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Yang Y, Chen X, Pan X, Tang X, Fan J, Li Y. The unmet needs of patients in the early rehabilitation stage after lung cancer surgery: a qualitative study based on Maslow's hierarchy of needs theory. Support Care Cancer 2023; 31:677. [PMID: 37934256 DOI: 10.1007/s00520-023-08129-z] [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] [Received: 05/04/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE This study aimed to explore the unmet needs of lung cancer patients in early rehabilitation, based on Maslow's hierarchy of needs theory. METHODS Information on the experiences of 20 patients was collected through semi-structured interviews. The interviews were conducted in the surgical nursing clinic within 1 week of discharge from hospital. The data were analysed using a combination of deductive (theory-driven) and inductive (data-driven) methods, using Maslow's Hierarchy of Needs as a framework for identifying and organising themes. RESULTS Patients had a mean age of 50.92 years (SD 11.88); n = 11 (55%) were female. Major themes aligned with the dimensions of Maslow's hierarchy of needs model. Five major themes with 12 corresponding sub-themes emerged: (1) physiological needs, including "self-care and independence in life", "return to pre-operative status as soon as possible", "increase exercise under specialist guidance" and "reduce cough and pain and improve sleep quality"; (2) safety and security needs, such as "symptom management", "regulation of the emotions of worry and fear" and "access accurate treatment information"; (3) love and belonging needs, including "accompany family members" and "chat with friends";(4)Esteem needs: "live with dignity";(5) Self-actualization, such as "accept and submit to the reality of cancer" and "live meaningfully". CONCLUSIONS The findings of this study indicated that there were many unmet needs for patients during the early recovery period after lung cancer surgery. An overview of the different areas of need identified in this study may guide future research and development of interventions to improve patients' quality of life during the home rehabilitation phase.
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Affiliation(s)
- Yingzi Yang
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
- Department of Nursing, Huadong Sanatorium, No. 67, Dajishan, Wuxi City, Jiangsu Province, 214100, People's Republic of China
| | - Xinxin Chen
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, No.507, Zhengmin Road, Shanghai, 200433, People's Republic of China
| | - Xiaoting Pan
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
| | - Xuefeng Tang
- Department of Nursing, Huadong Sanatorium, No. 67, Dajishan, Wuxi City, Jiangsu Province, 214100, People's Republic of China
| | - Jiaxin Fan
- School of Medicine, Tongji University, 1239 Siping Road, Shanghai, 200092, People's Republic of China
| | - Yumei Li
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, No.507, Zhengmin Road, Shanghai, 200433, People's Republic of China.
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Ochoa-Dominguez CY, Miller KA, Banegas MP, Sabater-Minarim D, Chan RY. Psychological Impact and Coping Strategies of Hispanic Parents of Children with Cancer: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5928. [PMID: 37297532 PMCID: PMC10252186 DOI: 10.3390/ijerph20115928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
Throughout the cancer trajectory, parents of childhood cancer survivors (CCSs) may experience mental and social challenges requiring continual adaptation to cancer-induced stress. Using Lazarus and Folkman's Transactional Model of Stress and Coping framework, this qualitative study aimed to describe Hispanic parents' psychological health and explore their coping strategies. Purposive sampling was used to recruit 15 Hispanic caregivers from a safety-net hospital in Los Angeles County. To be eligible, participants had to be: the primary caregiver of a CCS who had completed active treatment, the primary caregiver or child self-identified as Hispanic, and proficient in English or Spanish. The interviews lasted approximately 60 min, were audio-recorded (in English and Spanish), and professionally transcribed. Data were analyzed following a thematic content analysis with deductive and inductive approaches on Dedoose. Participants described high levels of stress and fear when their child was diagnosed with cancer. They also shared experiencing symptoms of social anxiety, post-traumatic stress disorder, and depression. Participants' coping strategies were encompassed by three major themes: problem-focused, emotion-focused, and avoidant coping strategies. Problem-focused coping strategies included self-efficacy, behavioral change, and social support. Emotion-focused coping strategies included religious practices and positive reframing. Avoidant coping strategies included denial and self-distraction. Despite the evident disparities in psychological health for Hispanic parents of CCSs, gaps remain in designing a culturally tailored program to help alleviate the caregiver burden. This study provides insights regarding coping strategies that Hispanic caregivers use to deal with the psychological impact of their child's cancer diagnosis. Our findings also delve into the contextual and cultural factors that impact psychological adjustment.
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Affiliation(s)
- Carol Y. Ochoa-Dominguez
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA 92037, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
- Center for Health Equity Education and Research, University of California San Diego, La Jolla, CA 92037, USA
| | - Kimberly A. Miller
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Matthew P. Banegas
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA 92037, USA
- Center for Health Equity Education and Research, University of California San Diego, La Jolla, CA 92037, USA
| | - Daniel Sabater-Minarim
- Center for Health Equity Education and Research, University of California San Diego, La Jolla, CA 92037, USA
- Department of Biological Sciences, University of California San Diego, San Diego, CA 92161, USA
| | - Randall Y. Chan
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Goyarrola R, Lipsanen J, Saarelainen SM, Suviranta R, Rahko E, Lamminmäki A, Klaavuniemi T, Ahtiluoto S, Ohvanainen A, Metso P, Pöyhiä R. Spiritual well-being correlates with quality of life of both cancer and non-cancer patients in palliative care - further validation of EORTC QLQ-SWB32 in Finnish. BMC Palliat Care 2023; 22:33. [PMID: 36991431 PMCID: PMC10061907 DOI: 10.1186/s12904-023-01153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The European Organisation for Research and Treatment of Cancer (EORTC) has developed the Spiritual Well-being Questionnaire (EORTC QLQ-SWB32), a measure of spiritual well-being validated with people receiving palliative care for cancer, although its usefulness is not restricted to that population. We aimed to translate and validate this tool in Finnish and to study the relationship between spiritual well-being (SWB) and quality of life (QOL). METHODS A Finnish translation was produced according to the guidelines of EORTC and included forward- and back-translations. Face, content, construct and convergence/divergence validity and reliability were studied in a prospective manner. QOL was assessed with EORTC QLQ-C30 and 15D questionnaires. Sixteen individuals participated in the pilot testing. 101 cancer patients drawn from oncology units, and 89 patients with other chronic diseases drawn from religious communities in different parts of the country participated in the validation stage. Retest was obtained from 16 individuals (8 cancer and 8 non-cancer patients). Inclusion criteria included patients with either a well-defined palliative care plan, or who would benefit from palliative care, as well as the capacity to understand and communicate in Finnish. RESULTS The translation appeared understandable and acceptable. Factorial analysis identified four scoring scales with high Cronbach alfa values: Relationship with Self (0.73), Relationship with Others (0.84), Relationship with Something Greater (0.82), Existential (0.81), and, additionally, a scale on Relationship with God (0.85). There was a significant correlation between SWB and QOL in all participants. CONCLUSIONS The Finnish translation of EORTC QLQ-SWB32 is a valid and reliable measure both for research and clinical practice. SWB is correlated with QOL in cancer and non-cancer patients undergoing palliative care or who are eligible for it.
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Affiliation(s)
- Raimo Goyarrola
- School of Medicine, University of Eastern Finland, Kuopio, Finland.
| | - Jari Lipsanen
- Department of Statistics, University of Helsinki, Helsinki, Finland
| | - Suvi-Maria Saarelainen
- School of Theology, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
| | - Raili Suviranta
- Diaconia Journal, Evangelical Lutheran Church of Finland, Helsinki, Finland
| | - Eeva Rahko
- Department of Oncology, University Hospital, Oulu, Finland
| | | | | | | | - Antti Ohvanainen
- Palliative care unit and hospital at home, Siun sote, Joensuu, Finland
| | - Pekka Metso
- School of Theology, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
| | - Reino Pöyhiä
- School of Medicine, University of Eastern Finland, Kuopio, Finland
- Palliative Center, Essote, Mikkeli, Finland
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Abstract
Increasingly more older people are now being cared for in their own homes. Furthermore, it has become more common that people stay at home to receive end-of-life care. Using interpretative phenomenological analysis (IPA), we analyzed the religious experiences of older people (aged 65+). We answered these questions: What kind of religious experiences do older people have when death is approaching? What does this tell us about their religious coping? As IPA is based on the in-depth analysis of small amounts of homogenous data, we analyzed five interviews with older people who were dying. We identified three main themes. First, religious experiences are relational, that is, deeply rooted in personal relationships. Second, religious experiences are real and can provide both struggles and comfort in the last stage of life. Third, the experience of encountering one’s mortality and planning for one’s death was calming; while many had unclear views on the afterlife, the idea of continuing bonds after death was comforting. More open discussion on religious matters, death, and dying would be welcomed as part of home-based end-of-life care.
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