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Lazenby BS, Guidry A, Donovan EE, Dailey R, Ivatury SJ. 'That gave me a lot of comfort, that he would ask my opinion about how we wanted to talk about this': A qualitative analysis of clinical communication experiences of ostomy patients. BMJ Open 2024; 14:e079362. [PMID: 38326256 PMCID: PMC10859983 DOI: 10.1136/bmjopen-2023-079362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES The purpose of this study was to investigate the communication challenges and successes that people with ostomies experienced during their healthcare encounters. DESIGN We conducted semistructured interviews of people with ostomies. Interviews focused on important social situations and health communication strategies for managing these situations. We transcribed interviews and coded them to create themes. PARTICIPANTS Participants were eligible to participate if they were above the age of 18 and have had an ostomy for at least a year. 27 people participated in the study. SETTING The study was conducted in a university setting. RESULTS Interviews with ostomates surfaced several themes related to ostomate needs. Participants benefited from communication that was open, thorough and had a positive outlook on ostomies. Participants found patient-clinician communication to be challenging when there was a lack of knowledge surrounding ostomy care, communication was unclear or inadequate, and when clinicians had a negative outlook on ostomies. CONCLUSIONS Findings from this project are intended to amplify existing patient and clinician education materials and to inform the creation of a communication guide specifically for the ostomy context.
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Affiliation(s)
- Braidyn S Lazenby
- Department of Communication Studies, The University of Texas at Austin, Austin, Texas, USA
| | - Ashley Guidry
- Department of Communication Studies, The University of Texas at Austin, Austin, Texas, USA
| | - Erin E Donovan
- Department of Communication Studies, The University of Texas at Austin, Austin, Texas, USA
| | - René Dailey
- Department of Communication Studies, The University of Texas at Austin, Austin, Texas, USA
| | - Srinivas Joga Ivatury
- Department of Surgery and Perioperative Care, The University of Texas at Austin, Austin, Texas, USA
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Wang Z, Chen X, Zhou J, Loke AY, Li Q. Posttraumatic growth in colorectal cancer survivors: A systematic review. Clin Psychol Psychother 2023; 30:740-753. [PMID: 36734107 DOI: 10.1002/cpp.2838] [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: 08/27/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The diagnosis of cancer is an adverse event; nevertheless, it can also exert positive changes on survivors, such as posttraumatic growth (PTG). This review aims to integrate researches on PTG in colorectal cancer (CRC) survivors, including manifestations and prevalence of PTG, factors associated with PTG and interventions on PTG. METHODS A systematic search was implemented on six databases to identify studies on PTG in CRC survivors published in English or Chinese from October 1995 to May 2022. We also performed a manual search for additional studies from the article reference lists. RESULTS Thirty-one studies were included. The results were integrated based on the PTG theoretical framework and PTG affective-cognitive processing model. PTG manifests in CRC survivor-caregiver dyads in five domains, including personal growth, appreciation of life, relating to others, new possibilities and spiritual change. Factors correlated with PTG can be integrated into levels of personality, event cognitions, appraisal mechanisms, emotional states, coping and social environmental context. Elements of interventions can be integrated according to the affective-cognitive processing PTG model. Existing interventions are effective in promoting PTG in CRC survivors. CONCLUSION We provide a systematic perspective on studies targeting PTG in CRC survivors. PTG manifested in survivor-caregiver dyads. Factors associated with PTG in CRC survivors are significant, and the interventions are effective. An intervention programme based on the affective-cognitive processing model and focused on CRC survivor-caregiver dyads would be significant for the dyads facing cancer.
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Affiliation(s)
- Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
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Abstract
This integrative literature review summarizes recent literature relating to patient adjustment to stoma. The search strategy included 5 databases (CINAHL Plus, PsychINFO, Web of Science, Scopus, and MEDLINE); 65 articles meeting criteria were retrieved. Eleven were removed as duplicates, and a further 29 were removed when read in full, yielding 25 elements. Three were randomized controlled trials; 2 were prospective descriptive studies; 15 were cross-sectional descriptive studies; and 5 were qualitative studies. The quality of studies was evaluated using the Mixed Methods Appraisal Tool (MMAT). The calculated mean quality score was 97%, and no studies were excluded on quality grounds. Limited evidence suggests that adjustment occurs over time and provides some insight concerning how rehabilitation leads to resumption of an altered normality. Some evidence suggests that long-term adjustment is associated with demographic and pre- and postoperative factors. A knowledge gap was identified regarding the role of support groups, which in other fields has been shown to positively benefit psychological well-being. This review revealed a paucity of interventional studies seeking to test ways to address adjustment-related problems. Longitudinal studies are recommended as ostomy care nurses work to facilitate adjustment in the person with a stoma over time.
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Kim HK, Yoo YS. [Effects of the Advanced Practice Nurse-Led Psychoeducational Program for Colorectal Cancer Survivors]. J Korean Acad Nurs 2022; 52:245-260. [PMID: 35818875 DOI: 10.4040/jkan.21207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/08/2022] [Accepted: 04/14/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE This study aimed to investigate the effects of an advanced practice nurse-led psychoeducational program on distress, anxiety, depression, coping with cancer (CWC), health promotion behavior (HPB), and quality of life (QOL) among colorectal cancer survivors. METHODS This study was designed as a quasi-experimental study with a non-equivalent control group pretest-posttest. The participants were survivors of colorectal cancer who underwent follow-up care. There were 39 survivors: 19 in the experimental group and 20 in the control group. The experimental group performed a psychoeducational program for 120 minutes per session, once a week for a total of six weeks, while the control group received routine education and counseling. Distress, anxiety, depression, CWC, HPB, and QOL were investigated before, immediately after, and 4 weeks after the intervention. The data were analyzed with SPSS/WIN ver. 24.0, using repeated measures ANOVA. RESULTS There were significant interactions between time and group for distress and anxiety. In addition, CWC interacted with the total of CWC and interpersonal coping, and QOL interacted with the total of QOL and functional status. However, there were no significant differences in the depression or HPB scores. CONCLUSION Based on the results of this study, we expect that this program can be used as an effective intervention for colorectal cancer survivors.
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Affiliation(s)
- Hye Kyung Kim
- Cancer Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yang-Sook Yoo
- College of Nursing, The Catholic University of Korea, Seoul, Korea.
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Zou W, Zhang Y, Gong L, Zhang M, Wu X, Xie J, Zhang M. Factors associated with psychosocial adjustment in working-age colorectal cancer survivors: A cross-sectional study. Asia Pac J Oncol Nurs 2022; 9:100057. [PMID: 35647223 PMCID: PMC9130516 DOI: 10.1016/j.apjon.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/25/2022] [Indexed: 12/05/2022] Open
Abstract
Objective This study aimed to describe the level of psychosocial adjustment and identify factors associated with psychosocial adjustment in working-age colorectal cancer survivors. Methods This cross-sectional study involved 212 colorectal cancer survivors visiting a cancer clinic at a specialized oncology hospital in China. Socio-demographic characteristics, disease-related characteristics, status of returning to work, Work Ability Index scores, M. D. Anderson Symptom Inventory for Gastrointestinal Cancer scores, and self-reported Psychological Adjustment to Illness Scale scores were collected from all participants. Data analyses included descriptive statistics, independent t-test, one-way analysis of variance, correlation analysis, and multiple linear regression analysis, which were performed using the Statistical Package for the Social Sciences version 25.0 (IBM Corporation, Armonk, NY, USA). Results Participants reported a medium level of psychosocial maladjustment (35.73 ± 19.68), with 19.3% of participants experiencing severe maladjustment, 29.7% experiencing moderate maladjustment, and 50.9% experiencing mild maladjustment, respectively. Age, gender, marital status, having a child, education level, having a stoma, comorbidities, return to work, work ability, and symptom distress were entered into a multiple linear regression analysis. The strongest factor influencing the level of psychosocial adjustment was work ability (β = −0.393, P < 0.001), followed by symptom distress (β = 0.380, P < 0.001) and an education level of college or above (β = 0.150, P = 0.027). These variables accounted for 46.1% of the variance in psychosocial adjustment. Conclusions Colorectal cancer survivors with low work ability, high symptom distress, and an education level of college or above are at a high risk for psychosocial maladjustment. Nursing interventions for psychosocial adjustment should attach increased importance to the work status and symptom distress of colorectal cancer survivors.
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Zeng W, Shang S, Fang Q, He S, Li J, Yao Y. Health promoting lifestyle behaviors and associated predictors among clinical nurses in China: a cross-sectional study. BMC Nurs 2021; 20:230. [PMID: 34789261 PMCID: PMC8597212 DOI: 10.1186/s12912-021-00752-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Nurses play a core role and encompass the main workforce in health care systems. Their role model of health promoting lifestyle behaviors (HPLB) would directly or indirectly affect their clients' beliefs or attitudes of health promotion. There is limited evidence on HPLB in clinical registered nurses. The current study aimed to explore the HPLB and associated influencing factors among clinical registered nurses in China. METHODS A multi-center cross-sectional anonymous online survey was conducted in 2020. Participants were asked to complete social demographic information as well as the revised Chinese edition of Health Promoting Lifestyle Profile (HPLP). Independent-Sample T-Test, One-Way ANOVA, and categorical regression (optimal scaling regression) were the main methods to analyze the relationship between demographic data and the score of HPLB. RESULTS 19,422 nurses were included in the study. The mean score of self-actualization, health responsibility/physical activity, nutrition, job safety, interpersonal support, and overall Health Promoting Lifestyle Profile were, 27.61(5.42) out of a score of 36, 22.71(7.77) out of a score of 44, 10.43(2.97) out of a score of 16, 22.05(3.97) out of a score of 28, 20.19(4.67) out of a score of 28, and 102.99 (19.93) out of a score of 144, respectively. There was a significant relationship among Hospital levels, working years, nightshift status, and monthly income per person, and mean score of all subscales and the overall HPLP (P < 0.05). CONCLUSIONS Nurses who participated in the study presented a moderate level of health promoting lifestyle behaviors. Hospital levels, working years, nightshift status, and monthly income per person were predictors for all subscales and overall HPLP.
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Affiliation(s)
- Wen Zeng
- Nursing School of Peking University Health Science Center, No.38, Xueyuan Road, Haidian District, 100191 Beijing , Beijing City China
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
| | - Shaomei Shang
- Nursing School of Peking University Health Science Center, No.38, Xueyuan Road, Haidian District, 100191 Beijing , Beijing City China
| | - Qian Fang
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
| | - Shan He
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
| | - Juan Li
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
| | - Yuanrong Yao
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
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Kim H, Son H. Moderating Effect of Posttraumatic Growth on the Relationship Between Social Support and Quality of Life in Colorectal Cancer Patients With Ostomies. Cancer Nurs 2021; 44:251-259. [PMID: 33886236 PMCID: PMC8081094 DOI: 10.1097/ncc.0000000000000887] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2020] [Indexed: 12/04/2022]
Abstract
BACKGROUND Little research has examined the moderating influence of posttraumatic growth (PTG) on the relationship between social support and quality of life. OBJECTIVES This study examined the relationship between social support and quality of life by the level of PTG in colorectal cancer patients with ostomies. METHODS Using a cross-sectional design, colorectal cancer patients with ostomies (n = 140) were recruited using convenience sampling. The City of Hope Quality of Life-Ostomy, the Multidimensional Scale of Social Support, and the Posttraumatic Growth Inventory measured quality of life, social support, and PTG, respectively. RESULTS Social support and PTG were positively related to psychological and social well-being. Higher social support was associated with better psychological and social well-being. Posttraumatic growth moderated the relationship between psychological and social well-being. At a low and moderate level of PTG, social support was more strongly associated with psychological and social well-being, whereas at high levels, this association was not significant. CONCLUSIONS Findings highlight the significance of social support to improve the quality of life for colorectal cancer patients with an ostomy, particularly those with low levels of PTG. IMPLICATIONS FOR PRACTICE Screening for patients' positive cognitive adaptations while living with an ostomy could identify those who might need further social support to improve their quality of life. Further, intensive social support programs might promote the quality of life for colorectal patients with an ostomy, which was found to be effective for those with low levels of PTG.
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