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Liu W, Xia HO. The Impact of Dietary Factors on the Relief of Bowel Dysfunction Among Patients with Rectal Cancer After the Sphincter-Saving Surgery-A Prospective Cohort Study. J Gastrointest Cancer 2024; 55:768-777. [PMID: 38240910 DOI: 10.1007/s12029-023-00997-2] [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] [Accepted: 12/06/2023] [Indexed: 06/20/2024]
Abstract
PURPOSE The study aims at exploring the impact of dietary intake on the relief of bowel dysfunction among patients with rectal cancer after the sphincter-saving surgery. METHODS A prospective cohort design was used. A total of 299 patients were followed up at a tertiary hospital in East China between April 2020 and July 2021. Postoperative food intake was assessed with a food frequency questionnaire, and bowel dysfunction was assessed with Memorial Sloan Kettering Cancer Center's bowel function scale. The generalized estimating equation and the generalized additive mixed model were used to analyze the collected data. RESULTS The average daily intake of livestock and poultry meats and dairy products during the first 6 months after sphincter-saving surgery was significantly associated with the relief of bowel dysfunction. Bowel dysfunction was relieved most quickly among patients who consumed 40.81 to 59.1 g/d of livestock and poultry meat during the first 3 months after surgery. Bowel dysfunction improved more slowly during the first 6 months after surgery among patients who consumed greater than 107.11 g/d dairy products than among patients who consumed 0 g/d dairy products. CONCLUSION The impact of dietary factors on bowel dysfunction observed in this study added to the limited evidence about the specific effects of consuming foods and nutrients on defecation dysfunction, and these results provided a theoretical basis for the use of dietary modification programs aimed at relieving bowel dysfunction as soon as possible.
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Affiliation(s)
- Wen Liu
- School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Pudong District, No 279 ZhouZhu Highway, Shanghai, 200000, People's Republic of China
- School of Nursing, Fudan University, Xuhui District, No. 305, Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Hai Ou Xia
- School of Nursing, Fudan University, Xuhui District, No. 305, Fenglin Road, Shanghai, 200032, People's Republic of China.
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Sun V, Crane TE, Arnold KB, Guthrie K, Freylersythe S, Braun-Inglis C, Jones L, Cohen SA, Al-Kasspooles M, Krouse RS, Thomson CA. SWOG S1820: Altering Intake, Managing Symptoms for bowel dysfunction in survivors of Rectal Cancer (The AIMS-RC intervention trial). Contemp Clin Trials Commun 2021; 22:100768. [PMID: 33997460 PMCID: PMC8105629 DOI: 10.1016/j.conctc.2021.100768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/01/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe the study protocol of SWOG S1820, a trial of the Altering Intake, Managing Symptoms intervention for bowel dysfunction in survivors of Rectal Cancer (AIMS-RC). DESIGN SWOG S1820 is a multi-site, randomized trial of 94 post-treatment survivors of rectal cancer, comparing the intervention and attention control arms. SETTING Affiliated institutions of the National Cancer Institute (NCI)-supported National Community Oncology Research Program (NCORP) and the National Clinical Trial Network (NCTN). PARTICIPANTS Survivors of rectal cancer who are between 6 and 24 months after treatment completion. INTERVENTION AIMS-RC is a 17-week, 10 session telephone coaching program to help survivors of rectal cancer track their symptoms and improve their diets for better health and bowel function. It includes telephone-based coaching, resource manual, and personalized text/email messaging for motivation in between the telephone sessions. MAIN OUTCOME MEASURES Bowel function, low anterior resection syndrome score, quality of life (QOL), dietary quality, motivation, self-efficacy, positive/negative affect, feasibility, adherence, retention, acceptability. ANALYSIS Thirty-seven participants per arm (74 total) provide 80% power to detect this 0.5 standard deviation effect size, based on a two-sample t-test with a 1-sided alpha = 0.1. A total of 94 randomized participants will be accrued to account for 7% ineligibility and 15% attrition at 6 months.
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Affiliation(s)
- Virginia Sun
- Department of Population Sciences, City of Hope, Duarte, CA, USA
- Department of Surgery, City of Hope, Duarte, CA, USA
| | - Tracy E. Crane
- College of Nursing, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - Kathryn B. Arnold
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Katherine Guthrie
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Lee Jones
- Research Advocate, SWOG Cancer Research Network, San Antonio, TX, USA
| | - Stacey A. Cohen
- University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Robert S. Krouse
- Perelman School of Medicine, University of Pennsylvania and the Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Cynthia A. Thomson
- University of Arizona Cancer Center, Tucson, AZ, USA
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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3
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Martin E, Hocking C, Sandham M. The impact of surviving bowel cancer on occupation: A scoping review. Br J Occup Ther 2020. [DOI: 10.1177/0308022619891837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction The number of people surviving bowel cancer is increasing globally, with many of those affected living with long-term psychological and physical sequelae that potentially disrupt occupations. Method A scoping review – guided by Arksey and O’Malley’s methodological framework – was conducted to provide an overview of what is known about the impact of having had bowel cancer on occupations, and to reveal the potential role of occupational therapy. A systematic search of four databases and a grey literature repository generated 244 results. Applying inclusion and exclusion criteria, 33 items addressing bowel cancer and occupations were selected and thematically analysed. Results Researchers have identified six domains of occupation that are impacted by bowel cancer (social activity, physical activity, sexual activity, employment and role functioning, physical functioning, and self-care) but survivors report a distinct lack of health professional support after completion of medical treatment and being left to devise self-management strategies to accommodate the long-term effects of their cancer. Conclusion The sequelae of bowel cancer can have a significant impact on occupational participation. There is scope for increasing and improving occupational therapy input to assist people with cancer-related loss of function to re-engage in valued occupations and improve wellbeing.
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Affiliation(s)
- Elizabeth Martin
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Clare Hocking
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Margaret Sandham
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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Jeong H, Park J. Factors influencing changing bowel habits in patients undergoing sphincter-saving surgery for rectal cancer. Int Wound J 2019; 16 Suppl 1:71-75. [PMID: 30793858 DOI: 10.1111/iwj.13060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 12/06/2018] [Indexed: 12/15/2022] Open
Abstract
A research survey research was conducted to identify factors affecting changes in bowel habits of rectal cancer patients undergoing sphincter-saving surgery and to provide basic information useful in nursing interventions supporting treatment for rectal cancer patients. The subjects were rectal cancer patients who had undergone sphincter-saving surgery over 2 years ago. The final analysis included 107 patients who had made outpatient visits to the colorectal surgery from 12th to 31st May, 2014. Collected data were processed with SPSS Version 21.0. Changes in bowel habits in the subjects were observed: frequent bowel movement in 74 patients (69.2%) and faecal incontinence in 48 (44.9%). Most of the patients used self-care to improve their bowel function including dietary modification (78.5%), regular exercise (72.0%) and pelvic floor exercise (34.6%). Frequent defecation was associated with adjuvant chemoradiation therapy (P < 0.001) and faecal incontinence was associated with age of ≥65 years (P = 0.019) and a group who underwent adjuvant radiation therapy (P < 0.001). It is necessary to give sufficient information about possible postoperative changes in bowel habits to patients with the risk factors before surgery.
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Affiliation(s)
- Hyeonju Jeong
- Department of Nursing, Asan Medical Center, Seoul, South Korea
| | - JeongYun Park
- Department of Clinical Nursing, University of Ulsan, Seoul, South Korea
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Sun V, Wendel CS, Demark-Wahnefried W, Grant M, McMullen CK, Bulkley JE, Herrinton LJ, Hornbrook MC, Krouse RS. Diet and Behavior Modifications by Long-term Rectal Cancer Survivors to Manage Bowel Dysfunction-Associated Symptoms. Nutr Cancer 2018; 71:89-99. [PMID: 30572723 PMCID: PMC6456395 DOI: 10.1080/01635581.2018.1524017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 08/06/2018] [Accepted: 09/07/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Rectal cancer (RC) survivors experience significant bowel function issues after treatment. We aimed to describe self-reported dietary and behavioral modifications among long-term (≥5 yr) RC survivors to manage bowel dysfunction. METHODS RC survivors from Kaiser Permanente Northern California and Northwest regions completed surveys either via postage-paid return mail or telephone. Summary statistics on diet/behavioral modifications data were tabulated by proportion of responses. Modifications and frequency of bowel symptoms cited and were compared by ostomy status. RESULTS A total of 575 respondents were included (overall response rate = 60.5%). Fruits and vegetables were troublesome for symptoms, but was also helpful in mitigating constipation, obstruction, and frequency, as well as improving predictability. Many respondents attributed red meat (17.7%), fried foods (13.9%), spicy foods (13.1%), carbonated beverages (8.0%), and sweets (7.6%) to increased diarrhea, gas, and urgency. Common behavioral modifications included controlling meal portions (50.6%), timing regularity (25.3%), and refraining from late night eating (13.8%). Permanent ostomy survivors were more likely to report symptoms of obstruction, while anastomosis survivors were more likely to report urgency. CONCLUSION Multiple modifications were attempted by RC survivors to manage bowel symptoms. Identifying diet changes among RC survivors can improve symptom management and survivorship care.
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Affiliation(s)
- Virginia Sun
- a Department of Population Sciences , City of Hope , Duarte , California , USA
| | | | | | - Marcia Grant
- a Department of Population Sciences , City of Hope , Duarte , California , USA
| | - Carmit K McMullen
- d Center for Health Research, Kaiser Permanente Northwest , Portland , Oregon , USA
| | - Joanna E Bulkley
- d Center for Health Research, Kaiser Permanente Northwest , Portland , Oregon , USA
| | - Lisa J Herrinton
- e Kaiser Permanente Northern California Division of Research , Oakland , California , USA
| | - Mark C Hornbrook
- d Center for Health Research, Kaiser Permanente Northwest , Portland , Oregon , USA
| | - Robert S Krouse
- f Corporal Michael J. Crescenz Veterans Affairs Medical Center and Perelman School of Medicine, University of Pennsylvania , Philadelphia , Pennsylvania , USA
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Abstract
Colorectal (bowel) cancer remains a common disease, particularly in developed countries. If diagnosed early, it has a high five-year survival rate, yet the disease remains a significant cause of mortality. This article aims to improve nurses' understanding of the signs and symptoms of colorectal cancer, and the role of all nurses in supporting early diagnosis and providing follow-up care. It also discusses the available treatment options for colorectal cancer, enabling nurses to offer informed care to patients, who in turn, can make informed decisions about their treatment.
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Affiliation(s)
- Jacquie Peck
- Lower gastrointestinal oncology, The Harley Street Clinic, HCA Healthcare UK, London, England
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Omran S, Mcmillan S. Symptom Severity, Anxiety, Depression, Self- Efficacy and
Quality of Life in Patients with Cancer. Asian Pac J Cancer Prev 2018; 19:365-374. [PMID: 29479979 PMCID: PMC5980921 DOI: 10.22034/apjcp.2018.19.2.365] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Despite advances in cancer disease prevention, diagnosis, and treatment patients with cancer suffer from a variety of sometimes severe physical and psychological symptoms regardless of the stage of the disease. The aim is to determine the relationship of antecedent factors and mediating variables to the quality of life (QOL) of patients with cancer. Materials and Methods: The study included 341 patients with cancer and symptoms. Data collection used the Cancer Symptom Scale, State-Trait Anxiety Inventory, Centers for Epidemiologic Study-Depression, Cancer Behavior Inventory, Multidimensional Quality of Life Index, and a Demographic Form. Results: A multiple regression equation containing all the variables explained 68% of the variance in QOL. Overall four variables accounted for the majority of the total variance: anxiety, depression, self-efficacy, and symptom severity. Three of these variables were mediating variables. Of the antecedent factors symptom severity had a significant indirect effect on QOL through the mediating variables. Symptom severity also had direct effect on QOL. Conclusion: Data indicate that anxiety, depression, and self-efficacy play major roles in determining the perception of QOL of cancer patients. These mediating variables either buffered or enhanced the impact of the antecedent factors of symptom severity on QOL. Nursing interventions should focus on enhancing self-efficacy. Nurses can use health promoting programs to assist patients who are physically impaired. Further research should be aimed at identifying other influential variables, with the ultimate goal of developing interventions to aid patients in their efforts to maintain their QOL while living with cancer.
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Affiliation(s)
- Suha Omran
- Adult Health Department, Faculty of Nursing, Jordan University of Science and Technology, Jordan.
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Lu LC, Huang XY, Chen CC. The lived experiences of patients with post-operative rectal cancer who suffer from altered bowel function: A phenomenological study. Eur J Oncol Nurs 2017; 31:69-76. [PMID: 29173830 DOI: 10.1016/j.ejon.2017.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/28/2017] [Accepted: 10/16/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE Altered bowel function is a common consequence of anal sphincter-saving surgery in rectal cancer patients, and bowel symptoms influence patients' daily life and psychosocial status. Patients have inadequate professional support because care specialists fail do fully appreciate the impact of the patients' symptoms. In-depth exploration of the individual's experience is essential to improve the quality of patient care. The purpose of this study was to explore the lived experiences of post-operative rectal cancer patients with altered bowel function. METHODS This Husserlian descriptive phenomenological study recruited 16 post-operative rectal cancer patients with altered bowel function. Data was collected through purposive sampling and one-on-one in-depth, semi-structured interviews. Narratives were analyzed thematically using Colaizzi's seven-step method. RESULTS Three themes emerged, namely: "living in the restroom", "never backward", and "rebalancing on a new road". "Living in the restroom" described how patients frequent the restroom due to post-operative physical changes. "Never backward" outlined that such changes disturbed their mood, interrupted their daily activities, and affected their family life. "Rebalancing on a new road" described the patients' coping strategies, which included spiritual reconstruction, a new excrement model, an adjusted lifestyle, and peer support. CONCLUSIONS Post-operative rectal cancer patients with altered bowel function frequent the restroom for prolonged periods, which disturbs their psychosocial status. However, they are forced to develop coping methods by themselves. Specialists can offer effective early post-operative interventions by thoroughly understanding each patient's symptomatic experience, symptom-related interferences, and primary concerns.
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Affiliation(s)
- Ling-Chun Lu
- Graduate Institute of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Road, 11219, Beitou, Taipei, Taiwan, ROC; Department of Nursing, Koo Foundation Sun Yat-Sen Cancer Center, 125, Lide Road, 11259, Beitou, Taipei, Taiwan, ROC.
| | - Xuan-Yi Huang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, 365, Ming Te Road, 11219, Beitou, Taipei, Taiwan, ROC.
| | - Chien-Chih Chen
- School of Medicine, National Yang-Ming University, Department of Surgery, Division of Colorectal Surgery, Koo Foundation Sun Yat-Sen Cancer Center, 125, Lide Road, 11259, Beitou, Taipei, Taiwan, ROC.
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9
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Patients' Vulnerability in Follow-up After Colorectal Cancer: A Qualitative Action Research Study. Cancer Nurs 2017; 40:152-159. [PMID: 27044060 DOI: 10.1097/ncc.0000000000000367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the transition between being a hospitalized patient with cancer and resuming "normal" life, many patients experience physical, mental, and social challenges. Scientifically, as well as politically, it is therefore recommended to undertake research with a focus on rethinking and reorganizing follow-up after cancer treatment. OBJECTIVE The aim of this study was to identify the perspectives of fast-track colorectal cancer surgery patients on challenges experienced in the transition from being a hospitalized patient with cancer to being a cancer survivor. METHODS The current article represents phase 1 in an ongoing action research project. Data were analyzed by using the "interpretive description" method. RESULTS Twelve patients (6 male and 6 female patients; mean age, 72.4 years) participated in the study. The analyses show that the patients physically experienced readiness to leave hospital after a few days; however, shortly after returning home, most of them became mentally overwhelmed by the feeling of vulnerability that was closely related to the feeling of being handed over the responsibility for a newly cancer-operated body and a fragile life situation. Four issues that challenged the patients emerged from the analysis: restore an everyday life, participate in a follow-up program, get relevant information, and manage contact with relevant health professionals. CONCLUSIONS The study indicates that the transition to restoring a normal life after cancer surgery had been an experience characterized by more vulnerability than expected by the patients in the study. IMPLICATIONS FOR PRACTICE The findings provide 4 well-defined themes, each of which constitutes a point of departure related to focused patient-centered interventions related to follow-up after cancer surgery.
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10
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Bowel Dysfunction and Self-management for Bowel Symptoms After Sphincter-Preserving Surgery. Cancer Nurs 2017; 40:E9-E16. [DOI: 10.1097/ncc.0000000000000393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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11
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Wu XD, Qin HY, Zhang JE, Zheng MC, Xin MZ, Liu L, Wu XJ, Jiang CN, Zhang MF. The prevalence and correlates of symptom distress and quality of life in Chinese oesophageal cancer patients undergoing chemotherapy after radical oesophagectomy. Eur J Oncol Nurs 2015; 19:502-8. [DOI: 10.1016/j.ejon.2015.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 02/09/2015] [Accepted: 02/13/2015] [Indexed: 11/25/2022]
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Sun V, Grant M, Wendel CS, McMullen CK, Bulkley JE, Altschuler A, Ramirez M, Baldwin CM, Herrinton LJ, Hornbrook MC, Krouse RS. Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors. Ann Surg Oncol 2015; 22:4317-24. [PMID: 26159443 DOI: 10.1245/s10434-015-4731-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors' health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. METHODS This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N = 856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high vs. low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. RESULTS CRC survivors made substantial, permanent dietary, and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CONCLUSIONS CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship.
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Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA.
| | - Marcia Grant
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Christopher S Wendel
- Southern Arizona Veterans Affairs Health Care System, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Carmit K McMullen
- The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Joanna E Bulkley
- The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | | | | | - Carol M Baldwin
- Arizona State University College of Nursing & Health Innovation, Phoenix, AZ, USA
| | | | - Mark C Hornbrook
- The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Robert S Krouse
- Southern Arizona Veterans Affairs Health Care System, University of Arizona College of Medicine, Tucson, AZ, USA
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Wheeler A. The Modern Role of the Clinical Nurse Specialist in Colorectal Cancer in a District General Hospital. CURRENT COLORECTAL CANCER REPORTS 2014. [DOI: 10.1007/s11888-014-0211-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Landers M, McCarthy G, Livingstone V, Savage E. Patients’ bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer. J Clin Nurs 2014; 23:2343-54. [DOI: 10.1111/jocn.12516] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Margaret Landers
- Catherine McAuley School of Nursing and Midwifery; University College Cork; Cork Ireland
| | - Geraldine McCarthy
- Catherine McAuley School of Nursing and Midwifery; University College Cork; Cork Ireland
| | - Vicki Livingstone
- Neonatal Brain Research Group; Department of Paediatrics and Child Health; University College Cork; Cork Ireland
| | - Eileen Savage
- Department of Nursing; School of Nursing and Midwifery; Catherine McAuley School of Nursing and Midwifery; University College Cork; Cork Ireland
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Zhang M, Chan SWC, You L, Wen Y, Peng L, Liu W, Zheng M. The effectiveness of a self-efficacy-enhancing intervention for Chinese patients with colorectal cancer: a randomized controlled trial with 6-month follow up. Int J Nurs Stud 2013; 51:1083-92. [PMID: 24406033 DOI: 10.1016/j.ijnurstu.2013.12.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/10/2013] [Accepted: 12/10/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Colorectal cancer is a major public health problem. There is growing support for colorectal cancer survivors who are experiencing problems after cancer treatment to engage in self-management programs to reduce symptom distress. However, there is inconclusive evidence as to the effectiveness of such program especially in Asian region. OBJECTIVES This study tested the effects of a six-month nurse-led self-efficacy-enhancing intervention for patients with colorectal cancer, compared with routine care over a six-month follow up. DESIGN A randomized controlled trial with repeated measures, two-group design. SETTING Three teaching hospitals in Guangzhou, China. PARTICIPANTS One hundred and fifty-two Chinese adult patients with a diagnosis of colorectal cancer were recruited. The intervention group (n=76) received self-efficacy-enhancing intervention and the control group (n=76) received standard care. METHOD The participants were randomized into either intervention or control group after baseline measures. The outcomes of the study (self-efficacy, symptom distress, anxiety, depression and quality of life) were compared at baseline, three and six months after the intervention. RESULTS Sixty-eight participants in the intervention group and 53 in the control group completed the study. Their mean age was 53 (SD=11.3). Repeated measure MANOVA found that the patients in the intervention group had significant improvement in their self-efficacy (F=7.26, p=0.003) and a reduction of symptom severity (F=5.30, p=0.01), symptom interference (F=4.06, p=0.025), anxiety (F=6.04, p=0.006) and depression (F=6.96, p=0.003) at three and six months, compared with the control group. However, no statistically significant main effect was observed in quality of life perception between the two groups. CONCLUSIONS The nurse-led self-efficacy enhancing intervention was effective in promoting self-efficacy and psychological well-being in patients with colorectal cancer, compared with standard care. The intervention can be incorporated into routine care. Future empirical work is required to determine the longer term effects of the intervention.
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Affiliation(s)
- Meifen Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Sally Wai-chi Chan
- Alice Lee Centre of Nursing Studies, National University of Singapore, Singapore.
| | - Liming You
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Yongshan Wen
- Department of Nursing, Cancer Center of Sun Yat-sen University, Guangzhou, China
| | - Lifen Peng
- Department of Nursing, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Weiyan Liu
- Department of Nursing, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Meichun Zheng
- Department of Nursing, Cancer Center of Sun Yat-sen University, Guangzhou, China
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16
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Lai X, Wong FKY, Ching SSY. Review of bowel dysfunction of rectal cancer patients during the first five years after sphincter-preserving surgery: a population in need of nursing attention. Eur J Oncol Nurs 2013; 17:681-92. [PMID: 23871359 DOI: 10.1016/j.ejon.2013.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 06/14/2013] [Accepted: 06/21/2013] [Indexed: 01/11/2023]
Abstract
PURPOSE The aim of the review was to summarize the longitudinal changes in bowel dysfunction among patients with rectal cancer within the first five years following sphincter-preserving resection. METHODS A series of literature searches were conducted on six English-language electronic databases. Articles published after 1990 were searched. A total of 29 articles (reporting 27 studies) was found. RESULTS Bowel dysfunction, including an alteration in the frequency of bowel movements, incontinence, abnormal sensations, and difficulties with evacuation, is reported among patients with rectal cancer within the first five years after sphincter-preserving resection. These problems are most frequent and severe within the first year, especially within the first six months, and stabilize after one year. Some of the problems may last for years. CONCLUSION Supportive care for bowel dysfunction is needed, and should include the provision of information and psychological support delivered in multiple steps. Oncology nurses can play an important role in providing supportive care for rectal cancer patients with bowel dysfunction.
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Affiliation(s)
- Xiaobin Lai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
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