since treatment (10%), slightly higher among those with less than 1 year since treatment (15%), and highest among those in active treatment (32%). In models controlled for sociodemographic and health-related covariates, the year(s) since treatment ended was inversely associated with the odds of cancer-specific worry but was not associated with depressive symptoms or psychological distress. CONCLUSIONS In this population-based sample, worry about cancer recurrence may diminish with years since treatment ended, while depressive symptoms and distress are persistent across the trajectory. These findings highlight unmet psychosocial needs among cancer survivors and demonstrate the importance of targeted interventions across the survivorship continuum.
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Affiliation(s)
- Sarah C Reed
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA.,Collaborative Cancer Care Research Group, University of California, Davis, Sacramento, CA, USA.,Jane Addams College of Social Work, University of Illinois at Chicago, Chicago, IL, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA.,Collaborative Cancer Care Research Group, University of California, Davis, Sacramento, CA, USA
| | | | - Rebecca Lash
- Department of Nursing Practice, Research, and Education, UCLA Health System, Los Angeles, CA, USA
| | - Katherine K Kim
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA.,Collaborative Cancer Care Research Group, University of California, Davis, Sacramento, CA, USA
| | - Richard J Bold
- Collaborative Cancer Care Research Group, University of California, Davis, Sacramento, CA, USA.,Comprehensive Cancer Center, University of California, Davis, Sacramento, CA, USA
| | - Jill G Joseph
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA.,Collaborative Cancer Care Research Group, University of California, Davis, Sacramento, CA, USA
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Abstract
BACKGROUND With the research focus on family caregiving shifting from the individual to the dyadic level, there is a need to explore cancer dyads' concerns and needs and to understand their experiences of coping together with cancer. OBJECTIVE To objectives of this study were to gain a better understanding of the experience of couples living with cancer and to explore cancer couples' concerns and needs related to the caring role and experience of spousal caregivers. METHODS The focus group study design with a purposeful sampling strategy was adopted. We conducted 4 focus group interviews with 11 cancer patients and 17 spousal caregivers in a hospital. RESULTS Four themes and 15 subthemes emerged after a conventional content analysis. The 4 themes include communication dynamics, living with changes, negative and positive impacts, and network of support. Based on the findings, we drew a preliminary conceptualization of the couples' experience of coping and living with cancer as a whole. CONCLUSIONS This study provided insights to healthcare professionals regarding daily struggles of couples living with cancer and the development of intervention programs to support these couples. IMPLICATIONS FOR PRACTICE Healthcare professionals need to (1) be sensitive to the couples' needs and concerns, (2) offer sufficient and useful information to couples who are coping with cancer, (3) encourage and help spousal caregivers to take care of themselves while coping with the changes in their spouses, and (4) instill realistic hopes in couples and help them to sustain a positive attitude with a focus on the future, not just on the present.
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17
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Ohlsson-Nevo E, Andershed B, Nilsson U. Psycho-educational intervention on mood in patients suffering from colorectal and anal cancer: A randomized controlled trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/2057158516679790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Psycho-educational interventions can moderate the negative impact of cancer on patients’ mental wellbeing, although studies of the effect on colorectal cancer (CRC) patients are scarce. Hence, the primary aim of this study was to test whether a nurse-led psycho-educational programme (PEP) could affect the emotional wellbeing of persons being treated for CRC and anal cancer. A secondary aim was to test whether there were any differences in emotional wellbeing in the patients before undergoing a PEP compared to a subset of the Swedish population. A randomized controlled trial was used. In total, 86 patients were randomized either to a PEP comprising seven lectures followed by discussions and reflections with peers or to standard treatment. Mental wellbeing was measured with the Mood Adjective Check List. The PEP significantly ( p < 0.04) increased the patients’ overall mood one month after the end of the intervention. The PEP seemed to have a short-term effect on patients’ overall mood. Other outcomes such as self-efficacy could be useful measures when evaluating PEP.
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Affiliation(s)
- Emma Ohlsson-Nevo
- Health Care Research Center, University Hospital, Örebro, Sweden
- School of Health Sciences, Örebro University, Sweden
| | - Birgitta Andershed
- Faculty of Health, Care and Nursing, Norwegian University of Science and Technology, Gjövik, Norway
- Department of Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden
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18
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Maguire R, Hanly P, Hyland P, Sharp L. Understanding burden in caregivers of colorectal cancer survivors: what role do patient and caregiver factors play? Eur J Cancer Care (Engl) 2016; 27. [PMID: 27271848 DOI: 10.1111/ecc.12527] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 01/22/2023]
Abstract
This study investigated how both caregiver and patient factors predict different aspects of burden in colorectal cancer caregivers. One hundred and fifty-three caregiver-survivor dyads separately provided information on patient disease and treatment-related factors, and perceived global health status (EORTC QLQ30), along with caregiver socio-demographic factors, health and care-related activities. Four multiple regression analyses were conducted to assess the influence of caregiver characteristics, patient characteristics and care-related activities on four dimensions of burden from the Caregiver Reaction Assessment scale. Caregiver characteristics significantly predicted health and financial burden (11%-13% of explained variance) with comorbidity and younger age increasing this risk. Patient health, in particular global health status and the presence of a stoma, predicted all burden scores, explaining 14%-22% of variance. Care-related activities was also a significant predictor of all burden scores, explaining an additional 5%-11% of variance, with time involved in caring the most consistent predictor. Results highlight that a combination of factors influence caregiver burden. These results may be used to identify those most at risk, allowing practitioners to deliver tailored effective support. In particular, efforts to alleviate the burden of caring on caregiver schedule may be merited, given that this was the domain in which the burden was greatest.
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Affiliation(s)
- R Maguire
- National College of Ireland, Dublin, Ireland
| | - P Hanly
- National College of Ireland, Dublin, Ireland
| | - P Hyland
- National College of Ireland, Dublin, Ireland
| | - L Sharp
- Newcastle University, Newcastle upon Tyne, UK
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19
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Abstract
BACKGROUND Cancer has a great impact on the well-being of affected persons and their caregivers long into survivorship. OBJECTIVE This article reviews the state of science on the survivorship experience of cancer survivors and caregivers, with a focus on symptom burden and quality of life (QOL) after treatment termination. METHODS The primary databases utilized included PubMed and CINAHL. Search results were limited to human participants, English language, and publications from 2008 to 2013. The articles retrieved included studies of prostate, breast, colorectal, and gynecologic cancers during adulthood. RESULTS As many as a third of cancer survivors experienced symptoms after treatment cessation equivalent to those experienced during treatment. Fatigue, depression or mood disturbance, sleep disruption, pain, and cognitive limitation were commonly reported by survivors across various malignancies; depression, anxiety, and sleep disturbance affected some caregivers. The studies indicated residual symptoms that extend into survivorship have a great impact on QOL and are associated with disability and healthcare utilization. Younger age, lower socioeconomic status, and increased comorbidities are associated with poorer QOL and higher symptom distress in cancer survivors. Younger age and lower income are associated with greater distress and poorer QOL in caregivers. CONCLUSIONS Survivors and caregivers struggle with symptom burden and diminished QOL long into survivorship. Longitudinal studies are needed to investigate the persistence and severity of symptom burden over time as well as long-term and late effects of these symptoms. IMPLICATIONS FOR PRACTICE Interventions designed to help alleviate symptom burden in those most affected are needed.
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20
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McCarthy M, Fergus K, Miller D. 'I-We' boundary fluctuations in couple adjustment to rectal cancer and life with a permanent colostomy. Health Psychol Open 2016; 3:2055102916633582. [PMID: 28070388 PMCID: PMC5193256 DOI: 10.1177/2055102916633582] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study investigates couples' adjustment to rectal cancer and a colostomy using the 'Classification System of Couple Adjustment to Cancer', a framework delineating fluctuations in couples' sense of 'I' and 'We' in response to cancer. Nine couples affected by rectal cancer and adjusting to life with a colostomy were interviewed. A theoretical thematic analysis of the transcripts was conducted; nearly all 'I-We' shifts of the Classification System of Couple Adjustment to Cancer were observed - often in unique ways in response to rectal cancer-specific challenges - and one new shift was described. The results provide a novel and experientially grounded means of conceptualizing complex dyadic coping processes.
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Affiliation(s)
| | - Karen Fergus
- Department of Psychology, York University, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada
| | - Debbie Miller
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada
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21
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Ohlsson-Nevo E, Karlsson J, Nilsson U. Effects of a psycho-educational programme on health-related quality of life in patients treated for colorectal and anal cancer: A feasibility trial. Eur J Oncol Nurs 2015; 21:181-8. [PMID: 26643400 DOI: 10.1016/j.ejon.2015.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 09/11/2015] [Accepted: 10/08/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Colorectal cancer (CRC) may have a negative impact on a person's quality of life. Psycho-educational interventions for patients with CRC are rarely studied. The purpose of this feasibility trial was to evaluate the effect of a psycho-educational programme (PEP) on the health-related quality of life (HRQL) of patients treated for CRC and anal cancer. METHODS Patients with CRC and anal cancer were randomly assigned to a PEP (n = 47) or standard treatment (n = 39). The PEP included informative lectures, discussion, and reflection. HRQL was evaluated using the SF-36 at baseline and 1, 6, and 12 months after the end of the PEP. RESULTS Patients in the PEP group had significantly better Mental Health scores after 1 month and significantly better Bodily Pain scores after 6 months compared with patients who received standard care. CONCLUSION The results of this study indicate that a PEP can have a short-term effect on the mental health and bodily pain of patients treated for CRC and anal cancer when comparing with a control group. The article discusses the methodological difficulties of evaluating an intervention such as this PEP in a clinical setting.
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Affiliation(s)
- Emma Ohlsson-Nevo
- Faculty of Medicine and Health, Department of Surgery, Örebro University, Örebro, Sweden; Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Faculty of Medicine and Health, Centre for Health Care Sciences, Örebro University, Örebro, Sweden.
| | - Jan Karlsson
- Faculty of Medicine and Health, Centre for Health Care Sciences, Örebro University, Örebro, Sweden; Faculty of Medicine and Health, Department of Medicine, Örebro University, Örebro, Sweden
| | - Ulrica Nilsson
- Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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22
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LeSeure P, Chongkham-Ang S. The Experience of Caregivers Living with Cancer Patients: A Systematic Review and Meta-Synthesis. J Pers Med 2015; 5:406-39. [PMID: 26610573 PMCID: PMC4695863 DOI: 10.3390/jpm5040406] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/10/2015] [Accepted: 11/12/2015] [Indexed: 11/16/2022] Open
Abstract
The objectives of this meta-synthesis were to: (1) explore the experience of caregivers who were caring for cancer patients, including their perceptions and responses to the situation; and (2) describe the context and the phenomena relevant to the experience. Five databases were used: CINAHL, MEDLINE, Academic Search, Science Direct, and a Thai database known as the Thai Library Integrated System (ThaiLIS). Three sets of the context of the experience and the phenomena relevant to the experience were described. The contexts were (1) having a hard time dealing with emotional devastation; (2) knowing that the caregiving job was laborious; and (3) knowing that I was not alone. The phenomenon showed the progress of the caregivers’ thoughts and actions. A general phenomenon of the experience—balancing my emotion—applied to most of the caregivers; whereas, more specific phenomenon—keeping life as normal as possible and lifting life above the illness—were experienced by a lesser number of the caregivers. This review added a more thorough explanation of the issues involved in caregiving for cancer patients. A more comprehensive description of the experience of caregiving was described. The findings of this review can be used to guide clinical practice and policy formation in cancer patient care.
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Affiliation(s)
- Peeranuch LeSeure
- McCormick Faculty of Nursing, Payap University, Chiang Mai 50000, Thailand.
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Johansson ACB, Axelsson M, Berndtsson I, Brink E. Self-Reorientation Following Colorectal Cancer Treatment - A Grounded Theory Study. Open Nurs J 2015; 9:25-31. [PMID: 26312124 PMCID: PMC4541305 DOI: 10.2174/1874434601509010025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/22/2014] [Accepted: 01/05/2015] [Indexed: 11/22/2022] Open
Abstract
After colorectal cancer (CRC) treatment, people reorganize life in ways that are consistent with their understanding of the illness and their expectations for recovery. Incapacities and abilities that have been lost can initiate a need to reorient the self. To the best of our knowledge, no studies have explicitly focused on the concept of self-reorientation after CRC treatment. The aim of the present study was therefore to explore self-reorientation in the early recovery phase after CRC surgery. Grounded theory analysis was undertaken, using the method presented by Charmaz. The present results explained self-reorientation as the individual attempting to achieve congruence in self-perception. A congruent self-perception meant bringing together the perceived self and the self that was mirrored in the near environs. The results showed that societal beliefs and personal explanations are essential elements of self-reorientation, and that it is therefore important to make them visible.
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Affiliation(s)
- Ann-Caroline B Johansson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Nursing, Health and Culture, University West, Trollhättan, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Ina Berndtsson
- Department of Nursing, Health and Culture, University West, Trollhättan, Sweden
| | - Eva Brink
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Nursing, Health and Culture, University West, Trollhättan, Sweden
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Hanly P, Maguire R, Hyland P, Sharp L. Examining the role of subjective and objective burden in carer health-related quality of life: the case of colorectal cancer. Support Care Cancer 2014; 23:1941-9. [PMID: 25504527 DOI: 10.1007/s00520-014-2551-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 11/30/2014] [Indexed: 12/17/2022]
Abstract
PURPOSE Our aim was to investigate associations between the subjective burden of care and health-related quality of life (both physical and mental) within colorectal cancer patient carers in Ireland, with supplementary analysis of carer objective factors. METHODS Two hundred twenty-eight colorectal cancer informal carers were sent a postal questionnaire between August 2010 and March 2011 which included the Caregiver Reaction Assessment (CRA) and the SF-12v2. Multiple regression analysis assessed whether five CRA domains (family support, finances, schedule, health and esteem) predicted carer mental or physical health. Between-group comparisons investigated differences in these domains across objective factors. RESULTS One hundred fifty-three carers (82% female) completed the questionnaire (response rate = 68%). Carers' mean physical component summary (PCS) was 48.56 (SD = 10.38) and mean mental component summary (MCS) was 49.22 (SD = 9.7). Five CRA factors explained 30% of variance in the PCS score and 28% of variance in the MCS score. Health burden (β = -.76, p < .001) and schedule burden (β = .28, p = .01) were significant predictors of PCS. MCS was significantly predicated by financial burden (β = -.24, p = .01) and esteem (β = -.18, p = .03). Younger carers, spouses, those with a comorbid condition and those with no income change had significantly lower PCS. There were no statistically significant group differences for carer mental health. CONCLUSIONS Our results demonstrate the need to recognise the distinctive aspects of the impact of caring (i.e., physical and mental) on carers and that different domains of subjective carer burden and objective factors impact differently on each of these. This has important implications for those delivering support to carers over the course of the survivorship continuum.
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Affiliation(s)
- Paul Hanly
- National College of Ireland, Mayor Street, Dublin 1, Ireland,
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25
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McCarthy B, Andrews T, Hegarty J. Emotional Resistance Building: how family members of loved ones undergoing chemotherapy treatment process their fear of emotional collapse. J Adv Nurs 2014; 71:837-48. [DOI: 10.1111/jan.12549] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 12/01/2022]
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Ostlund U, Persson C. Examining Family Responses to Family Systems Nursing Interventions: An Integrative Review. JOURNAL OF FAMILY NURSING 2014; 20:259-286. [PMID: 25026964 DOI: 10.1177/1074840714542962] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
To add to the small, but growing, number of literature reviews of family interventions in health care, a systematic literature search of Family Systems Nursing intervention research resulted in the inclusion of 17 empirical research reports. Family Systems Nursing intervention research to date has primarily used qualitative methods and a few quasi-experimental designs using pre-post outcome measures. Families' responses to Family Systems Nursing interventions were categorized in this integrative review using the cognitive, affective, and behavioral domains of family functioning proposed by Wright and Leahey. Family response in the cognitive domain found improved understanding, capability, and enhanced coping. The affective response categories showed caring more about each other and the family, improved family emotional well-being, and improved individual emotional well-being. Finally, family responses in the behavioral domain comprised caring more for each other and the family, improvement in interactions within and outside family, and healthier individual behavior. These findings may guide the design of future family nursing intervention research and the selection of family outcome measures to examine the usefulness of Family Systems Nursing interventions. More intervention research using experimental and quasi-experimental designs is needed to strengthen the evidence for Family Systems Nursing practice.
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Johansson AC, Axelsson M, Berndtsson I, Brink E. Illness perceptions in relation to experiences of contemporary cancer care settings among colorectal cancer survivors and their partners. Int J Qual Stud Health Well-being 2014; 9:23581. [PMID: 25056939 PMCID: PMC4108758 DOI: 10.3402/qhw.v9.23581] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2014] [Indexed: 12/20/2022] Open
Abstract
Illness is constituted by subjective experiences of symptoms and their psychosocial consequences. Illness perceptions concern people's lay beliefs about understandings and interpretation of a disease and expectations as to disease outcome. Our knowledge about illness perceptions and coping in relation to the cancer care context among persons with colorectal cancer (CRC) and their partners is incomplete. The aim of the present study was to explore illness perceptions in relation to contemporary cancer care settings among CRC survivors and partners. The present research focused on illness rather than disease, implying that personal experiences are central to the methodology. The grounded theory method used is that presented by Kathy Charmaz. The present results explore illness perceptions in the early recovery phase after being diagnosed and treated for cancer in a contemporary cancer care setting. The core category outlook on the cancer diagnosis when quickly informed, treated, and discharged illustrates the illness perceptions of survivors and partners as well as the environment in which they were found. The cancer care environment is presented in the conceptual category experiencing contemporary cancer care settings. Receiving treatment quickly and without waiting was a positive experience for both partners and survivors; however partners experienced the information as massive and as causing concern. The period after discharge was being marked by uncertainty and loneliness, and partners tended to experience non-continuity in care as more problematic than the survivor did. The results showed different illness perceptions and a mismatch between illness perceptions among survivors and partners, presented in the conceptual category outlook on the cancer diagnosis. One illness perception, here presented among partners, focused on seeing the cancer diagnosis as a permanent life-changing event. The other illness perception, here presented among survivors, concentrated on leaving the cancer diagnosis behind and moving forward. The importance of illness perceptions among survivors, and the differences in illness perceptions between survivors and partners, should be recognized by healthcare professionals to achieve the goals of person-centered contemporary cancer care.
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Affiliation(s)
- Ann-Caroline Johansson
- Department of Nursing, Health and Culture, University West, Trollhättan, Sweden; Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden;
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Sweden
| | - Ina Berndtsson
- Department of Nursing, Health and Culture, University West, Trollhättan, Sweden
| | - Eva Brink
- Department of Nursing, Health and Culture, University West, Trollhättan, Sweden; Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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28
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Smith F, Carlsson E, Kokkinakis D, Forsberg M, Kodeda K, Sawatzky R, Friberg F, Öhlén J. Readability, suitability and comprehensibility in patient education materials for Swedish patients with colorectal cancer undergoing elective surgery: a mixed method design. PATIENT EDUCATION AND COUNSELING 2014; 94:202-209. [PMID: 24290242 DOI: 10.1016/j.pec.2013.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 08/20/2013] [Accepted: 10/26/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To characterize education materials provided to patients undergoing colorectal cancer surgery to gain a better understanding of how to design readable, suitable, comprehensible materials. METHOD Mixed method design. Deductive quantitative analysis using a validated suitability and comprehensibility assessment instrument (SAM+CAM) was applied to patient education materials from 27 Swedish hospitals, supplemented by language technology analysis and deductive and inductive analysis of data from focus groups involving 15 former patients. RESULTS Of 125 patient education materials used during the colorectal cancer surgery process, 13.6% were rated 'not suitable', 76.8% 'adequate' and 9.6% 'superior'. Professionally developed stoma care brochures were rated 'superior' and 44% of discharge brochures were 'not suitable'. Language technology analysis showed that up to 29% of materials were difficult to comprehend. Focus group analysis revealed additional areas that needed to be included in patient education materials: general and personal care, personal implications, internet, significant others, accessibility to healthcare, usability, trustworthiness and patient support groups. CONCLUSION Most of the patient education materials were rated 'adequate' but did not meet the information needs of patients entirely. Discharge brochures particularly require improvement. PRACTICE IMPLICATIONS Using patients' knowledge and integrating manual and automated methods could result in more appropriate patient education materials.
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Affiliation(s)
- Frida Smith
- Department of Colorectal Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden.
| | - Eva Carlsson
- Department of Colorectal Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden
| | | | - Markus Forsberg
- Språkbanken/Department of Swedish language, University of Gothenburg, Sweden
| | - Karl Kodeda
- Department of Colorectal Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Richard Sawatzky
- Trinity Western University, School of Nursing, Providence Health Care, Centre for Health Evaluation and Outcomes Sciences, Vancouver, Canada
| | - Febe Friberg
- Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden; Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway
| | - Joakim Öhlén
- Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden; Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden
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Norlyk A, Martinsen B. The extended arm of health professionals? Relatives' experiences of patient's recovery in a fast-track programme. J Adv Nurs 2012; 69:1737-46. [DOI: 10.1111/jan.12034] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2012] [Indexed: 12/15/2022]
Affiliation(s)
- Annelise Norlyk
- Department of Nursing Science; Faculty of Health Sciences; Institute of Clinical Medicine/School of Public Health; Aarhus University; Denmark
| | - Bente Martinsen
- Department of Nursing Science; Faculty of Health Sciences; School of Public Health; Aarhus University; Denmark
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