Supportive care needs, quality of life and psychological morbidity of advanced colorectal cancer patients

Social determinants of health, diet, and symptom experiences in colorectal cancer survivors: A scoping review

PURPOSE

Colorectal cancer is the third most common cancer in the United States, and many colorectal cancer survivors often experience various symptoms significantly influenced by diet. Although it is known that social determinants of health can lead to notable inequities that affect lifestyle and quality of life, limited studies have examined the interplay of social determinants of health and diet on symptom experiences in this population. This scoping review aimed to explore relationships among social determinants of health, diet, and symptom experiences in colorectal cancer survivors.

METHODS

This study adhered to the Joanna Briggs Institute scoping review methodology, following the framework established by Arksey and O'Malley. Five databases were searched on September 22, 2023, and updated on April 2, 2024, including Medline, CINAHL, Embase, Web of Science, and APA PsycINFO. The review was performed using the PCC (Population, Concept, Context) format to examine symptom experiences in the context of social determinants of health and diet among colorectal cancer survivors.

RESULT

A total of 21 articles were included. Reported symptoms included gastrointestinal, chemotherapy-related, physical, and psychological symptoms. Social determinants of health at the individual level (age, gender, race/ethnicity, marital status, education, income) and relationship level (social support needs) were identified as influencing symptom experiences. Dietary choices and intake also impacted symptom experiences.

CONCLUSION/IMPLICATION

Significant associations exist between social determinants of health, diet, and symptom experiences in colorectal cancer survivors. Further exploration into how these factors influence symptom experiences is necessary to inform future tailored interventions to better support this population.

Interdependence relationships between unmet supportive care needs and its influencing factors in couples coping with colorectal cancer: a cross-sectional study

PURPOSE

To explore the unmet supportive care needs (USCNs) in colorectal cancer survivors and their spousal caregivers and identifying factors influencing USCNs from a dyadic perspective.

METHODS

In this cross-sectional survey, a total of 343 dyads consisting of Chinese colorectal cancer survivors and their spousal caregivers were recruited from a dyadic perspective. This study evaluated participants' USCNs, psychological distress of anxiety and depression, and benefit finding. The Actor-Partner Interdependence Mediation Model (APIMeM) as data analysis approaches was used to capture the bidirectional and mediating effects between the variables, revealing key factors influencing USCNs in colorectal cancer couples.

RESULTS

A total of 343 colorectal cancer couples were surveyed, reporting different USCNs. The analysis revealed that psychological distress and benefit finding play a central role in influencing USCNs. These factors affect the dyadic health outcomes of both cancer survivors and their spousal caregivers through bidirectional relationships. Specifically, psychological distress influences USCNs through its impact on benefit finding, which mediates the relationship between psychological distress and unmet care needs in the dyads.

CONCLUSIONS

This study highlights the USCNs and its influencing factors within colorectal cancer couples. The APIMeM findings suggest that USCNs can be enhanced by reducing psychological distress and strengthening the protective role of benefit finding. In response to the unique needs of colorectal cancer couples, tailored psycho-social supportive care interventions should be developed, focusing on alleviating psychological distress and reinforcing the positive aspects of benefit finding, thereby fostering stronger bi-directional relationships and improving USCNs in this population.

Gender-specific differences in factors influencing supportive care needs in colorectal cancer patients

BACKGROUND

Unmet supportive care needs reducing the quality of life of colorectal cancer (CRC) patients. As existing studies have indicated the supportive care needs of CRC patients of different genders differ, the main aim of this study was to investigate the factors influencing the supportive care needs of CRC patients based on gender.

METHODS

CRC patients were categorized by gender to compare each group's supportive care needs and demographic characteristics. Multiple linear regression analysis was employed to identify factors impacting the supportive care needs of patients by gender.

RESULTS

The study involved 257 males and 146 females CRC patients. Female patients reported higher levels of supportive care needs. Among male patients, those with higher education levels, higher anxiety, and a diagnosis of rectal cancer exhibited more significant supportive care needs. In contrast, anxiety was the only factor affecting supportive care needs for female patients.

CONCLUSION

This study provides new insights into the factors influencing supportive care needs in CRC patients. It revealed distinct differences in the levels and determinants of supportive care needs between male and female patients. Specifically, a higher level of education and the presence of rectal cancer were associated with increased supportive care needs in male patients. Meanwhile, increased anxiety levels were linked higher supportive care needs across both genders.

Evaluating the Implementation of Integrated Proactive Supportive Care Pathways in Oncology: Master Protocol for a Cohort Study

BACKGROUND

Supportive care (SC) refers to the prevention and management of complications of cancer and its treatment. While it has long been recognized as an important cancer care delivery component, a high proportion of patients face unaddressed SC needs, calling for innovative approaches to deliver SC.

OBJECTIVE

The objective of this master protocol is to evaluate the implementation of different integrated proactive SC pathways across the cancer care continuum in our institution (Gustave Roussy, Villejuif, France). Pathways studied in this master protocol may occur shortly after diagnosis to prevent treatment-related burden; during treatment to monitor the onset of toxicities and provide timely symptom management; and after treatment to improve rehabilitation, self-management skills, and social reintegration.

METHODS

This study is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. The primary objective is to evaluate the impact of SC pathways on patients' distress and unmet needs after 12 weeks, measured by the National Comprehensive Cancer Network's Distress Thermometer and Problem List. Secondary objectives will focus on the pathways (macrolevel) and each SC intervention (microlevel), evaluating their reach (administrative data review of the absolute number and proportion of clinical and sociodemographic characteristics of patients included in the pathways); short-term and long-term efficacy through their impact on quality of life (EQ-5D-5L and the 30-item European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire) and symptom burden (MD Anderson Symptom Inventory, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and 22-item European Organization for Research and Treatment of Cancer Sexual Health Questionnaire); adoption by patients and providers (administrative data review of SC referrals and attendance or use of SC strategies); barriers to and leverage for implementation (surveys and focus groups with patients, providers, and the hospital organization); and maintenance (cost-consequence analysis). Pilot evaluations with a minimum of 70 patients per pathway will be performed to generate mean Distress Thermometer scores and SDs informing the calculation of formal sample size needed for efficacy evaluation (cohorts will be enriched accordingly).

RESULTS

The study was approved by the ethics committee, and as of February 2024, a total of 12 patients were enrolled.

CONCLUSIONS

This study will contribute toward innovative models of SC delivery and will inform the implementation of integrated SC pathways of care.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06479057; https://clinicaltrials.gov/study/NCT06479057.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/52841.

Perceived communication efficacy and unmet needs for chemotherapy-associated symptom management in patients with lung and colorectal cancer: a cross-sectional study

BACKGROUND

Understanding cancer patients' unmet needs for chemotherapy-related symptom management will assist clinicians in developing tailored intervention programs. Little is known about the association between perceived communication efficacy and unmet care needs for symptom management in patients with lung and colorectal cancer.

OBJECTIVES

To examine the unmet care needs for symptom management of patients with lung and colorectal cancer and their association with perceived communication efficacy.

METHODS

A cross-sectional survey was conducted in a tertiary hospital in China from July to November 2020. A convenience sample of 203 patients with lung and colorectal cancer undergoing chemotherapy completed survey questionnaires, including the MD Anderson Symptom Inventory Scale and the Perceived Efficacy in Patient‒Physician Interactions Scale.

RESULTS

Approximately 43% of participants had at least one symptom with unmet needs. Fatigue was reported as the symptom with the highest occurrence (66%), the highest demand for supportive care (36%), and the highest prevalence of unmet needs (19%). Low levels of perceived communication efficacy independently predicted participants' unmet needs for symptom management (β=-0.13, p = 0.011).

CONCLUSIONS

This study highlights the necessity of introducing clinical assessment tools and guidelines to address fatigue and other chemotherapy-induced symptoms in patients with lung and colorectal cancer. Clinical programs designed to actively engage cancer patients to voice their needs and strengthen their communication efficacy are also warranted.

A Critical Overview of the Construct of Supportive Care Need in the Cancer Literature: Definitions, Measures, Interventions and Future Directions for Research

The growing amount of evidence about the role of supportive care in enhancing cancer patients' outcomes has made healthcare providers more sensitive to the need for support that they experience during cancer's trajectory. However, the lack of a consensus in the definition of supportive care and lack of uniformity in the theoretical paradigm and measurement tools for unmet needs does not allow for defined guidelines for evidence-based best practices that are universally accepted. Contemporary cancer literature confirms that patients continue to report high levels of unmet supportive care needs and documents the low effectiveness of most of the interventions proposed to date. The aim of this critical review is to consolidate the conceptual understanding of the need for supportive care, providing definitions, areas of expertise and a careful overview of the measurement tools and intervention proposals developed to date. The possible reasons why the currently developed interventions do not seem to be able to meet the needs, and the issues for future research were discussed.

Effect of a telephone-based perioperative nurse-led counselling programme on unmet needs, quality of life and sexual function in colorectal cancer patients: A non-randomised quasi-experimental study

PURPOSE

To investigate the effect of perioperative nurse-led counselling intervention on unmet needs, sexual function and quality of life in colorectal cancer patients.

METHOD

This quasi-experimental study included 82 patients who underwent colorectal cancer surgery (control n = 45, intervention n = 37). The telephone-based perioperative nurse-led counselling intervention, which contained implementation, follow-up, and assessment, was applied to start from pre-surgery to post-surgery 3rd month. Data were collected with the Unmet Needs of Cancer Survivors Scale, European Organisation for Treatment and Research of Cancer Quality of Life Scale-30, Colorectal-29, Female Sexual Function Index, and International Index of Erectile Function pre- and post-surgery 3rd-6th months. The control data was collected before the pandemic, and the intervention group throughout the pandemic. The Mann-Whitney-U, Wilcoxon rank test was used.

RESULTS

Compared to the control group, intervention group patients reported lower unmet and total needs scores (p = 0.000); higher quality of life (p = 0.000), physical, emotional (p = 0.000), role (p = 0.001), and social functioning scores (p = 0.002); lower fatigue (p = 0.000), constipation (p = 0.034), pain (p = 0.018), nausea-vomiting (p = 0.004), and insomnia scores (p = 0.003); and higher body image, anxiety (p = 0.000) and weight scores (p = 0.003), lower urinary frequency buttock pain (p = 0.000), dysuria (p = 0.001), abdominal pain (p = 0.001), fluctuance (p = 0.000), stool frequency (p = 0.002), and faecal incontinence (p = 0.006) scores at the sixth month (p < 0.05). There were no statistically significant differences between male and female sexual function scores (p > 0.05).

CONCLUSIONS

Perioperative nurse-led counselling reduced unmet needs and increased the overall quality of life by decreasing symptom levels but did not affect sexual health outcomes in patients with colorectal cancer surgery.

Supportive care needs of patients with colorectal cancer undergoing anticancer therapy: A latent class analysis

Objective

This study was aimed at identifying the potential subgroups of supportive care needs among Chinese patients with colorectal cancer (CRC) through latent class analysis (LCA) and clarifying the characteristics of patients with high needs.

Methods

From January to September 2020, a cross-sectional survey was conducted in the Oncology Department and Radiotherapy Department of four tertiary grade A hospitals in Suzhou by using the general information questionnaire and Comprehensive Needs Assessment Tool for patients with cancer. Potential subgroups of supportive care needs were identified through LCA, and the association between the subgroups and statistical variables was analyzed with chi-square tests to clarify the demographic characteristics of the high-need group. This study was not registered.

Results

A total of 403 patients with CRC were included in the survey. LCA indicated two subgroups of supportive care needs in patients with CRC: a high-need group (51.86% of patients) and a low-need group (48.14% patients). In both groups, the probability of healthcare staff and information needs was high (> 50%). Single/divorced/widowed patients had greater supportive care needs than married patients, and patients with rectal cancer had greater supportive care needs than those with colon cancer.

Conclusions

Patients' healthcare staff and information needs are of critical importance. Focus should be placed on unmarried, patients with rectal cancer, as well as those receiving chemotherapy plus radiotherapy or palliative treatment.

The supportive care needs and its influencing factors among thyroid cancer patients after surgery: A cross-sectional study

Objective

To study the supportive care needs (SCNS) of thyroid cancer (TC) patients after surgery, and to identity its influencing factors.

Methods

By convenience sampling method, total of 115 patients undergoing thyroid surgery who met the inclusion criteria from May 2021 to July 2021 were selected as the research objects. The general information questionnaire, Supportive Care Need Survey Short-Form (SCNS-SF34), functional subscale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) were used to investigate these patients.

Results

The average score for the items of SCNS-SF34 in 102 TC patients was 2.15 ± 0.71. The domain with the highest item average score was "health system information needs" (2.48 ± 1.17). The domain with the highest unsatisfied rate was "psychological needs" (69.6%). The item with the highest average score was "fear of cancer spreading" in the psychological needs domain (2.80 ± 1.48). The scores of physical function (r = -0.431, P < 0.001), role function (r = -0.428, P < 0.001), cognitive function (r = -0.531, P < 0.001), emotional function (r = -0.388, P < 0.001), social function (r = -0.464, P < 0.001) were correlated with the total score of SCNS-SF34. The univariate analysis of SCNS-SF34 scores showed that TC patients who were women (t = 2.013, P = 0.047), older (F = 1.353, P = 0.013), and with longer hospital stays (F = 3.705, P = 0.028) had higher demand of SCNS. The results of multiple linear regression analysis showed that the significant variables that entered the regression equation were gender, age, length of stay in hospital, cognitive function and social function (P < 0.05).

Conclusion

TC patients after surgery have many SCNS in different domains. It is necessary to focus on women, older patients, patients with long hospital stays and poor functioning. The implementation of a supportive care screening tool is recommended and the individualized interventions need to be developed to provide targeted support and care.

ASSESSMENT OF DISTRESS DYNAMICS AND QUALITY OF LIFE OF CANCER PATIENTS AT THE STAGE OF RADIATION THERAPY AND POSSIBILITIES OF THEIR CORRECTION

Radiation therapy (RT) is the main type of antitumor treatment in inoperable patients. Low awareness and fear of the development of radiation reactions contributes to the destabilization of psycho-emotional state of patients, which can result in withdrawal from treatment and deterioration of their quality of life (QOL). Despite a steady increase in cancer rates in Ukraine, there are currently no studies to develop measures to improve psychological condition of patients undergoing treatment in radiation therapy departments.

OBJECTIVE

to assess the dynamics of psycho-emotional status and QOL of cancer patients at the stage of radiation therapy.

MATERIALS AND METHODS

The study involved psychodiagnostic examination of 66 cancer patients who underwent radiation treatment in the clinic of the State Organization «Grigoriev Institute for Medical Radiology and Oncology of the NAMS of Ukraine», of whom Group 1 included 44 patients with head and neck cancer, Group 2 comprised 22 patients with colorectal cancer. Comparison group comprised 30 conditionally «healthy» respondents without cancer. All patients had stage III-IV cancer. The study implied the employment of «Distress Thermometer», Hospital Anxiety and Depression Scale (HADS), and the SF-36 Questionnaire (Short Form). The examination was performed before and following the course of radiation therapy. Group 1 patients underwent only psychodiagnostic examination, Group 2 patients apart from psychodiagnostic were accompanied by a psychologist before undergoing radiation procedures. In the comparison group, the survey was conducted once.

RESULTS AND DISCUSSION

Assessment of the data showed that before the start of RT most subjects (72.73 % in Group 1 and 77.3 % in Group 2) had a high level of distress, they were worried and nervous before the first radiation procedure, had fears about the consequences and side effects. The level of anxiety in Group 1 at the pathological and subclinical level was recorded in 54.55 % of patients, the rate of depression at the subclinical level was diagnosed in 18.20 %, and in 9.10 % of patients at the clinical one. In Group 2, the level of anxiety that exceeded the norm was recorded significantly less often (27.25 % vs. 54.55 %, pt < 0.05), and the rate of depression at the subclinical level was diagnosed significantly more often than in Group 1 (54.50 % vs. 18.20 %, pt < 0.05), and in 18.2 % of patients at the clinical level. After radiation, 81.81 % of Group 1 patients showed an increase in distress and anxiety, and depressive symptoms tended to worsen. The level of distress in Group 2 after consulting a psychologist in preparation for RT and undergoing radiation procedures decreased almost twice, the level of anxiety decreased to normal, the indicators of depressive symptoms remained unchanged. According to QOL assessments on the scales of physical and role functioning (PF and RP), general health (GH) and mental health (MH), patients in both groups had significantly lower scores before the RT than in the comparison groups. After the procedures, there was a significant deterioration in the RP scale in Group 1 (18.75 vs. 40.00, pt < 0.05), and an improvement of almost 2 times in Group 2 (35.73 vs. 68.33, pt < 0.06). The indicator of general health (GH) at the end of RT in Group 1 did not change, and in Group 2 it tended to improve (20.93 vs. 47.26, pt < 0.06). Life expectancy (LE) in Group 1 tended to decrease further after treatment, having increased 1.7 times in Group 2.

CONCLUSIONS

The study showed that cancer patients before the onset of RT experienced a rather strong distress and level of anxiety. Psychological correction of the emotional state at the beginning of treatment allowed for a significant improvement in the QOL of patients on the scales of role physical functioning (RF) and vitality (VT). An important area of work of a clinical psychologist at this stage of treatment involved correction of cognitive sphere, support of role functioning and formation of behavior aimed at further treatment.

Mapping a decade of interventions to address the supportive care needs of individuals living with or beyond cancer: a scoping review of reviews

PURPOSE

Individuals diagnosed with cancer have a range of supportive care needs that are often unmet despite substantial evidence supporting interventions to address them. Addressing this knowledge-translation gap represents a significant opportunity to improve health outcomes. A scoping review of reviews was conducted to map the breadth of evidence for interventions, highlighting those with an existing evidence base, as well as those requiring further research.

METHODS

Systematic or meta-analytic reviews that examined interventions targeting supportive care needs of adults and children with cancer published between 2009 and 2019 were identified via searches in Medline, PsycINFO, CINAHL, Scopus and Cochrane.

RESULTS

Five hundred fifty-one systematic reviews, including 250 meta-analyses, of interventions addressing supportive care needs, were included. Most reviews focused on interventions to address the physical and psychosocial needs of individuals with few reviews identified to address practical needs. Interventions using mental health therapies and physical activity were most commonly used to address all supportive care needs, followed by the use of pharmaceutical and medical devices, complementary and alternative therapies, information and education resources, dietary information and specific spirituality and return-to-work interventions.

CONCLUSION

This scoping review of reviews presents the first broad overview of the literature addressing the supportive care needs of people living with or beyond cancer. It provides a database that health service providers can search to identify appropriate interventions. Results highlight specific research gaps, particularly for practical needs, where reviews are needed. It highlights where a substantial evidence base exists that researchers and policy-makers can consider when implementing interventions.

Effects of a Single Sub-Anesthetic Dose of Ketamine on Postoperative Emotional Responses and Inflammatory Factors in Colorectal Cancer Patients

Objective: To investigate the effect of a single sub-anesthetic dose of ketamine on postoperative anxiety, depression, and inflammatory factors in patients with colorectal cancer. Methods: A total of 104 patients undergoing selective colorectal surgery in our hospital from Jan 2015 to Oct 2017 were included and randomly assigned (1:1:1:1) into a 0.1 mg kg^-1 ketamine group (K1 group), 0.2 mg kg^-1 ketamine group (K2 group), 0.3 mg kg^-1 ketamine group (K3 group), or control group (C group). Corresponding doses of ketamine were given intravenously in the K groups (K1, K2, and K3 groups) 5 min before operation, and the same amount of normal saline was given in the C group. The intravenous analgesia program was identical in the four groups. The patients' emotional reactions (anxiety and depression) were assessed by the Hospital Anxiety and Depression Scale (HAD), the quality of postoperative recovery was evaluated by the Quality of Recovery-40 (QoR-40) questionnaire, and the levels of IL-6, IL-8, and TNF-α in peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA) on the day before operation and within 24, 48, and 72 h post-operation respectively. Pain was estimated by the visual analog scale (VAS), and sedation was assessed with Ramsay score 30 min after extubation. The time points of anesthetic end and extubation were recorded. The complications during anesthesia and recovery such as cough and agitation 30 min after extubation were recorded. Results: The anxiety score (HAD-A) and depression score (HAD-D) of the K3 group were significantly lower than those of the C group post-operation (p < 0.05). The QoR-40 score of the K3 group was significantly higher than that of the C group (p < 0.05). The serum levels of IL-6, IL-8, and TNF-α in the K3 group were significantly lower than those in the C group (p < 0.05 and p < 0.01). There were no significant differences in HAD-A, HAD-D, and QoR-40 scores or serum levels of IL-6, IL-8, and TNF-α between the K1 and K2 groups and the C group. There were no significant differences in VAS pain score or Ramsay sedation score among the four groups 30 min after extubation. There were no significant differences in extubation time, postoperative cough, emergence agitation, or delirium among the four groups. Dizziness, nausea, vomiting, diplopia, or other adverse reactions were not found 30 min after extubation. Conclusion: A single sub-anesthetic dose (0.3 mg kg^-1) of ketamine can significantly improve the postoperative anxiety and depression of colorectal cancer patients and reduce the levels of IL-6, IL-8, and TNF-α.

Supportive Care Needs and the Impact of Loss of Functioning and Symptom Burden on the Quality of Life in Patients with Advanced Colorectal Cancer

Background/Aims Relationships between loss of functioning, symptom burden, supportive care needs, and quality of life (QoL) have been suggested in cancer populations. This cross-sectional study further investigates these relationships through mediation analyses. Methods 276 advanced colorectal cancer (CRC) patients completed validated instruments to assess cancer-related functioning, symptoms, supportive care needs and QoL. Pearson's correlations and multiple mediation models with bootstrapping method were performed. Results QoL had negative correlations with supportive care needs, positive correlations with functioning measures and negative correlations with symptom scales. Supportive care needs had negative correlations with functioning measures and positive correlations with symptom scales. Mediation analyses showed significant indirect effects of CRC-related functioning and symptoms on QoL through supportive care needs. Conclusions Significant links between CRC-related loss of functioning, symptom burden, QoL and supportive care needs have been established. Longitudinal studies are planned to clarify cause-and-effects relationships and establish sequences of events.

Unmet Supportive Care Needs of Jordanian Patients with Colorectal Cancer: A Cross-Sectional Survey

Objective:

Colorectal cancer (CRC) is ranked the second most common cancer diagnosed in both men and women in Jordan. This paper aims to explore the unmet supportive care needs (USCNs), and their predictors among Jordanian survivors with CRC.

Methods:

A cross-sectional descriptive correlational research design with a convenience sample of 180 patients with CRC was conducted. Participants completed the Supportive Care Needs Survey-Short Form 34.

Results:

Jordanian patients with CRC reported their highest perceived level of need in the information and psychological domains. Multiple linear regression revealed that income and the number of chemotherapy sessions were significant predictors in the physical and daily living domains. Age, type of surgical treatment, and type of clinical setting were significant predictors of USCN in the psychological, patient care and support, and the health system and information domains.

Conclusions:

The health-care systems should work to meet all the supportive care needs for patients with CRC, particularly the informational and psychological needs domains where patients express unmet needs. Special care should be given according to age, type of surgery, and the doses of chemotherapy received. This study further confirms a disparity in the care and support provided to Jordanian cancer patients with different health-care settings in the country.

Unmet Needs and Quality of Life of Cancer Patients and Their Families: Actor-Partner Interdependence Modeling

Unmet needs and quality of life (QOL) are important nursing issues for both patients and their families. However, studies into their direct association, considering the dyadic relationship between them, have not been done. We investigated the associations using the actor–partner interdependence modeling for dyadic data. Data were collected from 115 patient–family dyads at a tertiary teaching hospital. The study variables were assessed using the questionnaires and clinical data. To analyze patient–family dyad data, the actor–partner interdependence modeling and structural equation modeling were used. The cancer patients and their families experienced diverse and high levels of unmet needs that affected their quality of life, both physically and mentally. The cancer patients’ unmet needs decreased their physical and mental quality of life, while those of their families had a negative impact on their own physical and mental quality of life. However, the cancer patients’ unmet needs did not have partner effects on their families’ quality of life, and vice versa. Therefore, unmet needs played important roles in their QOL taking into dyadic relationships in the model. The results suggest that nursing intervention programs to meet the needs of both patients and their families are required to improve their quality of life.

Adjustment to life with metastatic cancer through psychodrama group therapy: A qualitative study in Turkey

PURPOSE

This study describes the experiences of patients with metastatic cancer participating in psychodrama group therapy.

DESIGN AND METHODS

This study was carried out at the cancer hospital of the university, Turkey. The sample consisted of patients with metastatic cancer who participated in 16 weekly psychodrama sessions of 3 h each. The study was analyzed using the NVivo 11 software, the sessions which summarize and code the interviews.

FINDINGS

Five main themes were identified: Anxiety of death, coping strategies, psychological resilience, relieving suffering, and the meaning of life.

PRACTICE IMPLICATIONS

Psychodrama can be used in patients diagnosed with metastatic and other types of cancer to cope with their psychosocial difficulties. Psychiatric nurses can play a leading role in this area.

Functional impairment, symptom severity, and overall quality of life in patients with advanced lung or colorectal cancer in six European countries: baseline findings from the ACTION study

BACKGROUND

People with advanced cancer often suffer from various symptoms, which can arise from the cancer itself and its treatment, the illness experience, and/or co-morbid conditions. Important patient-reported outcomes such as functional status, symptom severity, and quality of life (QoL) might differ between countries, as countries vary with regard to contextual factors such as their healthcare system.

PURPOSE

To assess self-reported emotional functioning, physical functioning, symptoms, and overall QoL in patients with advanced lung or colorectal cancer from six European countries, particularly in relation to their country of residence.

METHODS

We used baseline patient data from the ACTION trial, including socio-demographic and clinical data as well as patient-reported data regarding functioning, symptoms, and overall QoL (EORTC QLQ-C15-PAL).

RESULTS

Data from 1117 patients (55% lung cancer stage III/IV, 45% colorectal cancer stage IV) were used. The highest (worst) average symptom score was found for fatigue. We found similarities but also important differences in the outcomes across countries. The best scores (the highest for emotional functioning and QoL, the lowest for symptoms) were reported by Dutch and Danish patients. Belgian patients reported relatively low emotional functioning.

CONCLUSION

The optimization of functioning, symptom relief, and overall QoL should be important objectives of healthcare professionals who take care of patients with advanced cancer. There are similarities, but also substantial differences across countries in functional status, symptoms, and overall QoL. Policymakers should take these differences into account and invest in offering health care catered to the needs of their population.

Effects of cooperative nursing and patient education on postoperative infection and self-efficacy in gastrointestinal tumors

BACKGROUND

Gastrointestinal tumors have a high incidence rate. The application value of the cooperative nursing care system of medical care has received widespread attention in recent years. However, there are few studies on the value of the joint application of collaborative nursing care and self-efficacy education.

AIM

To explore the effect of cooperative nursing care management/self-efficacy education on postoperative infection and self-efficacy in gastrointestinal tumor surgery patients.

METHODS

A total of 102 patients with gastrointestinal tumors treated in our hospital from October 2018 to February 2020 were selected and divided into a conventional group (n = 51) and a combined group (n = 51) according to the nursing plan. The routine group adopted routine nursing, and the joint group adopted the medical care cooperative responsibility system nursing management combined with self-efficacy education. The self-efficacy scores, coping style scores, self-experience burden scores, and postoperative complication rates of the two groups before and after intervention were counted.

RESULTS

After intervention, the daily life behavior management, cognitive symptom management, and disease management scores of the two groups were higher than those before the intervention, and those of the combined group were higher than those of the conventional group (all P = 0.000). After the intervention, the positive response scores of the two groups were higher than those before the intervention, the negative response scores were lower than those before the intervention, and the combined group was better than the conventional group (all P = 0.000). After the intervention, the two groups’ emotional, economic, and physical factor scores were lower than those before the intervention, and the combined group was lower than the conventional group (all P = 0.000). The incidence of infection in the combined group (1.96%) was lower than that in the conventional group (15.69%) (P = 0.036).

CONCLUSION

Cooperative nursing care management and self-efficacy education improved the physical and mental states of gastrointestinal cancer surgery patients, change the response to disease, and reduce the risk of postoperative infection.