Intraperitoneal Chemotherapy: The Lived Experiences of Taiwanese Patients With Ovarian Cancer

Patient experiences: a qualitative systematic review of chemotherapy adherence

Adherence to chemotherapy treatment is recognized as a crucial health concern, especially in managing cancer patients. Chemotherapy presents challenges for patients, as it can lead to potential side effects that may adversely affect their mobility and overall function. Patients may sometimes neglect to communicate these side effects to health professionals, which can impact treatment management and leave their unresolved needs unaddressed. However, there is limited understanding of how patients' experiences contribute to improving adherence to chemotherapy treatment and the provision of appropriate support. Therefore, gaining insights into patients' experiences is crucial for enhancing the accompaniment and support provided during chemotherapy.This review synthesizes qualitative literature on chemotherapy adherence within the context of patients' experiences. Data were collected from Medline, Web of Science, CINAHL, PsychINFO, Embase, Scopus, and the Cochrane Library, systematically searched from 2006 to 2023. Keywords and MeSH terms were utilized to identify relevant research published in English. Thirteen articles were included in this review. Five key themes were synthesized from the findings, including positive outlook, receiving support, side effects, concerns about efficacy, and unmet information needs. The review underscores the importance for healthcare providers, particularly nurses, to focus on providing comprehensive information about chemotherapy treatment to patients. Adopting recommended strategies may assist patients in clinical practice settings in enhancing adherence to chemotherapy treatment and improving health outcomes for individuals living with cancer.

Communicating is analogous to caring: A systematic review and thematic synthesis of the patient-clinician communication experiences of individuals with ovarian cancer

OBJECTIVE

To systematically review and synthesize the patient-clinician communication experiences of individuals with ovarian cancer.

METHODS

The CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science databases were reviewed for articles that described (a) original qualitative or mixed methods research, (b) the experiences of individuals with ovarian cancer, and (c) findings related to patient-clinician communication. Relevant data were extracted from study results sections, then coded for descriptive and analytical themes in accordance with Thomas and Harden's approach to thematic synthesis. Data were coded by two authors and discrepancies were resolved through discussion.

RESULTS

Of 1,390 unique articles, 65 met criteria for inclusion. Four descriptive themes captured participants' experiences communicating with clinicians: respecting me, seeing me, supporting me, and advocating for myself. Findings were synthesized into three analytical themes: communication is analogous to caring, communication is essential to personalized care, and communication may mitigate or exacerbate the burden of illness.

SIGNIFICANCE OF RESULTS

Patient-clinician communication is a process by which individuals with ovarian cancer may engage in self-advocacy and appraise the extent to which they are seen, respected, and supported by clinicians. Strategies to enhance patient-clinician communication in the ovarian cancer care setting may promote patient perceptions of patient-centered care.

Lived time in ovarian cancer - A qualitative phenomenological exploration

PURPOSE

To explore lived time of women with ovarian cancer during chemotherapy.

METHODS

Consensual qualitative research combined with descriptive phenomenology on a purposive sample of 9 middle-aged women (aged between 33 and 52 years, mean age 41.7) with ovarian cancer undergoing chemotherapy in an outpatient chemo center in a clinical hospital. Patients partnered in the design of the study by reviewing the research questions.

RESULTS

Four essential temporal structures were uncovered, namely: 1) Explicit finitude - the vivid presence of the thoughts of one's limited lifespan and of time passing towards death. 2) Broken horizon - a sense of an overwhelming unpredictability of life that makes one living in the narrow present. 3) The paradoxes of the chemo-clock - treatment rhythm becoming a basis for the conceptualization of time while lived experience both decelerates and accelerates. 4) Happiness closed-off by regret - the past being distantiated yet present in the form of thoughts about actions that have not been accomplished and no longer can.

CONCLUSION

The research shows unsecure lived time of participants, particularly anxiety concerning premature death and fear of the future due to harsh prognosis. The proposed hybrid method of collecting and analyzing data is an example of combining phenomenological and scientific-objectifying procedures. It can lead to wider replications in different populations with respect to type and stage of the cancer and treatment.

Suffering experiences of people with cancer undergoing chemotherapy: A meta-ethnographic study

This meta-ethnography had the objectives of identifying, evaluating, and summarizing the findings of qualitative studies regarding the suffering experiences of people undergoing chemotherapy, as well as developing an explanatory conceptual structure regarding what affects these experiences. A systematic literature review was carried out, covering the past 10 years, in the following databases: CINAHL, Embase, Medline, LILACS and Scopus. By using meta-ethnographic synthesis methods, the following themes were found: the pain of loss; evaluating, measuring, and neutralizing the threat; and social contours of suffering. The experience of living with cancer and undergoing chemotherapy was synthesized into a theoretical-explanatory model with a structure that resembles barbed-wire loops. The model expresses people's suffering experiences as marked by the feeling of loss, restraint of emotions, and resilience. While transcendent movements broke the cycle of suffering, resilience emerged as a learning experience that made patients more resistant to the pain of loss. The results indicated a complex and diverse set of factors that influence suffering, which confirmed that experiences are individual, comprehensive, and continuously reinterpreted.

"From chemo to chemo"-the temporal paradox of chemotherapy

Purpose

To uncover the experience of time in women undergoing chemotherapy for ovarian cancer.

Methods

A combination of consensual qualitative research and Giorgi’s descriptive phenomenology.

Results

The key phenomenon found and pre-reflectively organizing the patients’ experience was the temporal paradox of chemotherapy—a sense of both acceleration and deceleration in between chemotherapy sessions that desynchronizes patients with the time of others.

Conclusion

The experienced paradoxes concentrating around the timings of the chemotherapy treatments are of particular relevance for supportive care. It is particularly important to acknowledge the disturbing effect of the cyclical nature of chemotherapy.