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Li L, Duan Y, Cao H, Zhou X, Kang Y, Wan Z, Huang D, Xie J, Cheng ASK. Effect of group online-based peer support intervention on psychological distress of adolescent and young adult cancer patients: a randomized controlled trial. Support Care Cancer 2024; 32:562. [PMID: 39085495 DOI: 10.1007/s00520-024-08765-z] [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: 01/29/2024] [Accepted: 07/25/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE Adolescent and young adult (AYA) cancer patients, aged between 15 to 39 years old, suffer from long-term psychological distress, confronting low self-efficacy and various psychological problems. This study constructs a group online-based peer support intervention combined with offline activities to explore its impact on the psychological distress of AYA cancer patients. METHODS A randomized, two-arm clinical trial was conducted in which 90 AYA cancer patients were recruited. The control group (N = 45) received conventional psychological care and treatment, and the experimental group (N = 45) received 8 weeks of an online peer support intervention. Outcome measures included psychological distress (Distress Thermometer, DT), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), perceived peer support (Cancer Peer Support Scales, CaPSS), and readiness for return to work (Readiness to Return-To-Work Scale, RRTW). RESULTS Eight-week peer support intervention was effective in improving psychological distress, anxiety, and depressive symptoms in the experimental group with statistically significant differences (P < 0.05). Time affected psychological distress, anxiety, and depressive symptoms in AYA cancer patients (P < 0.05), and there was an interaction with intervention factors (P < 0.05). The intervention has a positive effect on relieving the psychological status of AYA cancer patients. For readiness for return to work, the experimental group was in the preparation for the action-behavioral stage immediately, 1 month and 3 months after the end of the intervention (P < 0.01), supporting AYA cancer patients who have not returned to work to maintain optimal return-to-work readiness. CONCLUSIONS The group online-based peer support intervention is popular and has good scientificity, effectiveness, and practical significance for AYA cancer patients. TRIAL REGISTRATION This study was registered at clinicaltrials.gov. (ChiCTR2100053091, registered on 10 November 2021).
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Affiliation(s)
- Lijun Li
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yinglong Duan
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Huan Cao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xing Zhou
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yue Kang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Ziyu Wan
- Xiangya Nursing School, Central South University, Changsha, China
| | - Dawei Huang
- Department of Information, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, China.
| | - Andy S K Cheng
- School of Health Sciences, Western Sydney University, Sydney, Australia
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Jeffs L, Kuluski K, Flintoft V, MacLaurin A, Asselbergs M, Zeng RL, Bruno F, Schonewille N, Baker GR. Reconceptualizing Patient Safety Beyond Harm: Insights From a Mixed-Methods Qualitative Inquiry. J Nurs Care Qual 2024; 39:226-231. [PMID: 38198670 DOI: 10.1097/ncq.0000000000000757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Although patients' and care partners' perspectives on patient safety can guide health care learning and improvements, this information remains underutilized. Efforts to leverage this valuable data require challenging the narrow focus of safety as the absence of harm. PURPOSE The purpose of this study was to gain a broader insight into how patients and care partners perceive and experience safety. METHODS We used a mixed-methods approach that included a literature review and interviews and focus groups with patients, care partners, and health care providers. An emergent coding schema was developed from triangulation of the 2 data sets. RESULTS Two core themes-feeling unsafe and feeling safe-emerged that collectively represent a broader view of safety. CONCLUSION Knowledge from patients and care partners about feeling unsafe and safe needs to inform efforts to mitigate harm and promote safety, well-being, and positive outcomes and experiences.
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Affiliation(s)
- Lianne Jeffs
- Author Affiliations: Science of Care Institute, and Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada (Dr Jeffs); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Drs Jeffs, Kuluski, and Baker and Ms Flintoft); Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada (Dr Kuluski); Healthcare Excellence Canada, Ottawa, Ontario, Canada (Ms MacLaurin); Patients for Patient Safety Canada, Healthcare Excellence Canada, Ottawa, Ontario, Canada (Ms Asselbergs); and Sinai Health, Toronto, Ontario, Canada (Mss Zeng and Bruno and Mr Schonewille)
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Nicoll I, Lockwood G, Fitch MI. Cancer Survivors Living in Rural Settings: A Qualitative Exploration of Concerns, Positive Experiences and Suggestions for Improvements in Survivorship Care. Curr Oncol 2023; 30:7351-7365. [PMID: 37623014 PMCID: PMC10453435 DOI: 10.3390/curroncol30080533] [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: 03/23/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
In Canada, the number of cancer survivors continues to increase. It is important to understand what continues to present difficulties after the completion of treatment from their perspectives. Various factors may present barriers to accessing help for the challenges they experience following treatment. Living rurally may be one such factor. This study was undertaken to explore the major challenges, positive experiences and suggestions for improvement in survivorship care from rural-dwelling Canadian cancer survivors one to three years following treatment. A qualitative descriptive analysis was conducted on written responses to open-ended questions from a national cross-sectional survey. A total of 4646 individuals living in rural areas responded to the survey. Fifty percent (2327) were male, and 2296 (49.4%) were female; 69 respondents were 18 to 29 years (1.5%); 1638 (35.3%) were 30 to 64 years; and 2926 (63.0%) were 65 years or older. The most frequently identified major challenges (n = 5448) were reduced physical capacity and the effects of treatment. Positive experiences included family and friend support and positive self-care practices. The suggestions for improvements focused on the need for better communication and information about self-care, side effect management, and programs and services, with more programs available locally for practical and emotional support.
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Affiliation(s)
| | | | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M4C 4V9, Canada
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Civilotti C, Lucchini D, Fogazzi G, Palmieri F, Benenati A, Buffoli A, Girardi V, Ruzzenenti N, Di Betta A, Donarelli E, Veglia F, Di Fini G, Gandino G. The role of integrated psychological support in breast cancer patients: a randomized monocentric prospective study evaluating the Fil-Rouge Integrated Psycho-Oncological Support (FRIPOS) program. Support Care Cancer 2023; 31:266. [PMID: 37058253 PMCID: PMC10104919 DOI: 10.1007/s00520-023-07732-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 04/04/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE This study examined the effects of Fil-Rouge Integrated Psycho-Oncological Support (FRIPOS) in a group of women with breast cancer compared with a group receiving treatment as usual (TAU). METHODS The research design was a randomized, monocentric, prospective study with three time points of data collection: after the preoperative phase (T0), in the initial phase of treatments (T1), and 3 months after the start of treatments (T2). The FRIPOS group (N = 103) and the TAU group (N = 79) completed a sociodemographic questionnaire, the Symptom Checklist-90-R (SCL-90-R) at T0; the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and EORTC QLQ-BR23 at T1; and SCL-90-R, EORTC QLQ-C30, and EORTC QLQ-BR23 at T2. RESULTS A series of independent and paired t tests showed that patients in the FRIPOS group performed better on all scales related to symptomatic manifestations and on some quality of life scales (fatigue, dyspnea, and sleep disturbances) at T2. In addition, a series of ten multiple regressions were performed to predict each SCL subscale at T2 from the SCL score at T0 and the EORTC QLQ-C30 scores at T2. In nine of ten regression models (all except somatization), both FRIPOS group membership and QoL subscale contributed significantly to prediction. CONCLUSIONS This study suggests that patients in the FRIPOS group have more benefits in emotional, psychological, and collateral symptoms than patients in the TAU group and that these improvements are due to integrated psycho-oncology care.
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Affiliation(s)
- Cristina Civilotti
- Department of Psychology, University of Turin, Turin, Italy
- Salesian University Institute (IUSTO), Turin, Italy
| | - Diana Lucchini
- Breast Psycho-Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
- Associazione Priamo, Via della Lama, 61, 25133, Brescia, Italy
| | - Gianluca Fogazzi
- Breast Medical Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Fabrizio Palmieri
- Breast Surgery, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Alice Benenati
- Breast Surgery, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
- Radiation Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Alberto Buffoli
- Radiation Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Veronica Girardi
- Breast Radiology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Nella Ruzzenenti
- Breast Pathology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | | | | | - Fabio Veglia
- Department of Psychology, University of Turin, Turin, Italy
| | - Giulia Di Fini
- Department of Psychology, University of Turin, Turin, Italy.
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Heyn LG, Løkkeberg ST, Ellington L, van Dulmen S, Eide H. Understanding the role of positive emotions in healthcare communication - A realist review. Nurs Open 2023; 10:3447-3459. [PMID: 36611271 PMCID: PMC10170929 DOI: 10.1002/nop2.1604] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 10/18/2022] [Accepted: 12/23/2022] [Indexed: 01/09/2023] Open
Abstract
AIM To explore how the expression of positive emotions during the interaction between patients and providers can cultivate the patient-provider relationship. DESIGN We conducted a realist review guided by the Realist and Meta-narrative Evidence Syntheses: Evolving Standards. METHODS We systematically searched CINAHL, MEDLINE, PsychINFO and Scopus from inception to March 2019. Study selection and data extraction were performed blinded in pairs. From 3146 abstracts blinded in pairs, 15 papers were included and analysed. From each included paper, we extracted contexts, mechanisms and outcomes that were relevant to answer our research questions, creating a configuration between these elements (CMO configuration). RESULTS Our findings suggest that in the contexts of person orientation and positive outlook, patient-provider relationships improve by communication conveying and eliciting positive emotions. We found six underlying mechanisms for this that form either direct or indirect pathways between the context and the outcome.
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Affiliation(s)
- Lena Günterberg Heyn
- Center for Health and Technology, University of South-Eastern Norway, Drammen, Norway
| | - Stine Torp Løkkeberg
- Faculty of Health and Welfare Studies, Østfold University College, Halden, Norway
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Sandra van Dulmen
- Nivel (Netherlands Institute for Health Services Research), Utrecht, Netherlands.,Department of Primary and Community Care, Radboud University Medicalcenter, Radboud Institute for Health Sciences, Nijmegen, Netherlands.,Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Hilde Eide
- Center for Health and Technology, University of South-Eastern Norway, Drammen, Norway
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Fordham B, Smith TO, Lamb S, Morris A, Winter SC. Patient and physiotherapist perceptions of the Getting Recovery Right After Neck Dissection (GRRAND) rehabilitation intervention: a qualitative interview study embedded within a feasibility trial. BMJ Open 2022; 12:e064269. [PMID: 36375975 PMCID: PMC9664296 DOI: 10.1136/bmjopen-2022-064269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The Getting Recovery Right After Neck Dissection (GRRAND) intervention is a physiotherapy programme for patients with head and neck cancer who have undergone neck dissection. The aim of this qualitative study was to understand if the intervention was useful, acceptable and whether it was feasible to conduct a randomised controlled trial (RCT). DESIGN This qualitative study was embedded within the GRRAND-Feasibility (GRRAND-F) Study. SETTING Participants were recruited from four acute National Health Service hospitals in England between 2020 and 2021. PARTICIPANTS We interviewed four usual care and four intervention patient-participants from a single study site (Oxford). Six were male, two were female. All were white British ethnicity. We interviewed two physiotherapists from Oxford who delivered the GRRAND-F intervention, and physiotherapists from Birmingham, Poole and Norwich who were trained to deliver the intervention but were not able to deliver it within the study time frame. RESULTS The analysis identified five themes: (1) Acceptability, (2) Adherence, (3) Outcomes, (4) Feasibility and (5) Stand-alone themes (prehabilitation, video consultations, healthcare use).Patient-participants and physiotherapist-participants agreed that usual care was not meeting patients' rehabilitation needs. The GRRAND intervention provided biopsychosocial support. In comparison to the usual care group, patient-participants who received the intervention were more confident that they could perform rehabilitation exercises and were more motivated to engage in long-term adaptive behaviour change. Physiotherapists felt they needed more administrative support to participate in an RCT. CONCLUSION Participants felt that usual care was insufficient. GRRAND provided much needed, biopsychosocial support to patients. Participants were supportive that it would be feasible to test GRRAND in an RCT. TRIAL REGISTRATION NUMBER ISRCTN11979997.
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Affiliation(s)
- Beth Fordham
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Toby O Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Sarah Lamb
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Alana Morris
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Stuart C Winter
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Petersson Å, Hellström A, Assarsson J, Schildmeijer K. Following a standardised pathway: Healthcare professionals' perspectives on person-centred care within ERAS for patients with colorectal cancer. J Clin Nurs 2022. [PMID: 36262024 DOI: 10.1111/jocn.16562] [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: 06/27/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe healthcare professionals' perceptions of person-centred care for patients with colorectal cancer, within the standardised care concept of Enhanced Recovery After Surgery. BACKGROUND International guidelines for colorectal surgery describe standardised perioperative care. Combining standardised care with person-centred care could be accomplished using the person-centred nursing framework for establishing and maintaining relationships with patients. Despite strong evidence for the standardised care concepts' medical benefits, studies concerning the practice of person-centred care from a nursing point of view are sparse. DESIGN A qualitative descriptive design was used. METHODS Four focus groups interviews were performed including 22 healthcare professionals with 1-29 years' experience of caring for patients with colorectal cancer. Data were analysed using qualitative conventional content analysis. The COREQ checklist for reporting qualitative research was used. RESULTS Three themes emerged in the analysis; Framework in the healthcare system, Facing differences in participation and Interacting with the person beyond the illness. Conditions for person-centred care were related to the interactions between patients and healthcare professionals, the structure of care were also considered relevant. CONCLUSION There is a discrepancy between what is considered important to do and what is done in clinical practice to create conditions for patient participation. Interacting with patients and creating an interprofessional environment are important conditions, the structure of care is also a fundamental key to promoting person-centred care. There is a need for further improvement in care of patients with colorectal cancer to achieve person-centredness within standardised care. RELEVANCE TO CLINICAL PRACTICE The findings provide valuable insights into what healthcare professionals consider to be important for achieving person-centred care. This knowledge can be useful in clinical practice and education programs. PATIENT OR PUBLIC CONTRIBUTION At the outset of the study, three patients were interviewed aimed at improving the conditions for the healthcare professionals' focus groups.
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Affiliation(s)
- Åsa Petersson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Amanda Hellström
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
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Collet R, Major M, van Egmond M, van der Leeden M, Maccow R, Eskes A, Stuiver M. Experiences of interaction between people with cancer and their healthcare professionals: A systematic review and meta-synthesis of qualitative studies. Eur J Oncol Nurs 2022; 60:102198. [DOI: 10.1016/j.ejon.2022.102198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/16/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
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Experiences of People with Cancer from Rural and Remote Areas of Western Australia Using Supported Accommodation in Perth While Undergoing Treatment. Curr Oncol 2022; 29:1190-1200. [PMID: 35200600 PMCID: PMC8871240 DOI: 10.3390/curroncol29020101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 02/08/2023] Open
Abstract
The aim of the study was to explore the lived experiences of people diagnosed with cancer from rural and remote areas of Western Australia, who utilise supported accommodation services whilst undergoing treatment in the capital city (Perth). Methods A qualitative phenomenological approach was used in this study. Ten participants were recruited using purposive sampling, who were aged between 35–65 years, were diagnosed with cancer within the previous three months and used accommodation services within the past 12 months. Semi-structured in-depth interviews were conducted with a duration of approximately 45–60 min via Zoom, FaceTime or phone call. Interview data was transcribed, thematically analysed and coded into relevant themes. Results: Three overarching themes were derived from the interviews–“It’s harder to have cancer when you have to relocate for treatment,” “The paradoxical experience of staying at the accommodation,” and “Feeling grateful for the support offered’. Conclusions: People diagnosed with cancer who have to relocate during treatment require emotional, logistical, and social supports. Cancer accommodation services are essential in enabling individuals to continue engaging in meaningful occupations and maintain their quality of life. Our study highlights the need for cancer accommodation services to consider the complex needs of individuals completing treatment for cancer in locations away from their usual homes.
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Wang W, Li H, Li Y, Fang S, Zhang S, Zhang X, Meng X, Su J, Sun J. Colorectal cancer survivors' experience of continuity of care provided by different health professionals: A qualitative evidence synthesis. J Clin Nurs 2022; 31:2985-2999. [PMID: 34985169 DOI: 10.1111/jocn.16189] [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: 07/03/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 12/09/2022]
Abstract
AIMS AND OBJECTIVES To systematically identify, synthesise and characterise the available qualitative evidence on the experience of adult colorectal cancer survivors with continuity of care led by different health professionals. BACKGROUND The limited evidence base for effective continuity of care led by different medical staff who assist colorectal cancer survivors with their unique survivorship care hampers the development of effective interventions. Synthesising the data on survivors' experience of care led by different health professionals is critical to develop such interventions. DESIGN A qualitative evidence synthesis using the Thomas and Harden method and the PRISMA 2020 checklist provided by the EQUATOR network were used. METHODS PubMed, Web of Science, Embase, Cochrane, CINAHL and PsycINFO were searched through November 2020 for qualitative and mixed methods studies in English. JBI-QARI was used to undertake a quality review of the identified studies. The review findings were synthesised by a team of researchers, and the level of confidence was evaluated using GRADE-CERQual. RESULTS Eleven studies met the criteria for inclusion in the review. The identified analytical themes included experience of diversity, preference for health professionals and space for enhancement to facilitate improved medical care delivery. Colorectal cancer survivors report diverse experiences regarding continuity of care led by different providers. Specifically, they attach substantial importance to trusted relationships with providers that are closely associated with their overall care experience. CONCLUSION Effective communication and good rapport among stakeholders are cornerstones for addressing the complexity of ongoing care. Future interventions should include adjusting the percentage of care from different providers to deliver cost-effective and personalised continuity of care. RELEVANCE TO CLINICAL PRACTICE Synthesising data on survivors' experience facilitates the development of practical approaches to increase the quality of continuity of care and may also foster the integration of providers' advantages to enable more cost-effective intervention. The limited capacity of primary care providers may be enhanced by better cooperation and communication with specialists and by additional professional cancer-related training.
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Affiliation(s)
- Wenxia Wang
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Huanhuan Li
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Yijing Li
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Shuyan Fang
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Shuang Zhang
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Xu Zhang
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Xiangfei Meng
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Jianping Su
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Jiao Sun
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
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11
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Grilo AM, Santos B, Baptista I, Monsanto F. Exploring the cancer patients' experiences during external radiotherapy: A systematic review and thematic synthesis of qualitative and quantitative evidence. Eur J Oncol Nurs 2021; 52:101965. [PMID: 34023669 DOI: 10.1016/j.ejon.2021.101965] [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: 11/22/2020] [Revised: 03/28/2021] [Accepted: 04/14/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the subjective experience of adult cancer patients undergoing external radiotherapy and provide evidence for better practices in radiotherapy services. METHODS A systematic review was performed according to the PRISMA Statement Guidelines. Qualitative and mixed studies were identified through five electronic databases (CINAHL, PsychINFO, Medline, Scopus and Web of Science), between March and April 2020, using defined criteria. Methodological quality assessment was conducted, and the data integrated into a thematic synthesis. RESULTS Of the 886 studies identified, 13 met our inclusion criteria. Patients experiences were described into four main themes: (1) Time, (2) Physical Environment, (3) Treatment Concerns and (4) Radiotherapy Team. Time refers to waiting time and treatment time; Physical Environment states temperature in the treatment room and equipment; Treatment Concerns included side effects, daily activities, positioning and immobilization and treatment preparation (e.g., bladder filling); radiotherapy team comprised patients support; response to patients needs and recognized team. The generating analytical phase of thematic analysis allowed us to recognize that the effectiveness of the radiotherapy team operates as a facilitator of the patients' experience. In contrast, time in the waiting room, the treatment preparation when is required, and the positioning and immobilization, specifically for the neck and head patients, act as barriers. CONCLUSION Four distinct themes were identified to be positively and negatively associated with patients' experience during external radiotherapy. The evidence provides valuable recommendations to improved radiotherapy services organization, as well as to the delivery of more patient-centred care adjusted to the concerns and needs of patients.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal; CICPsi - Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Portugal.
| | - Bárbara Santos
- Medical Imaging and RT Degree, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
| | - Inês Baptista
- Medical Imaging and RT Degree, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
| | - Fátima Monsanto
- H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
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Reiter M, Gerken M, Lindberg-Scharf P, Fuerst A, Liebig-Hörl G, Ortmann O, Eberl I, Bartholomeyczik S. Health services research in colorectal cancer: a quasi-experimental interventional pilot study on in- and outpatient oncology. J Cancer Res Clin Oncol 2020; 147:1789-1802. [PMID: 33373026 PMCID: PMC8076149 DOI: 10.1007/s00432-020-03454-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 11/05/2020] [Indexed: 12/02/2022]
Abstract
Introduction Due to frequent treatment side effects and weight loss, colorectal cancer patients require oncologic care and nutritional counseling both during and after hospitalization. The current study evaluated differences in discharge and side effects management and nutritional behavior between colorectal cancer patients of a control group without systematic counseling and of an intervention group with access to structured in- and outpatient oncology nurse and nutritional counseling. Methods The presented explorative, quantitative, single-center, interventional pilot study is a health services research project with a quasi-experimental design. Using a self-designed standardized questionnaire, data were collected from the control group (n = 75) before and from the intervention group (n = 114) after the introduction of in- and outpatient oncology nurse and structured systematic nutritional counseling. The in- and outpatient counseling services were developed and evaluated in the form of a structured nurse-led counseling concept. Results Intervention group patients profited significantly from inpatient oncology nurse counseling in seven different areas of discharge management. No differences were observed concerning patient-reported general and gastrointestinal side effects except for xerostomia and dysphagia, but of the patients participating in both in- and outpatient oncology nurse counseling, 90.0% were better able to cope with general side effects of treatment. Patients with in- and outpatient structured systematic nutritional counseling more frequently received nutritional information (p = 0.001), were better at gauging food intolerances (p = 0.023), and followed the dietician's advice in cases of gastrointestinal side effects significantly more often (p = 0.003) than control patients. Counselor-reported outcomes concerning gastrointestinal side effects showed improvement in most of the patients taking part in systematic in- and outpatient nutritional counseling, except for weight loss in 4 patients. Conclusion In- and outpatient counseling in discharge and side effects management and nutrition improve the outcomes of colorectal cancer patients. Outpatient counseling should be further developed and evaluated in future studies.
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Affiliation(s)
- Margarete Reiter
- Diplom-Kauffrau, Faculty of Health, School of Nursing Science, PhD Student at the Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany. .,Caritas-Hospital Sankt Josef, Landshuter Straße 65, 93053, Regensburg, Germany.
| | - Michael Gerken
- Tumor Center Regensburg-Institute of Quality Management and Health Services Research of the University of Regensburg, Coordination, Epidemiology, Am Biopark 9, 93053, Regensburg, Germany
| | - Patricia Lindberg-Scharf
- Tumor Center Regensburg-Institute of Quality Management and Health Services Research of the University of Regensburg, Section Quality of Life, Am Biopark 9, 93053, Regensburg, Germany
| | - Alois Fuerst
- Director of the Department of General and Visceral Surgery, Caritas-Hospital Sankt Josef, Landshuter Straße 65, 93053, Regensburg, Germany
| | - Gudrun Liebig-Hörl
- Medical Coordinator of Colon Cancer Center, Caritas-Hospital Sankt Josef, Landshuter Straße 65, 93053, Regensburg, Germany
| | - Olaf Ortmann
- Director of the Department of Gynecology and Obstetrics, University Medical Center Regensburg, Caritas-Hospital Sankt Josef, Landshuter Straße 65, 93053, Regensburg, Germany
| | - Ingeborg Eberl
- Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Kapuzinergasse 2, 85072, Eichstätt, Germany
| | - Sabine Bartholomeyczik
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany
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Abstract
The purpose was to review the perspectives of cancer survivors about what they perceive constitutes positive cancer experiences. A national survey was conducted in collaboration with 10 Canadian provinces to identify experiences and unmet needs for cancer survivors between 1 and 3 years of posttreatment. The survey included open-ended questions designed to allow the respondents to add topics and details of importance. This publication presents the analysis of quantitative data and open-ended questions regarding cancer survivors' perspectives about positive experiences and gaps in care during their cancer journey. Of the 13 534 unique adult survey respondents, 7794 (57.6%) responded to the positive experiences question and 6434 (47.5%) to the question about gaps in care. Elements of positive experiences included the compassionate health care workers, maintaining a positive outlook and the support of family and friends. Gaps in care included a lack of access to services, information, and support. Respondents were able to identify positive aspects of their cancer experiences and where improvements were needed. These findings assist in determining how health care professionals can address the needs of cancer patients based on what survivors have identified as helpful.
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Affiliation(s)
- Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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14
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Widberg C, Wiklund B, Klarare A. Patients' experiences of eHealth in palliative care: an integrative review. BMC Palliat Care 2020; 19:158. [PMID: 33054746 PMCID: PMC7560207 DOI: 10.1186/s12904-020-00667-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022] Open
Abstract
Background With a growing world population, a longer life expectancy, and more deaths due to chronic diseases, the need for palliative care is increasing. Palliative care aims to alleviate suffering and to promote well-being for patients with progressive, incurable disease or injury. E-Health entails using of information and communication technology for healthcare provision. It is unclear to how patients experience use of eHealth technology within palliative care. Methods The aim of this study was to describe patients’ experiences of eHealth in palliative care. A systematic integrative review was performed using six databases: Cinahl Complete; MEDLINE; PubMed; Psychology and Behavioral Sciences Collection; Nursing and Allied Health; and PsycINFO. Twelve studies met the inclusion criteria of adult patients in palliative care, English language, published 2014–2019: comprising 397 patients. Six studies were from European countries, four from North America, one from South America and one from Oceania. Seven were feasibility or pilot studies. Results The findings are synthesized in the main theme: E-health applications – promoting communication on patients’ and families’ terms, and three sub- themes: usability and feasibility of eHealth applications; symptom control and individualized care; and use of eHealth applications increased sense of security and patient safety. Patients’ experiences were that eHealth promoted individualized care, sense of security, better symptom management and participation in care. Communication was facilitated by the inherent flexibility provided by technology. Conclusions E-Health applications seem promising in promoting equal, individualized care, and may be a tool to endorse accessibility and patient participation in palliative care settings. Indications are that eHealth communication resulted in patients and families receiving more information, which contributed to experiences of patient safety and feelings of security. At organizational and societal levels, eHealth may contribute to sustainable development and more efficient use of resources.
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Affiliation(s)
- Cecilia Widberg
- Stockholm Sjukhem Foundation, Department of Palliative Care, Stockholm, Sweden
| | - Birgitta Wiklund
- Stockholm Sjukhem Foundation, Department of Palliative Care, Stockholm, Sweden
| | - Anna Klarare
- Department of Health Care Sciences, Palliative Care Research Centre, Ersta Sköndal Bräcke University College, Box 11189, SE-100 61, Stockholm, Sweden. .,Department of Women's and Children's Health, Clinical Psychology in Healthcare, Uppsala university, Uppsala, Sweden.
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15
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Husebø AML, Karlsen B, Husebø SE. Health professionals' perceptions of colorectal cancer patients' treatment burden and their supportive work to ameliorate the burden - a qualitative study. BMC Health Serv Res 2020; 20:661. [PMID: 32680491 PMCID: PMC7367378 DOI: 10.1186/s12913-020-05520-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 07/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Support is pivotal for patients in managing colorectal cancer treatment, as they might be overwhelmed by the burden of treatment. There is scarce knowledge regarding health professionals' perceptions of colorectal cancer patients' burdens and supportive needs. The study aims to describe health professionals' perspectives on treatment burden among patients receiving curative surgical treatment for colorectal cancer during the hospital stay and how they support patients to ameliorate the burden. METHODS This study has a descriptive and explorative qualitative design, using semi-structured interviews with nine health professionals recruited from a gastrointestinal-surgery ward at a university hospital in Norway. Data were analysed by using systematic text condensation. RESULTS Data analysis identified the themes "capturing patients' burdens of colorectal cancer treatment" and "health professionals' support to ameliorate the burden". Patients with colorectal cancer had to face burdens related to a challenging emotional situation, treatment complications and side effects, and an extensive need for information. A trusting patient-carer relationship was therefore perceived as the essence of health professionals' support. Health professionals focused their support on safeguarding patients, motivating patients to self-manage, and involving family and peers as supporters. Patients' journey characteristics and illness severity challenged health professionals' supportive work. CONCLUSION Support from health professionals includes providing patients emotional support and relevant treatment-related information and motivating patients for early post-surgical mobilisation. Health professionals should be aware of identifying colorectal cancer patients' information needs according to the specific treatment stages, which may ameliorate the burden of colorectal cancer treatment and enable patients to self-manage.
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Affiliation(s)
- Anne Marie Lunde Husebø
- Department of Gastrointestinal Surgery, Stavanger University Hospital, N-4019, Stavanger, Norway.
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway.
| | - Bjørg Karlsen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
| | - Sissel Eikeland Husebø
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
- Department of Surgery, Stavanger University Hospital, N-4011, Stavanger, Norway
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16
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Patient and carer experience of nutrition care throughout treatment for head and neck cancer: a systematic qualitative review and thematic synthesis. Support Care Cancer 2020; 28:5633-5647. [PMID: 32642952 DOI: 10.1007/s00520-020-05576-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023]
Abstract
Nutrition care plays a critical role in the provision of best practice care to head and neck cancer (HNC) patients, with carers playing an important role in supporting patients to maintain nutrition intake. This qualitative systematic review investigated patient and carer experience of nutrition care throughout and beyond HNC treatment. Five databases were systematically searched for qualitative studies reporting on patient and carer experience of nutrition care throughout HNC. Twenty-five studies including 435 patients and 46 carers were identified, revealing three themes: information and support in the healthcare setting, enteral feeding challenges and management, and life outside hospital. Findings highlight the importance of providing individualised person-centred nutrition care to patients with HNC and their carers. Further qualitative research is needed to inform healthcare professionals about the needs of patients and carers to provide appropriate support throughout the treatment trajectory across and between different treatment modalities.
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17
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Andersen LF, Wessel I, Gotfredsen K, Øzhayat EB. Patients' and health professionals' experience of the Danish fast track treatment pathway for head and neck cancer patients receiving oral rehabilitation. Acta Odontol Scand 2020; 78:362-369. [PMID: 32070179 DOI: 10.1080/00016357.2020.1728377] [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: 10/25/2022]
Abstract
Objective: This study aims to investigate the responsiveness of the Danish treatment pathway for head-and-neck-cancer (HNC) patients receiving oral rehabilitation.Material and Methods: Eighteen HNC-patients who had received oral rehabilitation as well as five medical and four oral health care professionals involved in the treatment of HNC-patients filled in a questionnaire on responsiveness. The responsiveness was further described in individual interviews in the HNC-patients and focus group interviews in the health care professionals. All interviews were semi-structured and analysed using the grounded theory.Results: Patients and health care professionals overall reported good responsiveness of the pathway. Prompt attention was in both groups considered the most important aspect, although the patients found it difficult to cope mentally with the fast-track and the health care professionals reported insufficiencies giving prompt attention. The patients in general described a good relationship with their health care professionals, but along with the health care professionals also reported some problems regarding communication. Further, the health care professionals reported a gap between medical treatment and oral rehabilitation.Conclusions: The Danish treatment pathway for HNC-patients was, in general, evaluated positively. Communication and relationship between patient and health care professional can affect the responsiveness of the pathway.
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Affiliation(s)
- Lærke Fromm Andersen
- Section of Oral Rehabilitation, Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Esben Boeskov Øzhayat
- Section of Oral Rehabilitation, Department of Odontology, University of Copenhagen, Copenhagen, Denmark
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18
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Bennardi M, Diviani N, Gamondi C, Stüssi G, Saletti P, Cinesi I, Rubinelli S. Palliative care utilization in oncology and hemato-oncology: a systematic review of cognitive barriers and facilitators from the perspective of healthcare professionals, adult patients, and their families. BMC Palliat Care 2020; 19:47. [PMID: 32284064 PMCID: PMC7155286 DOI: 10.1186/s12904-020-00556-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/25/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite the high potential to improve the quality of life of patients and families, palliative care services face significant obstacles to their use. In countries with high-resource health systems, the nonfinancial and nonstructural obstacles to palliative care services are particularly prominent. These are the cognitive barriers -knowledge and communication barriers- to the use of palliative care. To date no systematic review has given the deserved attention to the cognitive barriers and facilitators to palliative care services utilization. This study aims to synthesize knowledge on cognitive barriers and facilitators to palliative care use in oncology and hemato-oncology from the experiences of health professionals, patients, and their families. METHODS A systematic review was conducted. PubMed, PsycINFO, International Association for Hospice and Palliative Care/Cumulative Index of Nursing and Allied Health Literature (IAHPC/CINAHL), and Communication & Mass Media Complete (CMMC) were systematically searched for the main core concepts: palliative care, barriers, facilitators, perspectives, points of view, and related terms and synonyms. After screening of titles, abstracts, and full-texts, 52 studies were included in the qualitative thematic analysis. RESULTS Four themes were identified: awareness of palliative care, collaboration and communication in palliative care-related settings, attitudes and beliefs towards palliative care, and emotions involved in disease pathways. The results showed that cognitive barriers and facilitators are involved in the educational, social, emotional, and cultural dimensions of palliative care provision and utilization. In particular, these barriers and facilitators exist both at the healthcare professional level (e.g. a barrier is lack of understanding of palliative care applicability, and a facilitator is strategic visibility of the palliative care team in patient floors and hospital-wide events) and at the patient and families level (e.g. a barrier is having misconceptions about palliative care, and a facilitator is patients' openness to their own needs). CONCLUSIONS To optimize palliative care services utilization, awareness of palliative care, and healthcare professionals' communication and emotion management skills should be enhanced. Additionally, a cultural shift, concerning attitudes and beliefs towards palliative care, should be encouraged.
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Affiliation(s)
- Marco Bennardi
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication; University of Lucerne, Department of Health Sciences and Medicine, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.
| | - Nicola Diviani
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication; University of Lucerne, Department of Health Sciences and Medicine, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland
| | - Claudia Gamondi
- Oncology Institute of Southern Switzerland, Palliative Care, Ospedale San Giovanni, 6500, Bellinzona, Switzerland
| | - Georg Stüssi
- Oncology Institute of Southern Switzerland, Hematology, Ospedale San Giovanni, 6500, Bellinzona, Switzerland
| | - Piercarlo Saletti
- Oncology Institute of Southern Switzerland, Medical Oncology, Ospedale Regionale Lugano, 6962, Viganello, Switzerland
| | - Ivan Cinesi
- Palliative TI - Associazione Cure Palliative Ticino, Via San Leonardo, 6599, Cadenazzo, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication; University of Lucerne, Department of Health Sciences and Medicine, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland
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19
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Luo D, Eicher M, White K. Individual resilience in adult cancer care: A concept analysis. Int J Nurs Stud 2020; 102:103467. [DOI: 10.1016/j.ijnurstu.2019.103467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 02/07/2023]
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20
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Klarare A, Rasmussen BH, Fossum B, Hansson J, Fürst CJ, Lundh Hagelin C. Actions helping expressed or anticipated needs: Patients with advanced cancer and their family caregivers' experiences of specialist palliative home care teams. Eur J Cancer Care (Engl) 2018; 27:e12948. [PMID: 30298967 DOI: 10.1111/ecc.12948] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 08/18/2018] [Accepted: 09/07/2018] [Indexed: 11/27/2022]
Abstract
Patients with advanced cancer and family caregivers in palliative care face physical, psychological, social and existential challenges, much of the time home alone. Specialist palliative home care team services can be instrumental for sense of security in an uncertain situation. The aim of this study was to describe patients' and family caregivers' experiences of specialist palliative home care team actions that are identified by the participants as helping or hindering interventions. Six patients and seven family caregivers were interviewed using the enhanced critical incident technique. Ninety-five critical incidents and wish list items were identified. Providing adequate resources, keeping promises and being reliable, and creating partnerships are actions by specialist palliative care teams that patients and family caregivers experienced as helping in meeting expressed or anticipated needs in patients and family caregivers. Being reliable and including patients and family caregivers in partnerships help to continue with daily life, even though death may be close. Unmet needs resulted in experiences of disrespect or violation of personal space/integrity.
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Affiliation(s)
- Anna Klarare
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Birgit H Rasmussen
- The Institute for Palliative Care, Region Skane, Lund University, Lund, Sweden.,Department of Health Care Sciences, Lund University, Lund, Sweden
| | - Bjöörn Fossum
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden.,Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - Johan Hansson
- Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden
| | - Carl Johan Fürst
- Department of Clinical Sciences and Oncology, Faculty of Medicine, The Institute for Palliative Care, Lund University, Lund, Sweden
| | - Carina Lundh Hagelin
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Department of Neurobiology, Care Science and Society, KarolinskaInstitutet, Stockholm, Sweden
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