Development of a Postsurgical Patient-Reported Outcome Instrument for Women With Vulvar Neoplasia

An evaluation of the information needs of radiotherapy patients and their families

Purpose:

To evaluate the information needs of radiotherapy patients and their families. To explore influential factors regarding information-seeking behaviours. To identify the preferred formats of information and the optimum time for radiotherapy patients to receive information. To assess the implications for clinical practice in satisfying patient information needs.

Method:

A Cumulative Index to Nursing and Allied Health Literature database search of literature was undertaken and publications screened for retrieval with 36 qualifying for inclusion in the evaluation.

Results:

There was inconclusive evidence exploring the impact that patient age, diagnosis, family background, and educational status had on the information-seeking behaviours and preferences of cancer patients. There is an agreement that there are positive and negative benefits of using different formats of information: verbal, written, virtual, and so on, and ultimately healthcare providers must utilise a combination of information formats to satisfy the information needs and preferences of individual patients. Inconsistent data were found on the optimum time to deliver cancer information to patients and professionals, and therapeutic radiographers should not assume that their information priorities are the same as those of their patients—every patient has unique and individually specific information needs.

Conclusion:

The information needs of patients and families are dependent on individual circumstances, and priorities have a tendency to change during the cancer management journey, presenting huge challenges for therapeutic radiographers who are required to regularly reassess and satisfy the varying needs and preferences. More research is needed within the area of information needs and preferences for cancer patients receiving radiotherapy.

["Alone with the taboo" - The social support experienced by women with vulvar neoplasia: a qualitative study]

"Alone with the taboo" - The social support experienced by women with vulvar neoplasia: a qualitative study Abstract.

BACKGROUND

Cancer of the vulva is a gynaecological disease often with relevant impact for these women's daily life. On top of the medical complications, psychological problems might arise as well, due to the impaired quality of life and the withdrawal from social life. We do not know whether and what type of support is given to these patients.

AIM

The qualitative study aimed at describing how the affected women experience the support they receive from their social environment from the time of the diagnosis to six months postoperatively.

METHODS

A qualitative design was used. In a secondary analysis, 20 transcribed interviews from the WOMN-PRO study were analysed by qualitative content analysis according to Mayring.

RESULTS

The findings from the study resulted in four main categories: having a serious disease shows how the patients experience the diagnosis as a shock and are confronted with questions of guilt and taboos. The category feel alone was strongly represented with features of not-speaking out, not looking at it and not-acting. Do it on your own features descriptions of the strategies the women use to get out of their loneliness. In experience help, it is shown that women who try to get in touch with their social environment usually receive support.

CONCLUSIONS

Patients have a high demand for information concerning the disease and its possible impacts on their daily life as well as emotional and practical support from their families / partners and especially from health professionals. We recommend designating someone who acts throughout the whole treatment process as a mediator and a person of trust.

Recommendations for symptom management in women with vulvar neoplasms after surgical treatment: An evidence-based guideline

PURPOSE

To develop an evidence-based guideline for nurses and other health care professionals involved in pre- and postsurgical care of women with vulvar cancer (VC) or vulvar intraepithelial neoplasia (VIN).

METHODS

This evidence-based guideline was developed according to six domains of the methodological framework AGREE II. Literature research with focus on cancer care, symptom management and self-management/counselling was conducted from April to August 2013 in the databases CINAHL, Cochrane Library, PsycINFO, PubMed as well as in 14 international guideline databases. Interdisciplinary experts (n = 14) were involved in the development of the guideline from December 2013 to January 2014. This guideline is currently tested in the WOMAN-PRO II RCT (Clinical Trial No: NCT01986725).

RESULTS

For the definition of recommendations, five guidelines, one meta-analysis, two systematic reviews and two randomized controlled trials were included. In total, 24 recommendations were formulated to answer 22 clinical questions based on patients' perspective and experts' opinion. Evidence ranged from 3.5 to 5 (3.5 = weak evidence and/or clinical relevance, 5 = best evidence and/or clinical relevance). The recommendations were subsumed under different themes regarding physical, psychological and psychosocial aspects.

CONCLUSIONS

The clinical practice guideline developed in this study firstly provides recommendations for symptom management issues focusing on self-management interventions for women with VC or VIN. As an interdisciplinary guideline it should be used in addition to the existing medical guideline in the German speaking context.