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Matheson L, Nayoan J, Rivas C, Brett J, Wright P, Butcher H, Gavin A, Glaser A, Watson E, Wagland R. A Qualitative Exploration of Prostate Cancer Survivors Experiencing Psychological Distress: Loss of Self, Function, Connection, and Control. Oncol Nurs Forum 2021; 47:318-330. [PMID: 32301932 DOI: 10.1188/20.onf.318-330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To explore the experiences of men with prostate cancer identified as having psychological distress and to identify factors influencing distress. PARTICIPANTS & SETTING 28 men with prostate cancer diagnosed 18-42 months earlier, identified as having psychological distress on survey measures. METHODOLOGIC APPROACH Semistructured telephone interviews were conducted. Thematic analysis using a framework approach was used. FINDINGS Men with psychological distress had strong perceptions of loss toward self (identity, sexuality/masculinity, self-confidence), function (physical activities), connection (relational, social, community), and control (future, emotional). Psychological vulnerability appeared heightened in particular groups of men. Maladaptive strategies of emotional concealment, help-seeking avoidance, and withdrawal appeared to contribute to distress. IMPLICATIONS FOR NURSING Distress in men with prostate cancer is multifaceted. Men with distress should be identified and offered support. Nurse- or peer-led interventions are required.
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Affiliation(s)
| | | | | | | | | | - Hugh Butcher
- Life After Prostate Cancer Diagnosis (LAPCD) patient user advisory group
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Adikari A, de Silva D, Ranasinghe WKB, Bandaragoda T, Alahakoon O, Persad R, Lawrentschuk N, Alahakoon D, Bolton D. Can online support groups address psychological morbidity of cancer patients? An artificial intelligence based investigation of prostate cancer trajectories. PLoS One 2020; 15:e0229361. [PMID: 32130256 PMCID: PMC7055800 DOI: 10.1371/journal.pone.0229361] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/04/2020] [Indexed: 11/29/2022] Open
Abstract
Background Online Cancer Support Groups (OCSG) are becoming an increasingly vital source of information, experiences and empowerment for patients with cancer. Despite significant contributions to physical, psychological and emotional wellbeing of patients, OCSG are yet to be formally recognised and used in multidisciplinary cancer support programs. This study highlights the opportunity of using Artificial Intelligence (AI) in OCSG to address psychological morbidity, with supporting empirical evidence from prostate cancer (PCa) patients. Methods A validated framework of AI techniques and Natural Language Processing (NLP) methods, was used to investigate PCa patient activities based on conversations in ten international OCSG (18,496 patients- 277,805 conversations). The specific focus was on activities that indicate psychological morbidity; the reasons for joining OCSG, deep emotions and the variation from joining through to milestones in the cancer trajectory. Comparative analyses were conducted using t-tests, One-way ANOVA and Tukey-Kramer post-hoc analysis. Findings PCa patients joined OCSG at four key phases of psychological distress; diagnosis, treatment, side-effects, and recurrence, the majority group was ‘treatment’ (61.72%). The four groups varied in expression of the intense emotional burden of cancer. The ‘side-effects’ group expressed increased negative emotions during the first month compared to other groups (p<0.01). A comparison of pre-treatment vs post-treatment emotions showed that joining pre-treatment had significantly lower negative emotions after 12-months compared to post-treatment (p<0.05). Long-term deep emotion analysis reveals that all groups except ‘recurrence’ improved in emotional wellbeing. Conclusion This is the first empirical study of psychological morbidity and deep emotions expressed by men with a new diagnosis of cancer, using AI. PCa patients joining pre-treatment had improved emotions, and long-term participation in OCSG led to an increase in emotional wellbeing, indicating a decrease in psychological distress. It is opportune to further investigate AI in OCSG for early psychological intervention as an adjunct to conventional intervention programs.
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Affiliation(s)
- Achini Adikari
- Research Centre for Data Analytics and Cognition, La Trobe University, Bundoora, Victoria, Australia
| | - Daswin de Silva
- Research Centre for Data Analytics and Cognition, La Trobe University, Bundoora, Victoria, Australia
| | - Weranja K. B. Ranasinghe
- Research Centre for Data Analytics and Cognition, La Trobe University, Bundoora, Victoria, Australia
- MD Anderson Cancer Center, University of Texas, Houston, Texas
- * E-mail:
| | - Tharindu Bandaragoda
- Research Centre for Data Analytics and Cognition, La Trobe University, Bundoora, Victoria, Australia
| | - Oshadi Alahakoon
- College of Engineering and Science, Victoria University, Heidelberg, Victoria, Australia
| | - Raj Persad
- NHS Trust, North Bristol, England, United Kingdom
| | - Nathan Lawrentschuk
- Department of Surgery, University of Melbourne and Olivia Newton-John Cancer Centre, Austin Hospital, Melbourne, Australia
- EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Damminda Alahakoon
- Research Centre for Data Analytics and Cognition, La Trobe University, Bundoora, Victoria, Australia
| | - Damien Bolton
- Department of Surgery, University of Melbourne and Olivia Newton-John Cancer Centre, Austin Hospital, Melbourne, Australia
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Bamidele O, McGarvey H, Lagan BM, Parahoo K, Chinegwundoh Mbe F, McCaughan E. "Man in the driving seat": A grounded theory study of the psychosocial experiences of Black African and Black Caribbean men treated for prostate cancer and their partners. Psychooncology 2019; 28:1712-1720. [PMID: 31216078 DOI: 10.1002/pon.5150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/30/2019] [Accepted: 06/02/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Evidence suggests that treatment side-effects of prostate cancer (CaP) substantially affect the psychosocial well-being of affected men and their partners. However, this phenomenon is poorly understood among high risk (1 in 4) Black African (BA)/Black Caribbean (BC) men and their partners, as they are currently under-represented in global research on CaP survivorship. This study explored the psychosocial experiences of BA/BC men with CaP and their partners in the United Kingdom as they lived through the side effects of CaP treatment within their own sociocultural and marital contexts. METHODS Using constructivist grounded theory methodology, interviews and focus groups were conducted with eligible men (n = 25), partners (n = 11), and health care professionals (HCPs) (n = 11) recruited in England. Data were iteratively analysed using constant comparison following the key stages of initial, focused, and theoretical coding until saturation was achieved. RESULTS Data analysis culminated in the development of a substantive theory "man in the driving seat," which describes the experiences of BA/BC men with CaP and their partners within their context. Culturally informed gender roles and identities influenced how men and partners responded and coped with the side effects of CaP treatment. There was a hierarchy of power within the BA/BC relationship, in which men were dominantly positioned as leaders, whilst partners mostly operated from a supportive but "accepting" position. CONCLUSION Inclusive and culturally sensitive individual and couple-focused psychosocial support, which is devoid of stereotyping and recognises the experiences of both BA/BC men and their partners is recommended.
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Affiliation(s)
- Olufikayo Bamidele
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland
| | - Helen McGarvey
- School of Nursing, Ulster University, Londonderry, Northern Ireland
| | - Briege M Lagan
- Institute of Nursing and Health Research and School of Nursing, Ulster University, Jordanstown, Northern Ireland
| | - Kader Parahoo
- Institute of Nursing and Health Research, Ulster University, Coleraine, Northern Ireland
| | | | - Eilís McCaughan
- Institute of Nursing and Health Research, Ulster University, Coleraine, Northern Ireland
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Clarke AL, Roscoe J, Appleton R, Dale J, Nanton V. "My gut feeling is we could do more..." a qualitative study exploring staff and patient perspectives before and after the implementation of an online prostate cancer-specific holistic needs assessment. BMC Health Serv Res 2019; 19:115. [PMID: 30755188 PMCID: PMC6373080 DOI: 10.1186/s12913-019-3941-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/31/2019] [Indexed: 12/04/2022] Open
Abstract
Background Men surviving prostate cancer report a wide range of unmet needs. Holistic needs assessments (HNA) are designed to capture these, but are traditionally paper-based, generic, and only carried out in secondary care despite national initiatives advocating a “shared care” approach. We developed an online prostate cancer-specific HNA (sHNA) built into existing IT healthcare infrastructure to provide a platform for service integration. Barriers and facilitators to implementation and use of the sHNA were explored from both the patients and healthcare professionals (HCPs) perspectives. Methods This qualitative study consisted of two phases. Phase 1 used semi-structured interviews to explore HCPs (n = 8) and patients (n = 10) perceptions of the sHNA, prior to implementation. Findings were used to develop an implementation strategy. Phase 2 used semi-structured interviews to explore HCPs (n = 4) and patients (n = 7) experienced barriers and motivators to using the sHNA, 9 to 12 months after implementation. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Themes were mapped to the Theoretical Domains Framework. Results HCPs and patients anticipated many benefits from using the sHNA. Barriers to implementation included: confidence to work in depth with prostate cancer patients, organisational and cultural change, and patient factors. Our implementation strategy addressed these barriers by the provision of disease specific training delivered in part by a clinical nurse specialist; and a peer-led IT supporter. Following implementation HCPs and patients perceived the sHNA as beneficial to their practice and care, respectively. However, some patients experienced barriers in using the sHNA related predominately to symptom perception and time since treatment. HCPs suggested minor software refinements. Conclusions This work supports the importance of identifying barriers and motivators to implementation, and using targeted action via the development of an implementation strategy to address these. Whilst this process should be on-going, undertaking this work at an early stage will help to optimise the implementation of the sHNA for future trials. Electronic supplementary material The online version of this article (10.1186/s12913-019-3941-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amy L Clarke
- Unit of Academic Primary Care, Division of Health Sciences, Warwick Medical School, University of Warwick, Room A115, First Floor, Coventry, CV4 7AL, UK.
| | - Julia Roscoe
- Unit of Academic Primary Care, Division of Health Sciences, Warwick Medical School, University of Warwick, Room A115, First Floor, Coventry, CV4 7AL, UK
| | - Rebecca Appleton
- Unit of Academic Primary Care, Division of Health Sciences, Warwick Medical School, University of Warwick, Room A115, First Floor, Coventry, CV4 7AL, UK
| | - Jeremy Dale
- Unit of Academic Primary Care, Division of Health Sciences, Warwick Medical School, University of Warwick, Room A115, First Floor, Coventry, CV4 7AL, UK
| | - Veronica Nanton
- Unit of Academic Primary Care, Division of Health Sciences, Warwick Medical School, University of Warwick, Room A115, First Floor, Coventry, CV4 7AL, UK
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Forbes CC, Finlay A, McIntosh M, Siddiquee S, Short CE. A systematic review of the feasibility, acceptability, and efficacy of online supportive care interventions targeting men with a history of prostate cancer. J Cancer Surviv 2019; 13:75-96. [PMID: 30610736 PMCID: PMC6394465 DOI: 10.1007/s11764-018-0729-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/19/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE To examine the feasibility, acceptability, and efficacy of online supportive care interventions targeting prostate cancer survivors (PCS). METHODS Studies were identified through structured searches of PubMed, Embase and PsycINFO databases, and bibliographic review. Inclusion criteria were (1) examined feasibility, acceptability, or efficacy of an online intervention designed to improve supportive care outcomes for PCS; (2) presented outcome data collected from PCS separately (if mixed cancer); and (3) evaluated efficacy outcomes using randomized controlled trial (RCT) design. RESULTS Sixteen studies met inclusion criteria; ten were classified as RCTs. Overall, 2446 men (average age 64 years) were included. Studies reported on the following outcomes: feasibility and acceptability of an online intervention (e.g., patient support, online medical record/follow-ups, or decision aids); reducing decisional conflict/distress; improving cancer-related distress and health-related quality of life; and satisfaction with cancer care. CONCLUSION We found good preliminary evidence for online supportive care among PCS, but little high level evidence. Generally, the samples were small and unrepresentative. Further, inadequate acceptability measures made it difficult to determine actual PCS acceptability and satisfaction, and lack of control groups precluded strong conclusions regarding efficacy. Translation also appears minimal; few interventions are still publicly available. Larger trials with appropriate control groups and greater emphasis on translation of effective interventions is recommended. IMPLICATIONS FOR CANCER SURVIVORS Prostate cancer survivors have a variety of unmet supportive care needs. Using online delivery to improve the reach of high-quality supportive care programs could have a positive impact on health-related quality of life among PCS.
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Affiliation(s)
- Cynthia C. Forbes
- Hull York Medical School, University of Hull, Allam Medical Building 3rd Floor, Cottingham Road, Kingston-Upon-Hull, East Yorkshire HU6 7RX UK
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia Canada
| | - Amy Finlay
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Megan McIntosh
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Shihab Siddiquee
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Camille E. Short
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
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