Meanings of quality of life held by patients with colorectal cancer in the context of chemotherapy

Quality of Cancer Care in Tanzania as Experienced by Patients: A Qualitative Study

Introduction

Cancer is a disease of public importance in Tanzania. Considering a limited health care system with few cancer centers and low health literacy in general, people are diagnosed at late stage and face difficulties in accessing care for their cancer. All these challenges affect the caring situation for the nurses who meet the patients at the cancer care centers.

Objective

This study aimed to explore the journey of cancer care experienced by patients with cancer.Research questions:How do patients experience the quality of care at the cancer care centers?How do patients experience the family's and the community's role?

Methods

Semi-structured qualitative interviews were carried out with 15 patients treated for colorectal-, breast-, or prostate cancer in three cancer care centers in Tanzania. A purposive sampling was used. Qualitative content analysis according to Graneheim and Lundman was employed.

Results

Three main themes and six sub-themes emerged. The main themes were e xperiences of cancer care services, the role of the family, community challenges and cancer care. The sub-themes were communication, resource allocation at the cancer care centers, fmily's denial, family challenges, limitations of primary care and misconceptions, and accessibility of cancer service and the health care system. The findings show that patients experienced incapacitated health care facilities for cancer care, misconceptions in the community and challenges for the families.

Conclusions

The quality of cancer care in Tanzania needs to be improved, patients face challenges in all levels of health care facilities, including families, and the community at large. The distance to oncology care, economic hardship, and lack of knowledge in the community including families, lead to late diagnosis and suffering for the patients. There is a great need for education regarding cancer within healthcare, as well as in the community, to change the situation for patients with cancer.

Searching for a harmonious survival: the experience of quality of life of urological cancer survivors

PURPOSE

This study aimed to analyze the experience of quality of life for urological cancer survivors.

METHODS

This is a qualitative narrative research based on the experience-centered approach. Twenty-one semi-structured face-to-face interviews were conducted with 12 survivors of urological cancer at different survival seasons. Participants were recruited from the convenience sampling. The thematic analysis approach was used to analyze the data. The findings are presented as narrative syntheses. The standards for reporting qualitative research (SPQR) were used in this study.

RESULTS

Two narrative syntheses were constructed: (1) Rupture in the different dimensions of QoL; and (2) QoL: Searching for a harmonious survival, each presenting their respective sub-themes. After the rupture in the different dimensions of QoL, the survivors resigned themselves and searched for a harmonious survival despite the physical, social, and psychological changes imposed by cancer treatments. Survivors achieved a new meaning of QoL with the support of family, hope, and spirituality.

CONCLUSIONS

The results highlight the changes experienced by survivors in different dimensions of QoL and the search for harmonious survival. Based on QoL experience reported in this study, health professionals can plan survival care and interventions that mitigate the consequences of treatment on QoL.

Patients’ experiences of medicines on initiation of antineoplastic agents for the treatment of colorectal cancer: a qualitative study

Objective

To explore the patients’ experiences on initiation of treatment with antineoplastic medicines for colorectal cancer.

Design

A qualitative study using semistructured, face-to-face interviews based on the adapted patients’ lived experience with medicines conceptual model was conducted. Ethics approval was granted. Interviews took place while eligible patients were receiving their first cycle of antineoplastic medicines, audiorecorded and transcribed verbatim. Interpretative phenomenological analysis was used.

Setting

National oncology hospital in Malta.

Participants

Adult patients over 18 years, newly diagnosed with colorectal cancer and initiating treatment with 5-fluorouracil/folinic acid and oxaliplatin (FOLFOX) or capecitabine plus oxaliplatin (XELOX) between October 2018 and September 2019 were recruited. Patients were included if fully aware of their diagnosis and the treatment being received. A purposive sample of 16 patients participated in the study.

Results

Five themes emerged from our analysis: (1) beliefs and knowledge on cancer and treatment; (2) healthcare system in relation to treatment; (3) medicine-taking practice; (4) medicine-related impact and (5) personal support structure. In addition, 16 subthemes were identified to describe the interplay of all aspects of the patients’ experiences on initiation of treatment with antineoplastic medicines.

Conclusion

This qualitative study illustrated that the patients find themselves in a complex situation on initiation of treatment with antineoplastic medicines. The patients’ knowledge on their specific treatment and active participation in making an informed decision need to be addressed. The healthcare system should develop tailored patient-centred services that specifically address the lack of patient empowerment and patient’s concern about treatment specific information.

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.

Lived Experiences of Iranian Cancer Patients After Survival: A Phenomenological Research

Background:

There are significant issues in the treatment of cancer patients. Despite these issues, there is still room to explore unique lived experiences after survival.

Aim:

This study aimed to explore the experiences of cancer survivors after chemotherapy.

Method:

A descriptive phenomenological study was conducted in Zabol, Iran. A purposeful sample of 15 cancer survivors was selected to gather data using semistructured interviews. Colaizzi’s method was used for data analysis.

Results:

Four themes were extracted from the interviews. These were altered body image, mood swings, uncertain and dark future, and choosing a solitary lifestyle.

Conclusion:

Cancer patients experience various physical, psychological, and social changes including stress, anger, nervousness, despair, worthlessness, depression, social isolation, and even the wish to die after chemotherapy.

Experience of the spouse of a woman with breast cancer undergoing chemotherapy: a qualitative case study

Abstract Objective: To identify the meaning attributed to the experience of a spouse of a woman with breast cancer undergoing chemotherapy. Methods: Descriptive study, with a theoretical-methodological orientation based on medical anthropology and utilizing an ethnographic case study strategy. Data were collected through semi-structured interviews and participant observation. Results: The meanings revealed that the diagnosis cause suffering. Chemotherapy was seen as giving hope of healing the wife's cancer. During this process, the spouse had to deal with the strong adverse effects of the treatment and subordinate to his wife to reduce the conflict experienced by the couple, which violated the rules of his masculinity. Religion and family were important support networks on this path. Final considerations and implications for practice: The results showed the importance of considering cultural aspects of spouses when they are faced with disease in their wives. The way spouses deal with breast cancer will depend on their cultural systems. Nursing care must be comprehensive and extend to spouses whose wives have breast cancer.

Gender differences in the perception of quality of life of patients with colorectal cancer

OBJECTIVES

To identify the gender differences in assessing quality of life of patients undergoing chemotherapy treatment for colorectal cancer.

METHODS

This is a cross-sectional investigation conducted with 144 patients (72 men and 72 women) undergoing chemotherapy treatment in a southeastern Brazilian hospital. Data were gathered trough a sociodemographic and clinical information form and the Health-related Quality of Life instrument from the European Organization for Research and Treatment of Cancer.

RESULTS

Cognitive function leads to lower general quality of life, with higher effect in men when compared to women. Body image (p=0.023), abdominal pain (p=0.020) and dry mouth (p=0.001) produced lower quality of life in women. On other hand, men showed lower quality of life related to the following symptoms: fecal incontinency (p<0.001), sexual impotency (p=0.027) and sexual arousal (p<0.001).

CONCLUSIONS

The illness symptoms and chemotherapy treatment effects that negatively impact on quality of life differ between men and women. Thus, healthcare needs to be focused on these specific factors that affect the quality of life according to the patient's gender.

Paradox of life among survivors of bladder cancer and treatments

Abstract OBJECTIVE: To interpret the meanings attributed to the experience of bladder cancer among survivors in therapeutic follow-up. METHOD: Qualitative methodological approach, based on medical anthropology and narrative methodology. After approval by the research ethics committee of a public university hospital, data were collected from January 2014 to February 2015, by means of recorded semi-structured interviews, direct observation and field journal entries on daily immersion with a group of six men and six women, aged between 57 and 82 years, in therapeutic follow-up. Narratives were analyzed by means of inductive thematic analysis. RESULTS: The meanings revealed difficulties with the processes of disease and treatment, such as breakdown of normal life, uncertainty about the future due to possible recurrence of the disease, difficulty with continuity of care and emotional control, relating it to conflicting ways of understanding the present life. Thus, the meaning of this narrative synthesis is paradox. CONCLUSION: Interpretation of the meaning of experience with bladder cancer among patients provides nurses with a comprehensive view of care, which encompasses biological, psychological and social dimensions, and thereby systematizes humanized care.