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Li ZY, Ren JY, Zhong JD, Zhang JE. Understanding the supportive care needs among discharged patients with esophageal cancer after esophagectomy: A qualitative study. Eur J Oncol Nurs 2023; 64:102337. [PMID: 37290163 DOI: 10.1016/j.ejon.2023.102337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Patients with esophageal cancer experience physical and psychosocial difficulties after surgery. Understanding their unmet supportive care needs could help medical staff in providing high quality of care. This study aimed to gain insights into the supportive care needs of discharged patients with esophageal cancer after esophagectomy. METHOD A descriptive qualitative study design was used. A purposive sample of 20 patients was studied using semi-structured interviews. The thematic analysis approach was used to analyze the data. RESULTS Four themes and 14 sub-themes emerged from the analysis: (1) symptom management needs (dysphagia, reflux, fatigue, and other symptoms), (2) dietary and nutritional needs (unclear nutrition information, eating habit change, and dining out restriction), (3) psychosocial adjustment needs (stigma, dependency, fear of recurrence, and desire for normalcy), and (4) social support needs (medical staff support, family support, and peer support). CONCLUSION Chinese patients with esophageal cancer have various unmet supportive care needs after esophagectomy. Medical professionals should recognize patients' unmet supportive care needs in time, provide professional access and practical guidance, relieve their bad mood, and fully utilize online communicating channels, such as a consulting platform or a WeChat group, for further support.
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Affiliation(s)
- Zi Yun Li
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China
| | - Jin Ying Ren
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China
| | - Jiu Di Zhong
- Department of Thoracic Oncology, Cancer Center, Sun Yat-Sen University, Dongfeng 1 Rd 651#, Guangzhou, Guangdong, PR China
| | - Jun E Zhang
- School of Nursing, Sun Yat-sen University, Zhongshan 2 Rd 74#, Guangzhou, Guangdong, PR China.
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2
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McDonnell S, Breslin T, Mascan B, Shahruddin NS, Elnour M, Fanning M, Galvin A, Moore J, Ravi N, Reynolds JV, Donohoe CL. Translating evidence in a priority setting partnership: knowledge gaps between healthcare providers and oesophageal cancer patients. Support Care Cancer 2023; 31:126. [PMID: 36680653 PMCID: PMC9860237 DOI: 10.1007/s00520-022-07523-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 11/26/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Despite the fact that health information is now more accessible than ever, knowledge gaps remain between patients and healthcare providers (HCPs). To date, the patients' need for information following a diagnosis of oesophageal cancer has not been adequately met. PURPOSE The purpose of this study was to identify why knowledge gaps exist between oesophageal cancer patients and HCPs and how to address them. METHODS Purposive sampling of a group of people living with and after oesophageal cancer who had participated in a priority-setting partnership where 45% of questions from patients had existing evidence-based answers. A 7-set question series was developed for use in a patient/HCP focus group in addition to 11 individual phone interviews with survivors of oesophageal cancer. Qualitative semistructured interviews were conducted to explore oesophageal cancer patients' access to information. The data was analysed thematically, which involved coding all patient transcripts before identifying and reviewing key themes. RESULTS The three primary themes that emerged were as follows: opportunity (HCP team factors and relationship development), ability (patient factors) and priority (pacing of information delivery). CONCLUSION Effective communication between patients and HCPs was identified as an integral component of the enhancement of patient knowledge. HCPs should continue to refine and improve methods of information delivery and encourage conversations regarding information preferences.
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Affiliation(s)
- Sarah McDonnell
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Tara Breslin
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Bianca Mascan
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Nur Shuhada Shahruddin
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mawaheb Elnour
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Michelle Fanning
- Department of Clinical Nutrition and Dietetics, Trinity St James Cancer Institute, Dublin, Ireland
| | - Anthony Galvin
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Jennifer Moore
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Narayansamy Ravi
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - John V. Reynolds
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Claire L. Donohoe
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
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3
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van de Graaf DL, Vlooswijk C, Bol N, Krahmer EJ, Bijlsma R, Kaal S, Sleeman SHE, van der Graaf WTA, Husson O, van Eenbergen MC. AYAs' online information and eHealth needs: A comparison with healthcare professionals' perceptions. Cancer Med 2022; 12:2016-2026. [PMID: 35879825 PMCID: PMC9883566 DOI: 10.1002/cam4.5048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/15/2022] [Accepted: 07/07/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) diagnosed with cancer fulfill their cancer-related information needs often via the Internet. Healthcare professionals (HCPs) have a crucial role in guiding patients in finding appropriate online information and eHealth sources, a role that is often overlooked. Misperceptions of AYAs' needs by HCPs may lead to suboptimal guidance. We aimed to examine the extent to which AYAs' online information and eHealth needs corresponded with HCPs' perceptions of these needs. METHODS Two cross-sectional online surveys (AYAs, n = 299; HCP, n = 80) on online information and eHealth needs were conducted. HCPs provided indications of their perceptions of AYA's needs. RESULTS AYAs reported significantly more online information needs compared with HCPs' perceptions regarding: survival rates (AYA = 69%, HCP = 35%, p < 0.001), treatment guidelines (AYA = 65%, HCP = 41%, p < 0.001), return of cancer (AYA = 76%, HCP = 59%, p = 0.004), "what can I do myself" (AYA = 68%, HCP = 54%, p = 0.029), and metastases (AYA = 64%, HCP = 50%, p = 0.040). Significantly more unmet eHealth needs were reported by AYAs compared with HCPs relating to access to own test results (AYA = 25, HCP = 0%, p < 0.001), request tests (AYA = 30%, HCP = 7%, p < 0.001), medical information (AYA = 22%, HCP = 0%, p = 0.001), e-consult with nurses (AYA = 30%, HCP = 10%, p < 0.001), e-consult with physicians (AYA = 38%, HCP = 13%, p = 0.001), and request prescriptions (AYA = 33%, HCP = 21%, p = 0.009). CONCLUSION AYAs' online information and eHealth needs are partially discrepant with the impression HCPs have, which could result in insufficient guidance related to AYAs' needs. AYAs and HCPs should get guidance regarding where to find optimal information in a language they understand. This may contribute to AYAs' access, understanding, and satisfaction regarding online information and eHealth.
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Affiliation(s)
- Daniëlle L. van de Graaf
- CoRPS ‐ Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands,Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Carla Vlooswijk
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Nadine Bol
- Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
| | - Emiel J. Krahmer
- Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
| | - Rhodé Bijlsma
- Department of Medical OncologyUniversity Medical CenterUtrechtThe Netherlands
| | - Suzanne Kaal
- Department of Medical OncologyRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Winette T. A. van der Graaf
- Department of Surgical OncologyNetherlands Cancer InstituteAmsterdamThe Netherlands,Department of Medical OncologyErasmus MC Cancer Institute, Erasmus MCRotterdamThe Netherlands
| | - Olga Husson
- Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamThe Netherlands,Department of Surgical OncologyErasmus MC Cancer Institute, Erasmus MCRotterdamThe Netherlands,Division of Clinical StudiesInstitute of Cancer ResearchLondonUK
| | - Mies C. van Eenbergen
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
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Flight IH, Chapman J, Harrison NJ, Bull J, Christensen C, Koczwara B, Wilson CJ. Mapping Information Needs over the Diagnosis, Treatment, and Survivorship Trajectory for Esophago-gastric Cancer Patients and Their Main Supporters: a Retrospective Survey. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:655-661. [PMID: 32876865 DOI: 10.1007/s13187-020-01862-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study reports preliminary data about the information needs of esophago-gastric cancer survivors and their supporters across diagnosis and treatment by identifying time-specific needs and whether the information provided aligned with the needs at each time point. Survivors (n = 26) and supporters (n = 15) were recruited from a public teaching hospital in South Australia. Both groups provided recall data describing personal information domain challenges at 6 clinically significant time points ranging from diagnosis to > 2 years post diagnosis. Responses were analyzed using descriptive statistics for non-normally distributed data. Needs relating to communication, tests, disease, and the physical effects information domains were consistently high across time and in groups. Supporters' overall needs were greater than those of survivors, particularly at times of high need. At times of low need, both groups reported information overload. Our results confirm that survivors and supporters require information throughout the cancer trajectory, up to 2 years after diagnosis, and supporters' needs are likely to be even greater. Results highlight the importance of timely and relevant information provision and provide a basis for the development of resources to empower survivors and supporters to identify and articulate their personal information needs. Patient navigators may provide an avenue to facilitate this approach.
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Affiliation(s)
- Ingrid H Flight
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Janine Chapman
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- National Centre for Education and Training on Addiction (NCETA), Flinders University, Bedford Park, South Australia, Australia
| | - Nathan J Harrison
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- National Centre for Education and Training on Addiction (NCETA), Flinders University, Bedford Park, South Australia, Australia
| | - Jeff Bull
- Department of Digestive Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
- College of Medicine and Public Health, Flinders University Discipline of Surgery, Bedford Park, South Australia, Australia
| | | | - Bogda Koczwara
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia
| | - Carlene J Wilson
- Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
- Olivia Newton-John Cancer Wellness Research Centre, Austin Health, Heidelberg, Victoria, Australia.
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.
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5
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Managing the Consequences of Oncological Major Surgery: A Short- and Medium-Term Skills Assessment Proposal for Patient and Caregiver through M.A.D.I.T. Methodology. Behav Sci (Basel) 2022; 12:bs12030077. [PMID: 35323396 PMCID: PMC8945744 DOI: 10.3390/bs12030077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023] Open
Abstract
The effects of cancer surgery and treatment harm patients’ life and working ability: major causes of this can be intensified by the postoperative symptoms. This study, the first part of the HEAGIS project (Health and Employment after Gastrointestinal Surgery), proposes a method to assess patients and caregivers’ competences in dealing with postoperative course and the related needs to improve the adequate competences. In this observational study, an ad hoc structured interview was conducted with 47 patients and 15 caregivers between the third and fifteenth postoperative day. Oesophageal (38%), esophagogastric junction (13%), gastric (30%), colon (8%) and rectum (11%) cancer patients were considered. Computerized textual data analysis methodology was used to identify levels of competences. Text analysis highlighted three different levels (low, medium and high) of four specific types of patients and caregivers’ competences. In particular, the overall trend of the preview of future scenarios and use of resource competences was low. Less critical were situation evaluation and preview repercussion of own actions’ competences. Caregivers’ trends were similar. The Kruskal–Wallis test did not distinguish any differences in the level of competences related to the characteristics of the participants. Patients and caregivers are not accurate in planning the future after surgery, using personal beliefs rather than referring to physicians, and not recognizing adequate resources. The medium-low competences’ trend leads to unexpected critical situations, and patients could not deal with them in a maximally effective way. Both patients and caregivers should be taken over by healthcare professionals to improve patients’ competences and make the curative surgery effective in daily life.
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6
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Hamaker ME, van Walree IC, Seghers PALN, van den Bos F, Soubeyran P, O'Hanlon S, Rostoft S. Information needs of older patients newly diagnosed with cancer. J Geriatr Oncol 2021; 13:265-272. [PMID: 34565693 DOI: 10.1016/j.jgo.2021.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/06/2021] [Accepted: 09/15/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Understanding what information patients want and need is an important step in optimizing care. Therefore, we set out to collect all available evidence about the information that is most important to older patients with a new cancer diagnosis and whether or not these information needs are sufficiently addressed. METHOD A systematic literature review of Embase and Medline. RESULTS We included eighteen studies addressing the importance of a range of information topics and studies addressing the sufficiency of information provided. On a scale from 1 to 10, patients ranked information about prognosis and the chance of cure as the most important category (median ranking 10, interquartile range (IQR) 8-10), followed by information on cancer itself (median 9, IQR 5.5-9), and treatment options (median 8, IQR 8-9). Information on side-effects of treatment (median 7, IQR 6-8), and practicalities (median 6, IQR 5-7.5) were also considered important. Patients rated information about the practicalities of treatment as the most insufficiently addressed (median 9.5), followed by self-care at home (median 9), and information about prognosis and side-effects (median 8 for both). CONCLUSION This systematic review demonstrates that information provision about the cancer itself and about treatment options is generally satisfactory to patients, while information about prognosis, practicalities of treatment and self-care at home could be improved. However, there is significant heterogeneity among older patients regarding which information is most important to them, thus requiring an ongoing dialogue between patients and health care providers about which information is most needed at any given time.
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Affiliation(s)
| | | | | | - Frederiek van den Bos
- Department of Internal Medicine, Leiden University Medical Centre, Leiden, the Netherlands
| | - Pierre Soubeyran
- Department of Oncology, Institut Bergonié, Université de Bordeaux, Bordeaux, France
| | - Shane O'Hanlon
- Department of Geriatric Medicine, St Vincent's University Hospital and University College Dublin, Dublin, Ireland
| | - Siri Rostoft
- Department of Geriatric, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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7
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Keinki C, Momberg A, Clauß K, Bozkurt G, Hertel E, Freuding M, Josfeld L, Huebner J. Effect of question prompt lists for cancer patients on communication and mental health outcomes-A systematic review. PATIENT EDUCATION AND COUNSELING 2021; 104:1335-1346. [PMID: 33593643 DOI: 10.1016/j.pec.2021.01.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 12/03/2020] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To provide a systematic review on the effects of question prompt lists (QPL) in oncological settings. METHODS A systematic literature search was conducted in Medline, PsycINFO and the Cochrane Collaboration. Randomized controlled studies (RCTs) that evaluated QPL-only interventions were included. Risk of bias of included studies was evaluated using the Cochrane RoB 2 tool. Data concerning effects on communicative processes in patient-physician relationship and psychological outcomes were analyzed. RESULTS 10 RCTs met the inclusion criteria. Results suggest that QPLs lead to a shift of topics discussed. There were weak indications that QPL interventions increase anxiety shortly before and after consultations, but may decline anxiety during follow-up. Patients consistently perceive QPLs as more helpful than usual information sheets. QPL-only interventions show limited impact on communicative processes and psychological outcomes. They help not to forget or discuss important questions. CONCLUSION With a better integration in patient-physician communication QPLs may become a useful tool for patients and physicians. Future research is needed to investigate if there is greater benefit from QPL interventions in specific settings. PRACTICE IMPLICATIONS QPLs are an inexpensive tool to influence communicative processes positively in oncological consultations.
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Affiliation(s)
- Christian Keinki
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany.
| | - Annika Momberg
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Katrin Clauß
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Gültekin Bozkurt
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Elizabeth Hertel
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Maren Freuding
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Lena Josfeld
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Jutta Huebner
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
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Lim J, Cho H, Bunds KS, Lee CW. Cancer family caregivers' quality of life and the meaning of leisure. Health Care Women Int 2020; 42:1144-1164. [PMID: 32490741 DOI: 10.1080/07399332.2020.1752214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this study, the authors examined cancer family caregivers' life experience and the meaning of leisure, focusing on their difficulties and the role of leisure. We found four main themes related to cancer family caregivers' life and leisure experiences: stressors, adapting, the need of leisure, and leisure experiences. Our results showed that the caregivers experienced high levels of psychological and physical stress and conflicts while caring for cancer patients, resulting in a poor quality of life. They believed that leisure activity is necessary and can improve their quality of life; however, they felt a sense of guilt while engaging in personal activities.
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Affiliation(s)
- Jinsun Lim
- Department of Leisure Sports Studies, Woosuk University, Wanju-Gun, South Korea
| | - Heetae Cho
- Department of Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Kyle S Bunds
- Department of Parks, Recreation and Tourism Management, North Carolina State University, Raleigh, North Carolina, USA
| | - Chul-Won Lee
- Department of Sport Industry Studies, Yonsei University, Seoul, South Korea
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9
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Larsen MK, Birkelund R, Mortensen MB, Schultz H. Being a relative on the sideline to the patient with oesophageal cancer: a qualitative study across the treatment course. Scand J Caring Sci 2020; 35:277-286. [PMID: 32271481 DOI: 10.1111/scs.12845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/19/2020] [Accepted: 03/11/2020] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- Malene Kaas Larsen
- Department of Surgery, Odense University Hospital, Odense C, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense M, Denmark
| | - Regner Birkelund
- Institute of Regional Health Research, University of Southern Denmark, Odense M, Denmark
| | - Michael Bau Mortensen
- Department of Surgery, Odense University Hospital, Odense C, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense M, Denmark
| | - Helen Schultz
- Department of Surgery, Odense University Hospital, Odense C, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense M, Denmark
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10
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Graham-Wisener L, Hanna J, Collins L, Dempster M. Psychological adjustment in patients post-curative treatment for oesophageal cancer: a longitudinal interview study. Psychol Health 2019; 34:901-921. [PMID: 30939933 DOI: 10.1080/08870446.2019.1579910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: Oesophageal cancer is an increasingly prevalent disease with a demanding post-curative treatment recovery period and sustained longer-term effects. Although post-curative treatment is a key transitionary period, the process of psychological adjustment for the individual is under-researched which limits the evidence base to inform supportive care. The aim of this study was to understand the process of adjustment for oesophageal cancer patients post-curative treatment, in particular the beliefs participants hold regarding their condition and how these are appraised against their experience. Design: Serial interviews were undertaken with six oesophageal cancer patients who have recently completed curative treatment, at baseline and at 6-month follow-up using interpretative phenomenological analysis. Results: The findings demonstrate an effortful process of adjustment, including recognising and accepting a changed self, fostering control beliefs over the course of the illness and physical sequelae, searching for meaning, developing illness coherence and moving away from self-blame. Conclusions: This study is the first to utilise a longitudinal qualitative design in oesophageal cancer, and provides an understanding of post-treatment adjustment over time for this clinical population through which to inform clinical practice and service development.
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Affiliation(s)
- Lisa Graham-Wisener
- a School of Psychology, Queen's University Belfast , Belfast , Northern Ireland
| | - Julie Hanna
- b Belfast Health and Social Care Trust , Belfast City Hospital , Belfast , Northern Ireland
| | - Louise Collins
- b Belfast Health and Social Care Trust , Belfast City Hospital , Belfast , Northern Ireland
| | - Martin Dempster
- a School of Psychology, Queen's University Belfast , Belfast , Northern Ireland
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11
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Cancer information needs according to cancer type: A content analysis of data from Japan's largest cancer information website. Prev Med Rep 2018; 12:245-252. [PMID: 30377575 PMCID: PMC6205331 DOI: 10.1016/j.pmedr.2018.10.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/15/2018] [Accepted: 10/21/2018] [Indexed: 01/05/2023] Open
Abstract
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. We examined similarities and differences in cancer information needs by tumor site. Common needs are symptoms, stages, treatment, cure, recovery, metastasis, recurrence. Site-specific needs include diet, pain, side effects, early detection, test values. Cancer information should be provided to meet frequent needs, by tumor site.
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12
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Otutaha B, Srinivasa S, Koea J. Patient information needs in upper gastrointestinal cancer: what patients and their families want to know. ANZ J Surg 2018; 89:20-24. [DOI: 10.1111/ans.14565] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/07/2018] [Accepted: 03/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Bacil Otutaha
- Department of Surgery; North Shore Hospital; Auckland New Zealand
| | - Sanket Srinivasa
- Department of Surgery; North Shore Hospital; Auckland New Zealand
| | - Jonathan Koea
- Department of Surgery; North Shore Hospital; Auckland New Zealand
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13
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Cowley A, Evans C, Bath-Hextall F, Cooper J. Patient, nursing and medical staff experiences and perceptions of the care of people with palliative esophagogastric cancer: a systematic review of the qualitative evidence. ACTA ACUST UNITED AC 2018; 14:134-166. [PMID: 27846123 DOI: 10.11124/jbisrir-2016-003168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
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.
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Affiliation(s)
- Alison Cowley
- 1Nottingham University Hospitals NHS Trust, Nottingham, UK 2School of Health Sciences, University of Nottingham 3The Nottingham Centre for Evidence-based Healthcare: a Joanna Briggs Institute Centre of Excellence, Nottingham, UK
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Graham-Wisener L, Dempster M. Peer advice giving from posttreatment to newly diagnosed esophageal cancer patients. Dis Esophagus 2017; 30:1-7. [PMID: 28859397 DOI: 10.1093/dote/dox089] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/13/2017] [Indexed: 12/11/2022]
Abstract
The benefits of peer support in cancer care include the sharing of information and experience, supporting adjustment by providing an illness trajectory which cancer patients can use to prepare for their own cancer journey. Information from peers is prioritized by esophageal cancer patients, yet the content of this experiential information is not well understood. The purpose of this study is to understand the content of peer advice giving from posttreatment to newly diagnosed esophageal cancer patients. Esophageal cancer survivors (n = 23) at median 67-months postdiagnosis completed a single open-ended survey item which asked for advice they would give to individuals newly diagnosed with esophageal cancer on how to cope emotionally with the cancer journey (including adjusting to life after treatment). Transcripts were assessed using qualitative content analysis, with five categories of advice identified: social support, psychological approach, realistic expectations, support from healthcare professionals and self-care. The categories of advice reported were distinct from information needs prioritized by clinicians. This study demonstrates that experiential information is accessible and has the potential to identify neglected information and supportive care needs, and may have a potential use in delivery of psychological support to newly diagnosed patients.
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Affiliation(s)
- L Graham-Wisener
- Marie Curie Hospice Belfast, Marie Curie Cancer Care.,School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - M Dempster
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
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Fletcher C, Flight I, Chapman J, Fennell K, Wilson C. The information needs of adult cancer survivors across the cancer continuum: A scoping review. PATIENT EDUCATION AND COUNSELING 2017; 100:383-410. [PMID: 27765377 DOI: 10.1016/j.pec.2016.10.008] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/29/2016] [Accepted: 10/08/2016] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To provide an updated synthesis of the literature that investigates the self-reported information needs of people diagnosed with cancer across the cancer continuum. METHODS We conducted a scoping review of the literature published from August 2003 to June 2015 and expanded an existing typology summarizing the information needs of people diagnosed with cancer. RESULTS The majority of the included studies (n=104) focused on questions relevant to the diagnosis/active treatment phase of the cancer continuum (52.9%) and thus the most frequently identified information needs related to this phase (33.4%). Information needs varied across the continuum and the results highlight the importance of recognising this fact. CONCLUSION People diagnosed with cancer experience discrete information needs at different points from diagnosis to survival. Much of the research conducted in this area has focused on their information needs during the diagnosis and treatment of cancer, and literature relating to information needs following completion of treatment is sparse. PRACTICE IMPLICATIONS Further research is needed to discern the specific nature of the treatment concerns and identify the information needs that survivors experience during recurrence of cancer, metastasis or changes in diagnosis, and the end of life phase of the cancer continuum.
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Affiliation(s)
- Chloe Fletcher
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia
| | - Ingrid Flight
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia.
| | - Janine Chapman
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia
| | - Kate Fennell
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia; Cancer Council SA, Adelaide, Australia
| | - Carlene Wilson
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia; Cancer Council SA, Adelaide, Australia
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Cowley A, Bath-Hextall F, Cooper J. Interventions for healthcare professionals, organizations and patients to enhance quality of life for people diagnosed with palliative esophagogastric cancer: a systematic review. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:840-852. [PMID: 28267035 DOI: 10.11124/jbisrir-2016-003108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Esophagogastric (EG) cancer is the fifth most common malignancy, and its incidence is increasing. The disease is fast paced, 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 into the most effective service models to support EG cancer patients. OBJECTIVES The overall objective of this quantitative systematic review was to establish best practice in relation to interventions targeted at healthcare professionals or the structures in which healthcare professionals deliver care (i.e. models of care and practice) and patients (diagnosed with palliative EG cancer) to enhance the quality of life for people diagnosed with palliative EG cancer. INCLUSION CRITERIA TYPES OF PARTICIPANTS The current review considered studies that included patients diagnosed with palliative EG cancer and any health professionals involved in the delivery of palliative care to this patient group in a hospital, home or community setting. TYPES OF INTERVENTION The current review considered studies that evaluated any intervention or combination of intervention strategies aimed at healthcare professionals, organizations or patients to improve quality of life for people diagnosed with palliative EG cancer. TYPES OF STUDIES The current review considered both experimental and epidemiological study designs. Studies were excluded that evaluated: screening programs, pharmacology alone, palliative oncology and palliative endoscopy. OUTCOMES The primary outcome measure was objectively measured quality of life. SEARCH STRATEGY A three-step search strategy was utilized. Sixteen databases were searched for papers from the year 2000 onward and followed by hand searching of reference lists. METHODOLOGICAL QUALITY Methodological quality was not assessed as no articles were found that met the inclusion criteria. DATA EXTRACTION Data extraction was not possible as no articles were found that met the inclusion criteria. DATA SYNTHESIS It was not possible to complete data synthesis as no articles were found that met the inclusion criteria. RESULTS Comprehensive searching and study selection process failed to identify any studies that were eligible for inclusion in the review. CONCLUSION There is currently a lack of published evidence to establish which interventions and strategies are most effective in delivering services to patients diagnosed with palliative EG cancer in terms of service structure, process and delivery.
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Affiliation(s)
- Alison Cowley
- 1Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom 2School of Health Sciences, University of Nottingham, Nottingham, United Kingdom 3The Nottingham Centre for Evidence-Based Healthcare: a Joanna Briggs Institute Centre of Excellence, University of Nottingham, Nottingham, United Kingdom
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Graham L, Wikman A. Toward improved survivorship: supportive care needs of esophageal cancer patients, a literature review. Dis Esophagus 2016; 29:1081-1089. [PMID: 26455727 DOI: 10.1111/dote.12424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The growing prevalence of esophageal cancer survivors represent a population typified by an extensive treatment regime, significant postsurgical long-term effects, and a dismal prognosis. Despite this, little is known of the supportive care needs of this patient group and the extent to which these are being met in practice. This review provides a synthesis of the research evidence to date; emphasizing opportunities for clinical application and setting a future agenda with research priorities. A literature search was performed using Medline/Embase, PsycINFO, and Web of Science. Search headings used included; [esophagus] or [esopohageal] or [upper gastrointestinal] or [upper GI] AND [cancer] or [carcinoma] or [squamous cell] AND [supportive care] or [survivorship] or [psychological] or [emotional] or [information] or [social] or [communication] or [spiritual] or [health-related-quality-of-life] or [HRQL] or [qualitative] or [patient narrative] or [clinical nurse specialist] or [CNS]. Related articles in English were reviewed, with additional articles harvested from reference sections. Esophageal cancer survivors report significant late-term effects posttreatment, encompassing sustained impairment in most areas of health-related quality of life. With a necessitated change in eating behavior, survivors find it particularly challenging to adjust to a new social identity and as a cancer population report high levels of psychological morbidity. Although the determinants of psychological morbidity are largely unknown, illness representations may be a key contributor. Several multidisciplinary supportive care interventions have been developed with promising results. The research summarized in this paper provides valuable insight into the psychosocial well-being of the esophageal cancer survivor. However, knowledge gaps remain, alongside a dearth of applied examples in meeting supportive care need.
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Affiliation(s)
- L Graham
- School of Psychology, Queen's University Belfast, Belfast, UK.,Marie Curie Cancer Care, Marie Curie Hospice Belfast, Belfast, UK
| | - A Wikman
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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Malmström M, Ivarsson B, Klefsgård R, Persson K, Jakobsson U, Johansson J. 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. Int J Nurs Stud 2016; 64:86-95. [PMID: 27701025 DOI: 10.1016/j.ijnurstu.2016.09.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/08/2016] [Accepted: 09/11/2016] [Indexed: 01/22/2023]
Abstract
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.
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Affiliation(s)
- Marlene Malmström
- Skåne University Hospital, Lund, Sweden; Department of Surgery, Skåne University Hospital, Lund, Sweden; Lund University, Sweden.
| | - Bodil Ivarsson
- Skåne University Hospital, Lund, Sweden; Lund University, Sweden; Department of Cardio-Thoracic Surgery, Skåne University Hospital, Lund, Sweden
| | | | - Kerstin Persson
- Skåne University Hospital, Lund, Sweden; Department of Surgery, Skåne University Hospital, Lund, Sweden
| | - Ulf Jakobsson
- Lund University, Sweden; Center for Primary Health Care Research, Faculty of Medicine, Lund University, Sweden
| | - Jan Johansson
- Skåne University Hospital, Lund, Sweden; Department of Surgery, Skåne University Hospital, Lund, Sweden; Lund University, Sweden
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McNair AGK, MacKichan F, Donovan JL, Brookes ST, Avery KNL, Griffin SM, Crosby T, Blazeby JM. What surgeons tell patients and what patients want to know before major cancer surgery: a qualitative study. BMC Cancer 2016; 16:258. [PMID: 27036216 PMCID: PMC4815149 DOI: 10.1186/s12885-016-2292-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 03/23/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The information surgeons impart to patients and information patients want about surgery for cancer is important but rarely examined. This study explored information provided by surgeons and patient preferences for information in consultations in which surgery for oesophageal cancer surgery was discussed. METHODS Pre-operation consultations in which oesophagectomy was discussed were studied in three United Kingdom hospitals and patients were subsequently interviewed. Consultations and interviews were audio-recorded, transcribed in full and anonymized. Interviews elicited views about the information provided by surgeons and patients' preferences for information. Thematic analysis of consultation-interview pairs was used to investigate similarities and differences in the information provided by surgeons and desired by patients. RESULTS Fifty two audio-recordings from 31 patients and 7 surgeons were obtained (25 consultations and 27 patient interviews). Six consultations were not recorded because of equipment failure and four patients declined an interview. Surgeons all provided consistent, extensive information on technical operative details and in-hospital surgical risks. Consultations rarely included discussion of the longer-term outcomes of surgery. Whilst patients accepted that information about surgery and risks was necessary, they really wanted details about long-term issues including recovery, impact on quality of life and survival. CONCLUSIONS This study demonstrated a need for surgeons to provide information of importance to patients concerning the longer term outcomes of surgery. It is proposed that "core information sets" are developed, based on surgeons' and patients' views, to use as a minimum in consultations to initiate discussion and meet information needs prior to cancer surgery.
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Affiliation(s)
- Angus G. K. McNair
- />School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS UK
- />Severn School of Surgery, Deanery House, Unit D, Vantage Office Park, Old Gloucester Road, Hambrook, Bristol, BS16 1GW UK
| | - F MacKichan
- />School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS UK
| | - J. L. Donovan
- />School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS UK
| | - S. T. Brookes
- />School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS UK
| | - K. N. L. Avery
- />School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS UK
| | - S. M. Griffin
- />Northern Oesophago-Gastric Unit, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP UK
| | - T. Crosby
- />Department of Oncology, Velindre Hospital, Whitchurch, Cardiff, CF14 2TL UK
| | - J. M. Blazeby
- />School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS UK
- />University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW UK
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Djärv T, Derogar M, Lagergren P. Influence of co-morbidity on long-term quality of life after oesophagectomy for cancer. Br J Surg 2014; 101:495-501. [PMID: 24474187 DOI: 10.1002/bjs.9417] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2013] [Indexed: 11/12/2022]
Abstract
BACKGROUND The extent to which co-morbidities affect recovery of health-related quality of life (HRQoL) in long-term survivors of oesophageal cancer surgery is poorly understood. METHODS This was a prospective, population-based, nationwide Swedish cohort study of patients who underwent surgery for oesophageal cancer between 2001 and 2005, and were alive 5 years after operation. The European Organization for Research and Treatment of Cancer QLQ-C30 and the QLQ-OES18 questionnaires were used to assess HRQoL up to 5 years after surgery. Eight aspects from the questionnaires were selected. Matched reference values from the Swedish general population were used as a proxy for HRQoL before presentation of the cancer. Adjusted multivariable linear mixed-effect models were used to assess mean score differences (MDs) of each HRQoL aspect in patients with or without co-morbidities. RESULTS Of 616 patients who underwent surgery, 153 (24·8 per cent) survived 5 years, of whom 141 (92·2 per cent) completed the questionnaires at 5 years. Among these, 79 (56·0 per cent) had co-morbidities. Patients with co-morbidity had clinically relevant (MD at least 10) and statistically significantly poorer global quality of life (MD -10, 95 per cent confidence interval -12 to -7), and more problems with dyspnoea (MD 10, 6 to 13) throughout the whole follow-up period than those without co-morbidity. Patients with co-morbidity had a clinically relevant worse level of fatigue at 6 months (MD 10, 1 to 19) and 5 years (14, 4 to 24). With regard to specific co-morbidities, only patients with diabetes reported more clinically relevant, but not statistically significant, problems with fatigue at 6 months (MD 16, 2 to 31) and 5 years (MD 13, -5 to 31) compared with patients without co-morbidity. CONCLUSION Among survivors of oesophageal cancer surgery, the presence of co-morbidity was associated with poor HRQoL over time and increasing symptoms of fatigue.
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Affiliation(s)
- T Djärv
- Unit of Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institute, Norra Stationsgatan 67, Level 2, SE-171 76, Stockholm, Sweden
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Malmström M, Klefsgård R, Johansson J, Ivarsson B. Patients' experiences of supportive care from a long-term perspective after oesophageal cancer surgery – A focus group study. Eur J Oncol Nurs 2013; 17:856-62. [DOI: 10.1016/j.ejon.2013.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 04/22/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
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McNair A, Brookes S, Kinnersley P, Blazeby J. What surgeons should tell patients with oesophago-gastric cancer: A cross sectional study of information needs. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2013; 39:1278-86. [DOI: 10.1016/j.ejso.2013.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 07/25/2013] [Accepted: 08/05/2013] [Indexed: 11/24/2022]
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Ançel G. Information needs of cancer patients: a comparison of nurses' and patients' perceptions. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:631-640. [PMID: 23007855 DOI: 10.1007/s13187-012-0416-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study aimed to identify nurses' and patients' perceptions and compare them in terms of the information needs of cancer patients. Another aim is to identify the association between the demographic and situational characteristics of patients'/nurses' and information needs. A total of 305 patients and 130 nurses participated in this descriptive and comparative study. Data was collected with a study-specific questionnaire developed for this study. Descriptive statistics, Pearson Chi-square and RIDIT analyses were used to analyze the data. Results indicated that there was incongruence between patients' and nurses' perceptions regarding information provision (p < 0.05), both congruence regarding how much information was needed (eight out of 16 information items), but also significant incongruence on the remaining items(p < 0.05). The other finding was that patients residing out of Ankara city needed to obtain more information rather than the others. No relationship was found between demographic and situational characteristics and nurses' perceptions regarding information need of patients.
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Affiliation(s)
- Gülsüm Ançel
- Ankara University Faculty of Health Sciences, Aktaş Kavşağı, Plevne Cad. Şükriye Mah.No.5, 06340, Ankara, Turkey.
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Henselmans I, Jacobs M, van Berge Henegouwen MI, de Haes HCJM, Sprangers MAG, Smets EMA. Postoperative information needs and communication barriers of esophageal cancer patients. PATIENT EDUCATION AND COUNSELING 2012; 88:138-146. [PMID: 22244819 DOI: 10.1016/j.pec.2011.12.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 11/24/2011] [Accepted: 12/11/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Given the poor prognosis of esophageal cancer and the impact of surgery on health-related quality of life (HRQL), addressing patients' postoperative information needs is important. This study aimed to examine (1) the content and type of patients' information needs and (2) patient perceived facilitators and barriers to patient participation. METHODS Interviews were conducted with 20 purposefully selected esophageal cancer patients. Open and structured questions were alternated. The transcribed interviews were analysed inductively and deductively, using MAXqda. RESULTS Patients' post-operative information needs concerned HRQL, medical care and prognosis, covering several sub-domains. Different types of needs were identified, e.g., requests for information about cause, course and self-management. Barriers to patient participation mostly reflected beliefs and skills, and could be categorized into agenda and communication barriers. Facilitators of patient participation reflected physician, patient and interaction characteristics, companion support and pre-visit preparation. Many patients saw merit in pre-visit preparation interventions; few endorsed skill-building interventions. CONCLUSION This study listed the postoperative information needs of esophageal cancer patients. Moreover, it gained insight into patient-perceived barriers and facilitators of patient participation. PRACTICE IMPLICATIONS The findings demonstrate what information physicians should have available and informs interventions to support patients in meeting their information needs.
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Affiliation(s)
- Inge Henselmans
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, The Netherlands.
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Abstract
Esophageal cancer is an aggressive and physically and emotionally devastating disease. It has one of the poorest survival rates among all malignant tumors, mainly due to late symptom presentation and early metastatic dissemination. Cure is possible through extensive surgery, typically followed by a long recovery period, affecting general well-being, as well as basic aspects of life, such as eating, drinking and socializing. Health-related quality of life (HRQL) is a multidimensional concept assessing symptoms and functions related to a disease or its treatment from the patient's perspective. HRQL is a fundamental part of treatment in surgical oncology, particularly in esophageal cancer. This review assesses the scientific data regarding some HRQL aspects after esophageal cancer surgery, for example, postoperative recovery time, determinants of postoperative HRQL and long-term HRQL.
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Affiliation(s)
- Therese Djärv
- Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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WITTMANN E, BEATON C, LEWIS W, HOPPER A, ZAMAWI F, JACKSON C, DAVE B, BOWEN R, WILLACOMBE A, BLACKSHAW G, CROSBY T. Comparison of patients' needs and doctors' perceptions of information requirements related to a diagnosis of oesophageal or gastric cancer. Eur J Cancer Care (Engl) 2011; 20:187-95. [DOI: 10.1111/j.1365-2354.2009.01169.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McCarthy B. Family members of patients with cancer: what they know, how they know and what they want to know. Eur J Oncol Nurs 2010; 15:428-41. [PMID: 21094087 DOI: 10.1016/j.ejon.2010.10.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 10/18/2010] [Accepted: 10/21/2010] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Bridie McCarthy
- School of Nursing & Midwifery, University College Cork, Cork, Ireland.
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Prevalence and Correlates of Supportive Care Needs in Oral Cancer Patients With and Without Anxiety During the Diagnostic Period. Cancer Nurs 2010; 33:280-9. [DOI: 10.1097/ncc.0b013e3181d0b5ef] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on depressive symptoms of the caregivers of children with leukemia. J Clin Psychol Med Settings 2010; 17:23-30. [PMID: 19898925 DOI: 10.1007/s10880-009-9177-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The present study examined the effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on the depressive symptoms of the caregivers of children with leukemia. The sample was composed of 71 caregivers of children with leukemia living in Turkey. The obtained data were analyzed by path analysis. The results show that caregivers of children with leukemia experience higher levels of depressive symptoms when they have negative illness representation and lower levels of depressive symptoms when they perceive higher levels of social support. Moreover, they perceive higher social support when they perceive high quality of information provided by health-care professionals. It can be suggested that intervention programs which aim to increase caregivers' social support and change their illness representation in a positive way would be helpful for the caregivers showing depressive symptoms.
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Adams E, Boulton M, Watson E. The information needs of partners and family members of cancer patients: a systematic literature review. PATIENT EDUCATION AND COUNSELING 2009; 77:179-186. [PMID: 19406609 DOI: 10.1016/j.pec.2009.03.027] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Revised: 01/30/2009] [Accepted: 03/23/2009] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This review examined the extent to which the information needs of partners and family members of cancer patients has been addressed in the literature. METHODS We conducted a systematic search of four databases for papers published between 1998 and 2008 which assessed the information needs of partners and/or family members of adult cancer patients. RESULTS Thirty-two papers were included in the review. Eleven categories of information need were identified. There was a predominant focus on breast or prostate cancer, leaving a knowledge gap in relation to other cancers. Few papers moved beyond the diagnosis and initial treatment phase, and most did not distinguish between met and unmet needs. Those that did, indicated that partners/family members are more likely to have unmet needs for information about supportive care than for medical information. The concept of 'information need' was generally poorly developed and theorised in the papers. CONCLUSION Establishing the information needs of partners and family members of cancer patients is an important, but as yet neglected, area of research. In order to develop our understanding of this area more empirical research, with sound conceptual and theoretical foundations is required.
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Affiliation(s)
- Eike Adams
- Oxford Brookes University, School of Health and Social Care, Oxford, UK.
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Chen SC, Lai YH, Liao CT, Chang JTC, Lin CC. Unmet information needs and preferences in newly diagnosed and surgically treated oral cavity cancer patients. Oral Oncol 2009; 45:946-52. [DOI: 10.1016/j.oraloncology.2009.06.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Revised: 06/03/2009] [Accepted: 06/04/2009] [Indexed: 11/28/2022]
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Choi Y, Dodd V, Watson J, Tomar SL, Logan HL, Edwards H. Perspectives of African Americans and dentists concerning dentist-patient communication on oral cancer screening. PATIENT EDUCATION AND COUNSELING 2008; 71:41-51. [PMID: 18242933 DOI: 10.1016/j.pec.2007.11.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2007] [Revised: 10/08/2007] [Accepted: 11/14/2007] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Mortality rates for oral cancer have not improved appreciably in decades, with Blacks less likely than others to survive 5-years post-treatment. Oral cancer is the fifth most common cancer among African American males, representing a pressing public health concern. This study compared how dentists and African American adults view the current state of dentist-patient communication regarding oral cancer and its detection. METHODS Five focus groups with 56 African American adults and two focus groups with 17 dentists were conducted in order to compare responses regarding oral cancer information needs and dentist-patient communication on oral cancer screening. RESULTS African American adults showed little knowledge about oral cancer and cancer screening, and great need for information. However, dentists reported rarely engaging in information exchange with their patients even while performing the examination. CONCLUSION African Americans' request for screening information and dentists' reticence about performing the screening and initiating communication with patients indicate a need for both public education on oral cancer and improved continuing education courses for dentists. PRACTICE IMPLICATIONS The dental care community should develop clear guidelines for communicating with patients about oral cancer and engage in continuing education on oral cancer screening procedure. Increased public health efforts aimed at increasing oral cancer awareness and knowledge among the public are warranted.
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Affiliation(s)
- Youjin Choi
- College of Journalism and Communications, University of Florida, Department of Health Education & Behavior, Gainesville, FL 32611-8400, USA.
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