Renegotiating hope while living with lymphoedema after cancer: a qualitative study

Hit by the wave: The experiences of adult males living with lymphoedema

Lymphoedema arises when the lymphatic system has been damaged and may occur secondary to cancer treatment. While much of the extant literature focuses on quality of life in females with breast cancer- related lymphoedema, this study explores the impact of living with lymphoedema secondary to cancer treatment in males. Semi-structured interviews were conducted with 13 male participants, aged between 50 to 85 years. Data collected were analysed using interpretative phenomenological analysis. The super-ordinate theme 'Hit by a wave' encompasses the profound impact of lymphoedema on the participants' quality of life. The males expressed body image concerns and struggled with feelings of frustration, anger, anxiety and depression. Physical changes such as weight increase, disrupted sleep, pain, swollen genitals and urinary difficulties were experienced. Changes in lifestyle were also expressed, such as an increased dependence on carers; work-related and role changes. Nevertheless, many participants endorsed the need to focus on the present moment and expressed a heightened appreciation of authenticity in life. By understanding the unique narratives of males with lymphoedema, health care practitioners together with patients can formulate care plans that truly resonate with the needs, concerns, and experiences of males living with lymphoedema.

A qualitative systematic review and meta-aggregation of the experiences of men diagnosed with chronic lymphoedema

BACKGROUND

Lymphoedema is a chronic condition that is estimated to affect up to four people per 1000 of the UK population with this increasing with age. Men account for up to 20% of lymphoedema service caseloads with research focussing upon women affected.

AIMS

To retrieve primary qualitative research on the experiences of men with chronic lymphoedema.

METHODS

A qualitative review was undertaken using the Joanna Briggs Institute (JBI) meta-aggregation method. A search strategy was applied to 12 databases, from inception to February 2021, with 22 studies identified and appraised. The findings were extracted and synthesised via the JBI approach.

RESULTS

Four synthesised findings were identified: (1) The 'New Norm', how diagnosis led to men being faced with a 'new version' of themselves; (2) 'Journey into the Unknown' relates to the unforeseen diagnosis of the condition; (3) 'Access' - challenge in receiving a diagnosis, and support; and (4) 'Personhood' - the impact of the condition upon external constructs and relationships.

CONCLUSIONS

Men are faced with similar challenges as women coupled with societal expectations with respect to gender identity and expression. This leads to those wishing to engage with men to adopt 'gender-based tailoring' within healthcare services, information and support.

Fear of cancer recurrence and hope level in patients receiving surgery for non-small cell lung cancer: a study on the mediating role of social support

PURPOSE

To study the level of fear of cancer recurrence (FCR) in patients receiving surgery for non-small cell lung cancer (NSCLC) and explore related factors that can increase levels of hope in this population, enhance the confidence to defeat the disease, and thus increase the quality of life.

METHODS

A total of 327 postoperative NSCLC patients from the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were enrolled. All participants completed the General Questionnaire, Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Herth Hope Index (HHI) Scale, and Social Support Rating Scale (SSRS).

RESULTS

The mean FoP-Q-SF score was (30.3 ± 9.48) points in postoperative NSCLC patients, Among them, there were 188 patients (57.5%) who had psychological dysfunction, indicated by a score of > / = 34. Patient sex and family income were independent risk factors for FCR (both p < 0.05). Correlation analysis revealed a negative association between FCR and hope level (p < 0.05) and a positive association between hope level and social support (p < 0.05). Notably, social support mediated the association between FCR and hope in patients receiving surgery for NSCLC (contribution effect: 30.24%).

CONCLUSION

Postoperative NSCLC patients experience a moderate level of FCR, especially females and those with a low family income. Social support partially mediates the relationship between FCR and hope in this population. Therefore, an increase in the level of social support can increase hope among these patients and advancing recovery.

The experience of hope in families of children and adolescents living with chronic illness: A thematic synthesis of qualitative studies

AIM

To synthesize qualitative studies on the experience of hope in families of children and adolescents living with chronic illness.

BACKGROUND

Hope is multidimensional, dynamic, and varies according to experienced events, cultural environments and stage of life. The qualitative synthesis of the experience of hope in the paediatric population with chronic conditions is scarce.

DESIGN

Thematic synthesis of qualitative studies.

DATA SOURCES

A systematic literature search in PubMed, CINAHL, LILACS, PsycINFO, Scopus, and Web of Science was performed supplemented by manual search strategies. Thirty-one studies from fifteen countries, published between 1981-2018, were included.

FINDINGS

Findings were integrated into an analytical theme "FAMILY HOPE: KEEPING THE DAY-TO-DAY BALANCE", encompassing the following five descriptive themes: Uncertainty; Support; Information; Between "dark thoughts" and positive thoughts; and Hoping to go back to normality.

CONCLUSION

This thematic synthesis brings a new dimension of hope among families of children and adolescents living with chronic illness. "Family Hope" highlights the influence of the relationships between relatives and the chronically ill child in the balance of hope. It is recommended that health professionals use a family-focused approach to support these families.

IMPACT

Shifting the focus to a family dimension of hope is a promising pursuit that has the potential to inform future nursing practices to support the experiences of families living with chronic illness in the paediatric context. A better understanding of the role and characteristics of family hope will promote the development of more effective interventions for families to adapt to long-term paediatric conditions.

Composing hope through collage: A community-based intervention for cancer survivors living with lymphedema

Secondary lymphedema after cancer may result in distress, yet few interventions exist to support coping skills in this population. As part of a community-based intervention, we piloted the use of creative practices to promote active orientations to hope. A total of 19 participants completed the workshops; 11 collaged. The main themes address the collage processes as well as their content. The former addresses sub-themes such as selecting/composing. The latter includes sub-themes related to movement depicted in the collages. Collages and their associated discussions concretized hoping as an active and accessible process for participants living with two chronic illnesses.