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Giuseppe P, Francesco Pio B, Eros S, Emilio S, Koosha MS, Pierluigi R, Filippo G, Battista FG, Francesco R, Marco C, Angelo T, Nazario F, Marco R. The mental and emotional status after radical cystectomy and different urinary diversion orthotopic bladder substitution versus external urinary diversion after radical cystectomy: A propensity score-matched study. Int J Urol 2024. [PMID: 39316514 DOI: 10.1111/iju.15586] [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: 05/20/2024] [Accepted: 09/09/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVES The quality of life in patients undergoing radical cystectomy and urinary diversion is gaining importance. Nowadays a broad consensus about the best urinary diversion does not exist. This study presents an all-round analysis of the impact of two types of urinary diversion on life's psycho-social aspects in patients undergoing radical cystectomy. METHODS This is an observational, single-centre, prospective study. Eligible participants underwent radical cystectomy and urinary diversion for bladder cancer in our department from January 2020 and February 2024. Of 130 included patients, 90 (45 with Bricker's ureteroileocutaneostomy and 45 received orthotopic bladder replacement) patients were matched and the study groups were well balanced for the baseline-matched variables. Patients completed 4 questionnaires (EORTC QLQ-C30, PGWBI, HADS, PSQI) at three different times: before the surgical procedure, and at 3 and 12 months. RESULTS Time shows a statistically significant effect (p < 0.0005) on four of the five functional scales explored (Physical Functioning, Role Functioning, Emotional Functioning, Social Functioning), and for all the nine symptoms/items' scales (p < 0.0005) and the Global Health Status (p = 0.003) in EORTC QLQ-C30. Neobladder's group shows a statistically significant improvement on the scales of Physical Functioning, Role Functioning, and Social Functioning, and for symptoms of nausea (p = 0.0027), pain (p = 0.0005), dyspnea (p = 0.012), insomnia (p = 0.004), constipation (p = 0.003). CONCLUSION We do not find a better urinary diversion in absolute terms. Neobladder obtained better results only for specific items and features. The urinary diversion's choice must be made in concert by the patient, the caregiver, and health professionals with adequate counseling.
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Affiliation(s)
- Palermo Giuseppe
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Bizzarri Francesco Pio
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
- Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Scarciglia Eros
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Sacco Emilio
- Catholic University of Sacred Heart, Rome, Italy
- Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
- Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Moosavi Seyed Koosha
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Russo Pierluigi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Gavi Filippo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Filomena Giovanni Battista
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Rossi Francesco
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
- Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Campetella Marco
- Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Totaro Angelo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Foschi Nazario
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Racioppi Marco
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
- Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
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Zhang T, Qi X. Caregiver Burden in Bladder Cancer Patients with Urinary Diversion Post-Radical Cystectomy and the Need for Comprehensive Nursing Education: A Narrative Literature. J Multidiscip Healthc 2024; 17:3825-3834. [PMID: 39131743 PMCID: PMC11317044 DOI: 10.2147/jmdh.s476029] [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: 04/29/2024] [Accepted: 06/27/2024] [Indexed: 08/13/2024] Open
Abstract
Background Bladder cancer ranks seventh in global cancer prevalence. Radical cystectomy and urinary diversion are standard for muscle-invasive bladder cancer. Family caregivers shoulder a substantial care burden, affecting their own quality of life, with repercussions extending to patients' health-related quality of life (HRQOL). Objective This narrative review aims to highlight the major concerns perceived by the caregivers and efficacy of nurse-led interventions in alleviating their concerns and improving HRQOL. Methods A systematic search of the PubMed, CINAHL, and Science Direct databases was carried out to identify studies published in the last 5 years (from Jan 2018 to Aug 2023) that have evaluated the concerns and problems of caregivers attending bladder cancer patients with urinary diversion. Additionally, studies evaluating the efficacy of nurse-led interventions in alleviating these concerns were also searched. Results Overall, 6 studies involving 933 BC patients with UD and 1042 caregivers were identified as suitable for inclusion in this narrative literature review. Major concerns identified included psychological well-being, medical assistance needs, and peer support. Significant psychological impact was evident in the caregivers which operated in a dyadic manner. Nurse-led stoma education programs have demonstrated potential in enhancing caregivers' quality of life, although they remain restricted. Conclusion Emphasizing caregivers' role and program effectiveness is critical. Our review addresses these gaps, focusing on caregivers' concerns and the impact of nursing education for improved patient outcomes. Implications for Practice Holistic and collaborative approach could enhance the overall well-being and quality of life of bladder cancer patients and their caregivers.
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Affiliation(s)
- Tian Zhang
- The First Internal Medicine Comprehensive Ward, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China
| | - Xiangxiu Qi
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China
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Thederan I, Zyriax BC, Heinzer H. [Role of nutrition in urological prehabilitation]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:1017-1024. [PMID: 37704860 DOI: 10.1007/s00120-023-02192-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/15/2023]
Abstract
Nutritional intervention plays an important role in prehabilitation, a multimodal concept designed to improve the physical condition of the patient prior to treatment in order to influence the outcome of surgery. The focus is on reducing the postoperative complication rate, while simultaneously shortening the hospital stay and the rehabilitation phase. The nutritional status should be optimized through individual counseling and the targeted intake of calories, protein, and nutritional supplements. A good nutritional status contributes to the strengthening of the immune system and improves wound healing. Especially after surgery, muscle mass declines rapidly. Adequate protein intake accompanying strength exercises can best preserve muscle and promote development of muscular fitness during prehabilitation. Despite the positive effects of nutritional interventions, prehabilitation programs with nutritional components in uro-oncology are rare and the evidence of the programs is therefore insufficient. Results from initial studies appear promising, but further prospective, randomized studies of high quality and with defined program content on the various types of cancer are needed.
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Affiliation(s)
- Imke Thederan
- Martini-Klinik am UKE GmbH, Martinistr. 52, 20246, Hamburg, Deutschland.
| | | | - Hans Heinzer
- Martini-Klinik am UKE GmbH, Martinistr. 52, 20246, Hamburg, Deutschland
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Koelker M, Alkhatib K, Briggs L, Labban M, Meyer CP, Dieli-Conwright CM, Kang DW, Steele G, Preston MA, Clinton TN, Chang SL, Kibel AS, Trinh QD, Mossanen M. Impact of exercise on physical health status in bladder cancer patients. Can Urol Assoc J 2023; 17:E8-E14. [PMID: 36121887 PMCID: PMC9872822 DOI: 10.5489/cuaj.8008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION There is a scarcity of data on the impact of behavioral habits, such as exercise, on physical health in patients with bladder cancer. We investigated the association of exercise on self-reported physical health status and examined the prevalence of bladder cancer patients with sedentary lifestyle. METHODS We examined cross-sectional data of participants diagnosed with bladder cancer within the Behavioral Risk Factor Surveillance System (BRFSS) from 2016-2020. Patient health status was surveyed using self-reported measures, such as the total days per month when their "physical health is not good." The primary outcome was patient-reported poor physical health for more than 14 days within a one-month period. RESULTS Out of 2 193 981 survey participants, we identified 936 with a history of bladder cancer. Nearly one in three bladder cancer patients reported being sedentary within the last month, as a total of 307 (32.8%) patients reported no exercise within the last 30 days. The remaining 628 (67.2%) reported exercising for at least one day within the last month. In multivariable logistic regression model analysis, we found that exercise is protective for self-reported poor physical health status (odds ratio 0.37, 95% confidence interval 0.25-0.56, p<0.001). Patients that exercised were less likely to report bad physical health. CONCLUSIONS Approximately one in three bladder cancer patients report no exercise within 30 days, suggesting a sedentary lifestyle. Patients that are active are less likely to self-report poor physical health status. Implementation of exercise programs for bladder cancer patients could be promising in improving health status.
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Affiliation(s)
- Mara Koelker
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Khalid Alkhatib
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Logan Briggs
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Muhieddine Labban
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Christian P. Meyer
- Department of Urology, Ruhr University Bochum, Klinikum Herford, Herford, Germany
| | - Christina M. Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Graeme Steele
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Mark A. Preston
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Timothy N. Clinton
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Steve L. Chang
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Adam S. Kibel
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Quoc-Dien Trinh
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
| | - Matthew Mossanen
- Brigham and Women’s Hospital, Division of Urological Surgery and Center of Surgery and Public Health, Boston, MA, United States
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Wulff-Burchfield E. Supportive and Palliative Care for Genitourinary Malignancies. Urol Oncol 2022. [DOI: 10.1007/978-3-030-89891-5_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rammant E, Fonteyne V, Van Goethem V, Verhaeghe S, Raes A, Van Hemelrijck M, Mohamed NE, Decaestecker K, Van Hecke A. Supportive Roles of the Health Care Team Throughout the Illness Trajectory of Bladder Cancer Patients Undergoing Radical Cystectomy: A Qualitative Study Exploring the Patients' Perspectives. Semin Oncol Nurs 2021; 37:151226. [PMID: 34758914 DOI: 10.1016/j.soncn.2021.151226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/15/2021] [Accepted: 09/27/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To explore patient perspectives of muscle-invasive bladder cancer (MIBC) on how the health care team and their social network can support them during their cancer trajectory. DATA SOURCES Sixteen semi-structured interviews were conducted with MIBC survivors who underwent radical cystectomies at Ghent University Hospital. The interviews were audiotaped, transcribed verbatim, and analyzed with an iterative content analysis approach. CONCLUSION Information to support people affected by bladder cancer (BC) in several aspects of their disease trajectory (eg, shared decision-making and self-management of their urinary diversion) was most important throughout the interviews (although type and source of required information varied). The clinical nurse specialist was important for informational and emotional support because receiving sufficient information might help patients reduce emotional stress. People affected by BC are still reluctant to consult a psychologist, and several barriers were indicated for this. Also physical needs in the early postoperative phase could be reduced with appropriate information. Communication skills of clinicians in the hospital and knowledge of general practitioners about the important aspects of BC care are also important aspects that should be further optimized. Furthermore, peer support groups and family members can offer important support throughout the BC pathway. IMPLICATIONS FOR NURSING PRACTICE This study provides an overview of how people affected by BC want to be supported by their health care team and their social network. This overview can serve as a basis to develop educational interventions for both patients and health care professionals to guide restructuring of BC pathways and can also be used to develop future intervention studies to improve BC outcomes.
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Affiliation(s)
- Elke Rammant
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Vincent Van Goethem
- Department of Public Health and Primary Care, End of Life Care Research Group, Ghent University, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium; Staff Member Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Anneleen Raes
- The Cancer Centre, Ghent University Hospital, Ghent, Belgium
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Studies, Translational Oncology and Urology Research (TOUR), King's College London, London, UK
| | - Nihal E Mohamed
- Department of Urology and Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff Member Nursing Department, Ghent University Hospital, Ghent, Belgium
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Wulff-Burchfield EM, Potts M, Glavin K, Mirza M. A qualitative evaluation of a nurse-led pre-operative stoma education program for bladder cancer patients. Support Care Cancer 2021; 29:5711-5719. [PMID: 33661368 PMCID: PMC7930519 DOI: 10.1007/s00520-021-06093-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Abstract
Introduction Radical cystectomy remains the standard of care for muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer. Postoperative ostomy education is common, but patients struggle to maintain self-management practices. A preoperative ostomy education program was developed to meet this need, and we conducted a qualitative study with participating patient-caregiver dyads to evaluate the educational and psychosocial impacts of the program and examine alignment with program objectives. Materials and methods A qualitative descriptive study was conducted utilizing a thematic analysis approach. Sixteen patients, eighteen caregivers, and three program educators completed semi-structured interviews from 3 to 18 months post the program. Interviews were audio-recorded and transcribed. Thirteen end-of-course surveys from the initial educational program cohort were transcribed, coded, analyzed; this data was triangulated with patient, caregiver, and educator interviews. Results Analysis uncovered three themes: (1) Patient and caregiver motivation to attend the program, (2) attitudes toward this life-changing event, and (3) education. For theme 1, patients and caregivers cited lack of knowledge, fear, and concern about ostomy surgery and care as motivation. For theme 2, there were a variety of attitudes toward the ostomy, ranging from avoidance to acceptance, and a similar breadth of attitudes toward caregiving, with some patients and caregivers describing ongoing dependence and other patients seeking complete independence. For theme 3, the interactive curriculum was determined to be effective, and the patient advocate was cited as the most memorable program component. Conclusions A formal preoperative ostomy education program employing an interactive educational approach and featuring a patient advocate can prepare bladder cancer patients and caregivers for ostomy self-management and post-ostomy life.
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Affiliation(s)
| | - Maryellen Potts
- University of Kansas School of Nursing, Kansas City, KS, USA
| | - Katherine Glavin
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Moben Mirza
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
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The Impact of Exercise and Nutrition as Part of a Person-Centered Approach to Prehabilitation in Patients with Bladder Cancer. Semin Oncol Nurs 2020; 36:151072. [DOI: 10.1016/j.soncn.2020.151072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Porserud A, Karlsson P, Rydwik E, Aly M, Henningsohn L, Nygren-Bonnier M, Hagströmer M. The CanMoRe trial - evaluating the effects of an exercise intervention after robotic-assisted radical cystectomy for urinary bladder cancer: the study protocol of a randomised controlled trial. BMC Cancer 2020; 20:805. [PMID: 32842975 PMCID: PMC7448437 DOI: 10.1186/s12885-020-07140-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 01/30/2023] Open
Abstract
Background Patients who have undergone radical cystectomy for urinary bladder cancer are not sufficiently physically active and therefore may suffer complications leading to readmissions. A physical rehabilitation programme early postoperatively might prevent or at least alleviate these potential complications and improve physical function. The main aim of the CanMoRe trial is to evaluate the impact of a standardised and individually adapted exercise intervention in primary health care to improve physical function (primary outcome) and habitual physical activity, health-related quality of life, fatigue, psychological wellbeing and readmissions due to complications in patients undergoing robotic-assisted radical cystectomy for urinary bladder cancer. Methods In total, 120 patients will be included and assigned to either intervention or control arm of the study. All patients will receive preoperative information on the importance of early mobilisation and during the hospital stay they will follow a standard protocol for enhanced mobilisation. The intervention group will be given a referral to a physiotherapist in primary health care close to their home. Within the third week after discharge, the intervention group will begin 12 weeks of biweekly exercise. The exercise programme includes aerobic and strengthening exercises. The control group will receive oral and written information about a home-based exercise programme. Physical function will serve as the primary outcome and will be measured using the Six-minute walk test. Secondary outcomes are gait speed, handgrip strength, leg strength, habitual physical activity, health-related quality of life, fatigue, psychological wellbeing and readmissions due to complications. The measurements will be conducted at discharge (i.e. baseline), post-intervention and 1 year after surgery. To evaluate the effects of the intervention mixed or linear regression models according to the intention to treat procedure will be used. Discussion This proposed randomised controlled trial has the potential to provide new knowledge within rehabilitation after radical cystectomy for urinary bladder cancer. The programme should be easy to apply to other patient groups undergoing abdominal surgery for cancer and has the potential to change the health care chain for these patients. Trial registration ClinicalTrials.gov. Clinical trial registration number NCT03998579. First posted June 26, 2019.
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Affiliation(s)
- Andrea Porserud
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden. .,Allied Health Professionals Function, Medical unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
| | - Patrik Karlsson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Allied Health Professionals Function, Medical unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Elisabeth Rydwik
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Allied Health Professionals Function, Medical unit Ageing, Health and Function, Karolinska University Hospital, Stockholm, Sweden
| | - Markus Aly
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Patient Area Pelvic Cancer, Prostate Cancer Patient Flow, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Lars Henningsohn
- Department of Clinical Science, Intervention and Technology, CLINTEC, Division of Urology, Karolinska Institutet, Stockholm, Sweden
| | - Malin Nygren-Bonnier
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Allied Health Professionals Function, Medical unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Allied Health Professionals Function, Medical unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.,Region Stockholm, Academic Primary Health Care Centre, Stockholm, Sweden
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10
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Banerjee S, Semper K, Skarparis K, Naisby J, Lewis L, Cucato G, Mills R, Rochester M, Saxton J. Patient perspectives of vigorous intensity aerobic interval exercise prehabilitation prior to radical cystectomy: a qualitative focus group study. Disabil Rehabil 2019; 43:1084-1091. [PMID: 31411925 DOI: 10.1080/09638288.2019.1651907] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE Preoperative cardiopulmonary fitness is increasingly being recognized as an important factor influencing postoperative recovery outcomes in cancer patients. The aim of this study was to explore patient perspectives of preoperative high intensity aerobic interval exercise before radical cystectomy. MATERIALS AND METHODS Focus groups involving a purposive convenience sample of patients with bladder cancer (N = 14; mean age ± SD: 72.3 ± 6.0 years) were undertaken in a hospital education department. Data were analyzed using Framework analysis. RESULTS Participants identified physical (e.g., fitness) psychological (e.g., preparing for their operation) and social (e.g., peer support) benefits of the program. Key motivational factors for engaging in exercise prehabiliation were identified as social support, previous exercise experience and objective measures of progression. The need for clear information from healthcare providers to ensure that patients are adequately prepared for sessions was highlighted. CONCLUSIONS This qualitative study provides new insights into the perspectives and experiences of patients with bladder cancer regarding participation in preoperative vigorous intensity aerobic exercise. The study yielded novel perceptions on the physical, psychological and social health benefits accruing from the exercise program and patient views on program design features, which are important for informing future interventions and implementation strategies.IMPLICATIONS FOR REHABILITATIONA preoperative high intensity aerobic interval exercise program before radical cystectomy provides physical, psychological and social benefits to individuals living with bladder cancer.Supervised exercise, objective improvement, and peer and family support all contribute to motivation to engage with preoperative high intensity aerobic interval exercise.Individuals may require support post-radical cystectomy in order to continue with exercise due to the uncertainty around this.
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Affiliation(s)
- Srijit Banerjee
- Department of Urology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Kelly Semper
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Katy Skarparis
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
| | - Jenni Naisby
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Liane Lewis
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK
| | - Gabriel Cucato
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
| | - Robert Mills
- Department of Urology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Mark Rochester
- Department of Urology, Norfolk and Norwich University Hospital, Norwich, UK
| | - John Saxton
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
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