Family members' experiences, information needs and information seeking in relation to living with a patient with oesophageal cancer

Risk Perception and Preventive Behavior During the COVID-19 Pandemic : Testing the Effects of Government Trust and Information Behaviors

Given the absence of COVID-19 treatments, the best way to control the spread of the virus is to break the chain of infection by increasing public participation in preventive behaviors recommended by health authorities. This study proposes a moderated mediation model of information behaviors (e.g. information seeking and information verification) and trust in government that explores the relationship between risk perception and preventive behaviors regarding COVID-19. Using a survey study in South Korea, we conducted the moderated mediation analysis with latent moderated structural equation modeling (LMS). We found serial mediation effects for risk perception, information behaviors, and preventive behaviors, as people both seek out information and verify that information before adopting preventive behaviors. Additionally, trust in government moderated information behaviors in the relationship between risk perception and preventive behaviors, suggesting that trust in government encourages people to adopt more preventive actions via information seeking and information verification. Further implications are discussed to promote public understanding of the health crisis and public participation in preventive measures.

Using the Delphi Method to Elucidate Patient and Caregiver Experiences of Cancer Care

Objective: Identify the most salient elements of the head and neck cancer (HNC) care experience described by patients and caregivers in focus group interviews. Methods: Three focus groups of patients and caregivers were facilitated by research assistants and clinicians. Open-ended guiding questions captured/elicited aspects of care that were appreciated, warranted improvement, or enhanced communication and information. A four-step Delphi process derived consensus among focus group facilitators (n = 5) regarding salient discussion points from focus group conversations. Results: Seven salient themes were identified: (1) information provision, (2) burden related to symptoms and treatment side effects, (3) importance of social support, (4) quality of care at both hospital and provider levels, (5) caring for the person, not just treating cancer, (6) social and emotional impact of HNC, and (7) stigma and insufficient information regarding human papillomavirus-related HNC. Conclusion: Participants reported varying needs and support preferences, a desire for individualized communication, and to feel cared for as both a person and a patient. Findings illuminate the intricate details underlying high-quality, compassionate, person-centered HNC cancer care.

Undertaking responsibility and a new role as a relative: a qualitative focus group interview study

BACKGROUND

Being a relative of a patient with oesophageal cancer can evoke strong emotions and uncertainty about the future. As a consequence of the treatment course for oesophageal cancer and an increase in outpatient treatment, relatives are becoming increasingly responsible for patients' physical and emotional care. There is a lack of research exploring relatives' experiences with illness, treatment and decision-making.

AIMS AND OBJECTIVES

To explore relatives' experiences with illness, treatment of the patient and decision-making in the context of oesophageal cancer.

DESIGN

A qualitative explorative design was chosen.

METHODS

We conducted two focus group interviews with 11 relatives. The analysis was based on Ricoeur's theory of interpretation.

RESULTS

Throughout illness and treatment, relatives faced the fear of loss, leading to distress and anxiety. Relatives were simultaneously taking responsibility and asserting a new role during treatment as they regarded treatment as a joint affair. Regarding decision-making, relatives positioned themselves on the sidelines, awaiting the authority of the patients and healthcare professionals to give them space for participation.

CONCLUSION

Relatives of patients with oesophageal cancer undergoing treatment are suppressing their anxiety and doubt about the future. As they are undertaking responsibility during treatment, they are claiming control in new areas, which leads to changing roles within the family. However, they do not feel empowered in decision-making because they recognise patients' decision-making authority. This study highlights the complexity of balancing patients' authority with acknowledgement of relatives' role as active collaborators.

Health Information Sources and the Influenza Vaccination: The Mediating Roles of Perceived Vaccine Efficacy and Safety

Although the influenza vaccine is widely recognized as an effective preventive measure, influenza vaccination rates among U.S. adults remain low. Moreover, influenza-related respiratory illnesses may increase the risk of adverse outcomes of COVID-19. Thus, this study examines the mechanisms involved in influenza vaccination uptake. Specifically, this study investigates how health information sources are associated with perceived vaccine efficacy and safety, which, in turn, associated with influenza vaccine uptake. Analyzing cross-sectional survey data from a national U.S. adult sample (N = 19,420), mediation analyses were conducted. Results revealed that considering vaccine efficacy, health information seekers who assigned more value to medical professionals, medical journals, and newspaper articles were more likely to perceive a vaccine as effective, thus being more likely to receive the influenza vaccine. By contrast, individuals who placed more value in social media were less likely to perceive vaccine efficacy, and, in turn, were less likely to get the influenza vaccine. Turning to vaccine safety, the value ascribed to medical professionals was positively associated with vaccine safety, which, in turn, related to influenza vaccine uptake. By contrast, social media, family or friends, and promotions were negatively associated with vaccine safety, and then influenza vaccine uptake.

Being a relative on the sideline to the patient with oesophageal cancer: a qualitative study across the treatment course

BACKGROUND

Being a relative of patients with oesophageal cancer or cancer in the oesophageal junction is stressful, as the healthcare system often overlooks concerns about the future as well as the roles and needs of relatives. There is a lack of research addressing relatives' experiences, roles and needs for participation in decisions.

AIMS AND OBJECTIVES

To explore relatives' experiences before the start of treatment and their subsequent roles and needs for participation in treatment decisions.

DESIGN

A qualitative approach based on a phenomenological - hermeneutical methodology was used.

METHODS

Data consisted of participant observations and semi-structured interviews with 19 relatives of patients with oesophageal cancer. We analysed data with inspiration from Ricœur's theory of interpretation.

RESULTS

The relatives were fellow sufferers, experiencing uncertainties and fear for the future with the patients, but they were simultaneously a challenged anchor during a difficult time, actively involved in handling the diagnosis and the everyday life. The relatives were positioned on the sideline both by the professionals and by themselves; they took a passive and subordinate part in decisions.

CONCLUSION

Relatives are central to cancer care and treatment. Adequate and timely information is imperative for relatives as well for patients in order to facilitate shared decision-making. We advocate for a new approach to relatives in order to prepare the relatives for their roles and support their individual needs but also to acknowledge relatives' knowledge about everyday life from the relatives' perspective.

Online health information-seeking behavior by endocrinology patients

PURPOSE

Given that the Internet is important for health-related information (HRI) and the fact that online health information (OHI)-seeking behavior has never been studied in endocrinology, we set out to examine how and why the Internet is utilized for HRI, the frequency of such activity, its impact, future information needs, and the effect of language.

METHODS

A mainly quantitative, embedded mixed-methods study was performed, employing a questionnaire survey. We included 312 patients (78.4% response rate).

RESULTS

OHI-seeking was reported by 175 patients (56.1%), especially in younger (p = 0.037) and more educated (p = 0.006) patients. OHI-seekers perceived OHI to be high-quality (135, 77.1%) but 104 (59.4%) were unaware of website certification tools. Among OHI-seekers, 63 (36.6%) reported positive behavioral changes after seeking OHI. Only 45 (25.7%) OHI-seekers discussed their gathered information with their endocrinologist. If an interactive e-learning module was available, 194/312 (62.2%) patients expressed willingness to use it, especially those reporting a need for more HRI (p = 0.024). Native speakers were more likely to report that OHI did not meet their information needs (p < 0.001).

CONCLUSIONS

OHI-seeking by patients attending the endocrinology outpatients is widely practiced. The availability of OHI in the native language and e-learning modules may enhance the utility of the Internet for health information.

Cancer information needs according to cancer type: A content analysis of data from Japan's largest cancer information website

The provision of information about cancer is an important aspect of cancer care. Cancer information provided online is expected to meet the needs of information seekers. Whether information needs vary according to tumor site is largely unknown. We aimed to examine similarities and differences in informational needs by cancer type. Data were collected using a questionnaire administered on Japan's largest cancer information website, “Ganjoho service”. A total of 2782 free descriptive responses in the period from April 2012 to December 2017 were analyzed using text-mining software. We identified the top 10 informational need contents, in order of appearance frequency, for eight tumor sites: gastric, colorectal, esophageal, lung, pancreatic, breast, cervical, and prostate cancer. Frequent information needs common to all tumor sites included symptoms, disease stages, treatments, chance of cure, recovery, metastasis, and recurrence. A need for information about diet, pain, side effects of treatments, complementary and alternative medicine was frequent for some tumor sites. Tumor site-specific information should include the following, according to cancer type: information of scirrhous carcinoma for gastric cancer; unusual feces for colorectal cancer; lung X-ray images for lung cancer; early detection for pancreatic cancer; adenocarcinoma, sexual activity, pregnancy, and childbirth for cervical cancer; breast conservation or reconstruction and triple negative cancer for breast cancer; test values and diagnosis and urinary problems for prostate cancer; and hormone therapy for breast and prostate cancer. Cancer information provided online should meet these frequent informational needs, considering similarities and differences of the information required according to tumor site.

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We examined similarities and differences in cancer information needs by tumor site.

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Common needs are symptoms, stages, treatment, cure, recovery, metastasis, recurrence.

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Site-specific needs include diet, pain, side effects, early detection, test values.

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Cancer information should be provided to meet frequent needs, by tumor site.

Living With Hepatocellular Carcinoma Near the End of Life: Family Caregivers' Perspectives

PURPOSE/OBJECTIVES

To explore family caregivers' perspectives of caring for patients with terminal hepatocellular carcinoma (HCC) as patients approached the end of life.
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RESEARCH APPROACH

Longitudinal, qualitative descriptive design.
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SETTING

Oregon Health and Science University in Portland and Veterans Affairs Portland Health Care System in Oregon.
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PARTICIPANTS

13 family caregivers with a mean age of 56 years (range = 22-68 years). The majority of family caregivers were female (n = 10) and identified as White (n = 11).
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METHODOLOGIC APPROACH

Interview data were collected from family caregivers once a month for as many as six months, for a total of 39 interviews. Data were analyzed using conventional content analysis.
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FINDINGS

Five core categories and nine subcategories were identified. From the time of the terminal diagnosis to the end of life, family caregivers felt unprepared, uncertain, and in need of information. They struggled with whether symptoms were HCC- or cirrhosis-related.
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INTERPRETATION

Nurses can support family caregivers by eliciting their knowledge and concerns, and attending to symptom presentation and interpretation and to treatment challenges. Understanding challenges caregivers experience is crucial for developing interventions that address their desire for information, support, and help along the HCC disease trajectory.
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IMPLICATIONS FOR NURSING

Nurses play a critical role in preparing caregivers to understand the importance of pain assessment and management and early referral to palliative care.

Health Information Seeking Among Singaporeans: Roles and Collective Contexts

This article seeks to contribute to the literature on health information seeking (HIS) by culturally locating the search for health information within the local contexts of everyday life in Singapore, and within the meaning-making processes that individuals participate in. Based on in-depth interviews with 100 participants selected through stratified sampling, it asks: How do Singaporeans make sense of HIS in the realm of their everyday lived experiences? The study contributes to the literature on the roles familial ties play in information gathering and sharing in a collective context. More importantly, these familial ties provide perspective on the ways in which culture spatio-temporally constitutes HIS. HIS is informed by familial role expectations in a collectivist context where filial piety and "respect for the elderly" are guiding anchors for behavior. Moreover, harmony and community well-being define societal roles and responsibilities of caregiving, directed broadly at communal care. These collective-oriented contexts therefore inform HIS.

Patient, nursing and medical staff experiences and perceptions of the care of people with palliative esophagogastric cancer: a systematic review of the qualitative evidence

BACKGROUND

Esophagogastric cancer is the fifth most common malignancy and its incidence is increasing. The disease progresses quickly and five-year survival rates are poor. Treatment with palliative intent is provided for the majority of patients but there remains a lack of empirical evidence on the most effective service models to support esophagogastric cancer patients.

OBJECTIVES

The overall objective of this systematic review was to synthesize the best available evidence on the experiences and perceptions of patients and health professionals with regard to the care of people diagnosed with palliative esophagogastric cancer.

INCLUSION CRITERIA TYPES OF PARTICIPANTS

The review considered studies that included patients diagnosed with palliative esophagogastric cancer and any health professionals involved in the delivery of palliative care to this patient group in a hospital, home or community setting.

PHENOMENA OF INTEREST

The review considered studies that investigated the experiences and perceptions of people diagnosed with palliative esophagogastric cancer and staff working with these people.

CONTEXT

Studies that were carried out in any setting, including in-patient and outpatient areas, specialist cancer and non-specialist palliative care services and those were any patient were in receipt or had experiences of palliative care services were considered. All types of health practitioners delivering palliative care to esophagogastric cancer patients were considered.

TYPES OF STUDIES

Studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and narrative approaches were considered. Mixed methods studies were considered in the review only if qualitative findings were reported separately.

SEARCH STRATEGY

A three-step search strategy was utilized. A total 11 databases were searched for studies from 2000 onward, followed by hand searching of reference lists.

METHODOLOGICAL QUALITY

Methodological quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument critical appraisal tool (JBI-QARI).

DATA EXTRACTION

Qualitative findings were extracted using the JBI-QARI data extraction Instrument.

DATA SYNTHESIS

Qualitative research findings were pooled using a pragmatic meta-aggregative approach.

RESULTS

The review included two publications. There were 46 findings which were aggregated into four categories and one overall synthesized finding: "In addition to support for physical needs, patients need support that takes into account changing life situations to achieve the best quality of life."

CONCLUSIONS

The review shows that patients value services and support that addresses their complex, fluctuating and highly individual needs. No evidence was uncovered regarding how these services should be designed and delivered.

'It gets into your head as well as your body': The experiences of patients with cancer during oncology treatment with curative intent

This study explored the psychosocial experiences of patients with cancer during the course of oncology treatment with curative intent. Our aim was to gather in-depth insights into the shared elements of oncology treatment across a range of cancer types. A total of 10 individuals undergoing oncology treatment participated in semi-structured interviews. Six themes were identified using interpretative phenomenological analysis: diminished well-being, perceived role changes in intimate relationships, heightened awareness of limited time, a new order of priorities, taking things as they come and development of trust in health professionals. These themes indicate relevant areas of patients' well-being, which might be enhanced through psychosocial support services.

The effects of informal carers' characteristics on their information needs: The information needs state approach

BACKGROUND

There has been little research that provides a comprehensive account of the nature and aspects of information needs of informal carers. The authors have previously developed and validated a framework that accounts for major underlying states of information need. This paper aims to apply this framework to explore whether there are common demographic and socioeconomic characteristics that affect the information needs states of carers. A questionnaire about the information needs states was completed by 198 carers above 18 years old. We use statistical methods to look for similarities and differences in respondents' information needs states, in terms of the demographic and socioeconomic variables. At least one information needs state varies among carers, in terms of seven demographic and socioeconomic variables: the age of the patient(s) that they are caring for; the condition(s) of the patient(s) that they are caring for; the number of patients that they are caring for; their length of time as a carer; their gender; the country that they live in; and the population of the area that they live in. The findings demonstrate the utility of the information needs state framework. We outline some practical implications of the framework.

The effect of a nurse led telephone supportive care programme on patients' quality of life, received information and health care contacts after oesophageal cancer surgery-A six month RCT-follow-up study

BACKGROUND

Following oesophagectomy, a major surgical procedure, it is known that patients suffer from severely reduced quality of life and have an unmet need for postoperative support. Still, there is a lack of research testing interventions aiming to enhance the patients' life situation after this surgical procedure.

AIM

The aim of the study was to evaluate the effect of a nurse led telephone supportive care programme on quality of life (QOL), received information and the number of healthcare contacts compared to conventional care following oesophageal resection for cancer.

METHOD

The study was designed as a randomized controlled trial (RCT) aiming to test the effect of a nurse led telephone supportive care program compared to conventional care. Patient assessments were conducted at discharge, 2 weeks, 2, 4 and 6 months after discharge and comprised evaluation of QOL, received information and the number of health care contacts. Statistical testing were conducted with repeated measurements analysis of variance to test if there were differences between the groups during follow-up.

RESULT

The results show that the intervention group was significantly more satisfied with received information for items concerning the information they received about things to do to help yourself, written information and for the global information score. The control group scored significantly higher on the item regarding wishing to receive more information and wish to receive less information. No effect of the intervention was shown on QOL or number of health care contacts.

CONCLUSION

Proactive nurse-led telephone follow-up has a significant positive impact on the patients' experience of received information. This is likely to have a positive effect on their ability to cope with a life that may include remaining side effects and adverse symptoms for a long time after surgery.

"It's not if I get cancer, it's when I get cancer": BRCA-positive patients' (un)certain health experiences regarding hereditary breast and ovarian cancer risk

RATIONALE

Women with a harmful mutation in the BReast CAncer (BRCA) gene are at significantly increased risk of developing hereditary breast and ovarian cancer (HBOC) during their lifetime, compared to those without. Such patients-with a genetic predisposition to develop cancer but who have not yet been diagnosed with cancer-live in a constant state of uncertainty and wonder not if they might get cancer but when.

OBJECTIVE

Framed by uncertainty management theory, the purpose of this study was to explore BRCA-positive patients' health experiences after testing positive for the BRCA genetic mutation, specifically identifying their sources of uncertainty.

METHODS

Thirty-four, qualitative interviews were conducted with female patients. Participants responded to online research postings on the non-profit organization Facing Our Risk of Cancer Empowered's (FORCE) message board and social media pages as well as HBOC-specific Facebook groups. The interview data were coded using the constant comparison method.

RESULTS

Two major themes representing BRCA-positive patients' sources of uncertainty regarding their genetic predisposition and health experiences emerged from the data. Medical uncertainty included the following three subthemes: the unknown future, medical appointments, and personal cancer scares. Familial uncertainty encompassed the subthemes traumatic family cancer memories and motherhood.

CONCLUSIONS

Overall, the study supports and extends existing research on uncertainty-revealing uncertainty is inherent in BRCA-positive patients' health experiences-and offers new insight regarding uncertainty management and HBOC risk.

How health information is received by diabetic patients?

Background:

Knowledge of correct information-seeking behavior by the patients can provide health specialists and health information specialists with valuable information in improving health care. This study aimed to investigate the passive receipt and active seeking of health information by diabetic patients.

Materials and Methods:

A survey method was used in this research on 6426 diabetic patients of whom 362 patients were selected by a no percentage stratified random sampling. The Longo information-seeking behavior questionnaire was used to collect data and they were analyzed by SPSS 20 software.

Results:

The most common information source by diabetic patients was practitioners (3.12). The minimum usage among the information sources were from charity organizations and emergency phone lines with a usage of close to zero. The amount of health information gained passively from each source has the lowest average of 4.18 and usage of this information in making health decision has the highest average score of 5.83. Analysis of the data related to active seeking of information showed that knowledge of available medical information from each source has the lowest average score of 3.95 and ability in using the acquired information for making medical decisions has the highest average score of 5.28. The paired t-test showed that differences between passive information receipt (41.68) and active information seeking (39.20) considered as statistically significant (P < 0.001).

Conclusion:

Because diabetic patients are more passive information receivers than active information seekers, the health information must be distributed by passive means to these patients. In addition, information-seeking behavior during different time periods should be investigated; to identify more effective distribution of health information.

Linking health information seeking to behavioral outcomes: antecedents and outcomes of childhood vaccination information seeking in South Korea

Although research on health information has made significant progress in identifying the antecedents of individuals' information-seeking behavior in the context of the United States, the results have not been generalizable to the contexts of many other countries. Moreover, little is known about how one's information-seeking behavior is connected to actual behavioral outcomes relevant to the search action. The authors conducted an online survey with a stratified random sample of 1,004 mothers to examine the applicability of the comprehensive model of health information seeking in predicting the use of diverse childhood vaccination information sources in South Korea, and to investigate associations between the mothers' engagement with specific vaccine information sources and behavioral intention to immunize their children. Findings indicated that the hierarchical structure and the role of predictors within the comprehensive model of health information seeking provided a valid framework in the context of vaccine information seeking in Korea. In addition, the authors found negative associations between the use of certain types of information sources and mothers' intention to vaccinate. This suggests that the dissemination of critical health information through a variety of available sources does not automatically lead to prudent behavioral decisions when the specific characteristics of the different sources are not considered.

Information needs and information sources of family caregivers of cancer patients

Purpose

– The purpose of this paper is to analyse the information needs of family caregivers of cancer patients. Information sources used by the caregivers were also examined.

Design/methodology/approach

– We interviewed 15 family caregivers (nine females, six males) in Taiwan for this study. The participants were aged from 23 to 67 years, and all except two had attained college or higher degrees. Their relationships with patients included spousal, parental, and that of son or daughter.

Findings

– Family caregivers’ information needs varied along the cancer journey, and they used various information sources to satisfy these needs. Demographic variables affected the information-seeking behaviour of the family caregivers.

Originality/value

– The majority of studies on this topic have been based in western countries. This paper reveals the importance of considering cultural factors. The findings can assist researchers in gaining a greater understanding of the information-seeking behaviour of family caregivers of cancer patients worldwide.

Improving rural newspaper coverage of nutrition stories: an educational assessment of editors' attitudes and learning needs

Local newspapers are an important source of information for rural residents but often lack accurate or helpful nutrition-related information. To improve the quantity and quality of nutrition stories in rural, local newspapers, it is important to understand the perspective of editors. An online survey of 51 rural Midwest editors was conducted to assess attitudes toward writing nutrition stories, sources of information, perceived challenges, and interest in learning more about writing such stories. Of respondents, 49% were female, and 63% had at least a 4-year college degree. Through a mix of closed- and open-ended questions, the majority indicated positive attitudes toward nutrition stories, were confident in their abilities to write them, and expressed interest in learning more. Challenges cited include lack of print space, small staff, lack of specific requests from readers for nutrition stories, and the need to avoid offending local agricultural businesses. Results should be useful in planning an educational intervention for editors. Meanwhile, public health practitioners should provide concise press releases to their local newspapers about their activities. Also, greater expressions of appreciation from public health professionals and other readers may lead to higher prioritization of nutrition-related stories, and ultimately to an environment more supportive of healthy eating.

Nutrition Information In Community Newspapers: Goal Framing, Story Origins, and Topics

Obesity rates are high in the rural United States. Because small communities often have few health care practitioners, nutrition news in community newspapers may be a useful source of information. This content analysis of a random sample of 164 nutrition stories from 10 community newspapers in the rural West North Central Midwest was guided by concepts from goal-framing theory. Locally generated stories comprised nearly half of the sample, suggesting that nutrition is a salient topic in many rural communities. Hedonic frames related to food enjoyment were twice as frequent as health improvement frames. Results suggest food promotion was the most common topic of nutrition stories, with guidelines for a healthy diet appearing about half as often. Stories about a healthy diet and food promotion were most often written locally. Findings are discussed with recommendations for improvement of community news coverage of nutrition.

Family members of patients with cancer: what they know, how they know and what they want to know

BACKGROUND

Recent changes in healthcare management generally and in cancer care in particular, indicate a major shift in the clinical management of cancer from hospitals and healthcare professionals (HCPs) to patients and families. In light of these changes national and international policies and reports by the Department of Health and Children (2001, 2006) and the World Health Organisation (2004) have recommended that HCPs support family members (FMs) to care for loved ones. The purpose of this review therefore was to explore the extent to which FMs' needs are realised by HCPs in practice.

OBJECTIVES

To examine recent research (2000-2010) in relation to; the type of information that FMs of patients with cancer generally seek, how they seek this information from HCPs, and, FMs' experiences of communicating with HCPs in this context.

METHODS

A review of the literature was conducted using key databases Medline, Pub med, Psych-Info and CINAHL.

RESULTS

Thirty four papers were included in the review. Overall the studies demonstrated that FMs of patients with cancer have similar information needs and demonstrate similar strategies for seeking information. While many FMs report positive communication experiences with HCPs and have information needs met, the majority of FMs report negative communication encounters with HCPs.

CONCLUSION

HCPs are highly significant in the lives of FMs of patients with cancer. The review concludes with identifying; FMs most wanted information needs, their struggles with accessing HCPs and the type of communication encounters FMs most desire to have with HCPs. Recommendations for education, practice and research are addressed.

Balancing a changed life situation: the lived experience from next of kin to persons with inoperable lung cancer

The purpose of this study was to identify and describe the experiences of quality of life/life situation among those who were next of kin to persons with inoperable lung cancer. Data were collected in qualitative interviews, where 11 next of kin articulated their lived experiences, and were interpreted through interpretive phenomenology. Four themes were identified: changed life situation, experiences of uncertainty due to awareness of the ill person's changed health status, interpersonal relationships, and false hopes due to health care professionals' treatment. These four themes gave a structure presenting the essence: balancing a changed life situation. The findings of the study point out the importance of promoting support for the next of kin, because they are significantly affected by the changed life situation. There is a need to identify their needs and to support them.

Cancer informational support and health care service use among individuals newly diagnosed: a mixed methods approach

AIM

To report on the integration of quantitative and qualitative findings to increase understanding of the role of cancer informational support and use of health care services among individuals newly diagnosed with breast or prostate cancer.

METHODS

A mixed methods sequential design was used. First, a quantitative secondary analysis considered self-report data from a large number of individuals newly diagnosed with cancer (n = 250); next, a follow-up, in-depth qualitative inquiry with distinct individuals also newly diagnosed was conducted (n = 20); last, using a quantitative-hierarchical strategy, quantitative and qualitative findings were merged and re-analyzed.

RESULTS

Quantitative analyses showed significant relationships between informational support and health care services. For instance, individuals who received more intense cancer informational support [face-to-face and information technology (IT)] spent more time with nurses. Women with breast cancer as opposed to men with prostate cancer also were found to rely primarily on nurses for cancer information and information on health services available, whereas men relied mostly on their oncologists. In-depth interviews revealed that informational support could be construed as positive, unsupportive, or mixed depending on context. The mixed design analysis documented positive experiences for individuals who reported to be better prepared for consultations and treatments with information provided by more than one source. Negative experiences with physicians were reported by both women and men but the former was about quality of cancer information provided and the latter in terms of quantity.

CONCLUSIONS

A mixed methods approach allowed a deeper understanding of the role of informational support on subsequent use of health care services by individuals with cancer. Further studies may include other types of cancer and diverse background characteristics to clarify how informational support and subsequent use of health services may be jointly determined by these factors.

The impact of a multimedia informational intervention on healthcare service use among women and men newly diagnosed with cancer

This quasi-experimental longitudinal study documented the impact of a comprehensive cancer informational intervention using information technology on healthcare service use among individuals newly diagnosed with cancer. Women with breast cancer (n = 205) and men with prostate cancer (n = 45) were recruited within 8 weeks of diagnosis at 4 university teaching hospitals in Montreal, Quebec, Canada. The intervention group (n = 148) received a 1-hour training on information technology use, a CD-ROM on cancer, and a list of reputable cancer-related Web sites. The intervention material was available for a period of 8 weeks. The control group (n = 102) received usual care. Self-reported questionnaires were completed at T1 (baseline), T2 (1 week after intervention), and T3 (3 months after intervention). Using multivariate statistics, the experimental group reported significantly more satisfaction with cancer information received compared to the control group. No significant differences were found between experimental and control groups in their reliance on healthcare services. However, women as opposed to men spent more time with nurses, were more satisfied with cancer information received, and relied more heavily on health services. Future research would explore whether the latter observations reflect genuine sex differences or are more contingent on the specific cancer diagnosis.

Factors that influence cancer patients' and relatives' anxiety following a three-person medical consultation: impact of a communication skills training program for physicians

BACKGROUND

No study has yet assessed the impact of physicians' skills acquisition after a communication skills training program on changes in patients' and relatives' anxiety following a three-person medical consultation. This study aimed at comparing, in a randomized study, the impact, on patients' and relatives' anxiety, of a basic communication skills training program and the same program consolidated by consolidation workshops and at investigating physicians' communication variables associated with patients' and relatives' anxiety.

METHODS

Consultations with a cancer patient and a relative were recorded and analyzed by the Cancer Research Campaign Workshop Evaluation Manual. Patients' and relatives' anxiety were assessed with the State-Trait Anxiety Inventory-State.

RESULTS

No statistically significant change over time and between groups was observed. Mixed-effects modeling of changes in patients' and relatives' anxiety showed that decreases in both patients' and relatives' anxiety were linked with patients' and relatives' self-reported distress (p = 0.031 and 0.005), and that increases in both patients' and relatives' anxiety were linked with physicians' breaking bad news (p = 0.028 and 0.005).

CONCLUSION

No impact of the training program was observed. Results indicate the need to further study communication skills which may help reduce patients' and relatives' anxiety especially when breaking bad news.

Uncertainty of social network members in the case of communication-debilitating illness or injury

Uncertainty is a consequential aspect of chronic illness for patients as well as their family and friends, yet little research has focused on how non-ill individuals experience uncertainty about the condition of someone in their social network. Thirty-one individuals with loved ones who had a communication-debilitating illness or injury (CDI) participated in one-on-one interviews about their experiences. We analyzed transcripts for participants' sources of uncertainty and for ways that they managed the uncertainty. Participants' experiences with uncertainty included questions about the condition itself and involved the impaired communication resulting from the CDI. Participants described managing uncertainty through information seeking, changing the ways they communicated with the person with the CDI, and creating schemata to help reduce uncertainty. We discuss the findings in terms of predominant conceptualizations of uncertainty in illness and address the prevalence of communication as both a significant source of uncertainty and an important means of managing uncertainty.

Health information seeking behavior

Seeking information about one's health is increasingly documented as a key coping strategy in health-promotive activities and psychosocial adjustment to illness. In this article, the authors critically examine the scientific literature from 1982 to 2006 on the concept of health information-seeking behavior (HISB) to determine its level of maturity and clarify the concept's essential characteristics. A principle-based method of concept analysis provides the framework for exploring the nature of HISB. The authors reviewed approximately 100 published articles and five books reporting on HISB. Although HISB is a popular concept used in various contexts, most HISB definitions provide little insight into the concept's specific meanings. The authors describe the concept's characteristics, contributing to a clearer understanding of HISB, and discuss operationalizations, antecedents, and outcomes of HISB. Such an analysis of HISB might guide further theorizing on this highly relevant concept and assist health care providers in designing optimal informational interventions.

Information needs following a diagnosis of oesophageal cancer; self-perceived information needs of patients and family members compared with the perceptions of healthcare professionals: a pilot study

This pilot study was undertaken to describe patients' and family members' information needs following a diagnosis of oesophageal cancer and healthcare professionals' (HCP) perceptions concerning patients' and family members' information needs. Another aim was to describe patients' and family members' satisfaction with information provided. Data were collected by means of a self-report questionnaire. A total of 15 patients, 16 family members and 34 HCP participated. Patients and family members consider most information to be important. The high rating for information about tests/treatment and self-care means that both patients and family members consider this to be the most important areas of information. Healthcare professionals tend to underestimate both patients' and family members' needs for information. Patients and family members were only partly satisfied with the information received, with patients in general more satisfied with information given compared with family members. Patients' and family members' needs for information following a diagnosis of oesophageal cancer are substantial and have not been adequately met by HCP. A qualitative study might be helpful to complete the description of patients' and family members' needs. If a questionnaire is employed, it ought to be less extensive.