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Gaughan S, Williams M. The holistic management of malignant bowel obstruction in women with advanced ovarian cancer at end of life. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:550-555. [PMID: 37344127 DOI: 10.12968/bjon.2023.32.12.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Bowel obstruction is commonly a pre-terminal event in women with advanced ovarian cancer. Management of symptoms will often be the focus rather than surgical intervention. Determining the patient's end-of-life wishes is paramount - because the prognosis for these patients can be short, advanced care planning is key. This case study will explore the management of nausea and vomiting associated with malignant bowel obstruction and demonstrate how a patient's psychological and social wellbeing is as important as managing the physical symptoms. It will discuss how skilled and effective communication is vital early in the disease trajectory in ensuring the patient's needs are met. Additionally, by undertaking a thorough holistic needs assessment, all aspects of end-of-life care can be discussed with the patient and family, which may enable the achievement of a preferred place of care and a peaceful, dignified death. Multidisciplinary working and co-ordination of care may allow for quick interventions, meeting individual needs and symptoms being managed more effectively.
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Affiliation(s)
- Sarah Gaughan
- Macmillan Lung and Rarer Clinical Nurse Specialist and Team Lead, Buckinghamshire Hospitals NHS Trust: Aylesbury
| | - Mary Williams
- Senior Lecturer in Cancer, Palliative and End of Life Care, Buckinghamshire New University, High Wycombe
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2
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Farrington N, Richardson A, Bridges J. 'A real fine balancing act': A secondary qualitative analysis of power imbalance in comorbid cancer and dementia in an outpatient treatment setting. J Adv Nurs 2023. [PMID: 36929372 DOI: 10.1111/jan.15629] [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: 10/17/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
AIMS Studies of health services reveal a focus on provision of scheduled care at the expense of patient need, placing the health service in a position of power and the patient as passive recipient. This secondary qualitative analysis of a focused ethnography draws on the Foucauldian concept of power as pervasive and relational, to examine how an imbalance of power is manifested in situations where people with both cancer and dementia are being treated for cancer. DESIGN Secondary qualitative analysis of a focused ethnographic study. DATA SOURCES In the original study, qualitative data were gathered from observation and interviews with people with cancer and dementia (n = 2), caregivers (n = 7) and staff (n = 20). The study was conducted in the outpatient departments of two teaching hospitals in England between January 2019 and July 2021. Data from all sources were analysed for this secondary analysis using constant comparison. RESULTS The principal theme was balance, encapsulating the competing priorities involved in delivering cancer treatment. There was tension between maintaining safety and ensuring an individual's right to treatment, and difficulty reconciling the needs of the system with the needs of individuals. CONCLUSION The pervasive nature of power can be harnessed to enhance the agency of people with cancer and dementia by incorporating principles of shared decision making. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE We recommend incorporating the principles of personalized care to achieve more equitable power relations, reduce health inequalities and ensure that cancer treatment offered to people with dementia is safe and appropriate. REPORTING METHOD EQUATOR (COREQ) guidelines have been used for reporting. PATIENT OR PUBLIC CONTRIBUTION Patients and the public were involved in designing the original research questions and the study protocol including documentation such as interview topic guides and participant information sheets.
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Affiliation(s)
- Naomi Farrington
- Clinical Academic Facility, University Hospital Southampton NHSFT & University of Southampton, Southampton, UK
| | - Alison Richardson
- Clinical Academic Facility, University Hospital Southampton NHSFT & University of Southampton, Southampton, UK.,University of Southampton, Faculty of Health Sciences, Southampton, UK
| | - Jackie Bridges
- University of Southampton, Faculty of Health Sciences, Southampton, UK
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Rogers K, McCabe C, Dowling S. What are the holistic experiences of adults living long-term with the consequences of cancer and its treatment? A qualitative evidence synthesis. Eur J Oncol Nurs 2020; 50:101864. [PMID: 33220598 DOI: 10.1016/j.ejon.2020.101864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The number of people living with and beyond cancer is increasing; a significant number of these people will experience the long-term and late effects of cancer and its treatment. Research into this group has been identified as a priority to better understand healthcare needs. This review identified and synthesised qualitative research data relating to the lived experience of the consequences of cancer and its treatment. METHODS A systematic search via electronic databases was conducted in July 2019. Literature was identified that explored the experience of adults living beyond cancer from their own perspective. Thematic synthesis was used to extract and analyse data. RESULTS Six articles were reviewed. Three main themes were identified with four subthemes:1. Living with an altered sense of self; 2. Things are never going to be quite the same again (2.1. The unexpected. 2.2 The uncertain.); 3. Ways of coping with the unexpected and the uncertain. (3.1. Drawing on internal resilience. 3.2. The influence and impact of external relationships.). The findings showed that the participants' world-view changed after cancer and this affected everyday lives both positively and negatively. CONCLUSIONS The experience of having had cancer remains significant long after diagnosis and treatment, yet effective preparation and ongoing support for living beyond cancer is lacking. The experience of living long-term after cancer is characterised by an altered sense of self and has implications for long-term wellbeing. Further research should explore healthcare needs and services required to adequately meet the needs of this growing group of people.
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Affiliation(s)
- Kathy Rogers
- University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK.
| | - Candy McCabe
- University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK; Florence Nightingale Foundation, Deans Mews, Cavendish Square, London, W1G 0AN, UK; Dorothy House Hospice Care, Winsley, Bradford-On-Avon, BA15 2LE, UK.
| | - Sally Dowling
- University of the West of England, Blackberry Hill, Bristol, BS16 1DD, UK.
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An exploration of the Role of the Prostate Cancer Specialist Nurse from Two International Perspectives. Semin Oncol Nurs 2020; 36:151043. [PMID: 32718757 DOI: 10.1016/j.soncn.2020.151043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE A diagnosis of prostate cancer is a major life-changing event that brings social, psychological, physical, financial, and spiritual challenges. In both the United Kingdom (UK) and Australia, prostate cancer specialist nurses (PCSNs) have a unique role in the care of men and their families. Prostate cancer specialist nursing roles are described from the UK and Australian perspective. DATA SOURCES Government regulations, peer-reviewed journal articles, nursing society and government websites. CONCLUSION Specialist nursing roles have developed within different frameworks and in response to very different political drivers in the UK and in Australia. An evidence base has developed demonstrating that PCSNs offer positive outcomes for men and their families. Despite some differences in the scope of international roles, there are common aspects. Both health care settings have challenges in terms of education, role definition, and capacity. Yet both PCSN roles have delivered innovative models of specialist care in terms of service delivery and patient support and education. IMPLICATIONS FOR NURSING PRACTICE PCSNs have the potential to significantly decrease the burden on the public health system and influence change. For men with prostate cancer and their families, PCSNs can improve care through holistic nursing models focussing on what is important to individuals: support, education, management of side effects, rehabilitation, and by delivering and improving access to high-quality care.
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Kang KA, Choi Y. Comparison of the Spiritual Needs of Terminal Cancer Patients and Their Primary Family Caregivers. HAN'GUK HOSUP'ISU WANHWA UIRYO HAKHOE CHI = THE KOREAN JOURNAL OF HOSPICE AND PALLIATIVE CARE 2020; 23:55-70. [PMID: 37497079 PMCID: PMC10332713 DOI: 10.14475/kjhpc.2020.23.2.55] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/07/2020] [Accepted: 02/09/2020] [Indexed: 07/28/2023]
Abstract
Purpose This study was conducted to examine differences in Spiritual Interests Related to Illness Tool (SpIRIT) scores and the degree of spiritual needs (SNs) between patients with terminal cancer and their primary family caregivers and to compare spiritual needs between them. Methods The study participants were inpatients with terminal cancer and their primary family caregivers at 40 national hospice centers. The final analysis included 120 SpIRIT surveys from patients and 115 from family members, and 99 SNs questionnaires from patients and 111 from family members. Data analysis was conducted using descriptive statistics, the t-test, one-way analysis of variance, and Pearson correlation coefficients. Results There were no significant between-group differences in SpIRIT scores or SNs. The SpIRIT sub-dimensions that ranked high for both patients and primary family caregivers were "maintaining positive perspective", "loving others", and "finding meaning". The SNs sub-dimensions were ranked identically in both groups, in the order of "love and connection", "hope and peace", "meaning and purpose", respectively. In both groups, the recognition of the importance of spiritual matters and religion were major factors influencing SpIRIT scores and SNs. Conclusion The SpIRIT scores and degree of SNs of patients with terminal cancer and their primary family caregivers were found to be very closely related, and the needs for coherence and meaning were greater than religious needs. When providing spiritual care for patients with terminal illness, family members should also be considered, and their prioritization of spiritual needs and the importance of spiritual matters and religion shall be taken into account.
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Affiliation(s)
- Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Korea
| | - Youngsim Choi
- Palliative care nurse, Hospice Unit, Chungnam National University Hospital, Daejeon, Korea
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Anderson B. Bladder cancer: overview and disease management. Part 1: non-muscle-invasive bladder cancer. ACTA ACUST UNITED AC 2019; 27:S27-S37. [PMID: 29749774 DOI: 10.12968/bjon.2018.27.9.s27] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Part 1 of this two-part article provides an overview of bladder cancer and discusses its management. Since publication of a previous article entitled 'Understanding the role of smoking in the aetiology of bladder cancer' ( Anderson, 2009 ), the author has received many requests for an update. This article provides an overview of bladder cancer and its current management practices, underlining the continued role of smoking as the predominant risk factor in the disease's development. The management of bladder cancer is governed by specific guidelines. Management of non-muscle-invasive cancers, including surgical intervention with transurethral resection, and intravesical therapy using chemotherapy and immunotherapy agents, is discussed. Cystectomy (removal of the bladder), is sometimes necessary. Treatments are effective in reducing tumour recurrence, but the effects of the risks and side-effects on the individual's quality of life can be significant. The prevalence of bladder cancer, and the nature of its management make this cancer one of the most expensive for the NHS to treat. The effectiveness of health promotional strategies in increasing peoples' awareness of their risk of developing the disease, and in enabling them to change long-term health behaviours is discussed. The role of the multidisciplinary team is explored, along with that of the uro-oncology cancer nurse specialist. Part 2 will consider the management of muscle-invasive and metastatic bladder cancer.
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Affiliation(s)
- Beverley Anderson
- Macmillan Uro-oncology Clinical Nurse Specialist, Epsom and St Helier University Hospitals NHS Trust
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Le Boutillier C, Archer S, Barry C, King A, Mansfield L, Urch C. Conceptual framework for living with and beyond cancer: A systematic review and narrative synthesis. Psychooncology 2019; 28:948-959. [PMID: 30812066 PMCID: PMC6594071 DOI: 10.1002/pon.5046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The concept of living with and beyond cancer is now emerging in policy and literature. Rather than viewing this notion simply as a linear timeline, developing an agreed understanding of the lived experience of people affected by cancer will aid the development of person-centred models of care. METHODS A systematic review was conducted. The review question was "What does the term 'living with and beyond cancer' mean to people affected by cancer?" The protocol for the review was preregistered in the PROSPERO database (PROSPERO CRD42017059860). All included studies were qualitative, so narrative synthesis was used to integrate descriptions and definitions of living with and beyond cancer into an empirically based conceptual framework. RESULTS Out of 2345 papers that were identified and 180 that were reviewed, a total of 73 papers were included. The synthesis yielded three interlinked themes: Adversity (realising cancer), Restoration (readjusting life with cancer), and Compatibility (reconciling cancer), resulting in the ARC framework. CONCLUSIONS Three themes describe the experience of living with and beyond cancer: adversity, restoration, and compatibility. The ARC framework provides an empirically informed grounding for future research and practice in supportive cancer care for this population.
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Affiliation(s)
- Clair Le Boutillier
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | - Stephanie Archer
- Department of Surgery & Cancer, Faculty of MedicineImperial College LondonLondonUK
- Public Health and Primary CareUniversity of Cambridge, Strangeways Research LaboratoryCambridgeUK
| | - Claire Barry
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | - Alex King
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
| | | | - Catherine Urch
- Department of Surgery, Cardiovascular and CancerImperial College Healthcare NHS TrustLondonUK
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Briggs L, Cooper J, Cox K, Blake H. Concerns, coping and the electronic Holistic Needs Assessment: experiences of UK breast cancer survivors. J Res Nurs 2019; 25:97-110. [PMID: 34394613 DOI: 10.1177/1744987119829801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Physical and psychological concerns associated with a breast cancer diagnosis continue long after treatment. Macmillan Cancer Support developed an electronic Holistic Needs Assessment (eHNA) to help identify these concerns and allow a healthcare professional to address these as part of The Recovery Package. Aims The study aim was to understand the women's experiences of having breast cancer, and of completing Macmillan's eHNA as part of their care. Methods A qualitative approach was adopted. Semi-structured interviews were undertaken with 15 women, 12-18 months following surgical treatment for invasive breast cancer. Thematic analysis identified key themes. Results Four main themes were identified in relation to experiences of the eHNA, experiences of breast cancer, coping with breast cancer and the psychological effects of surviving. Perceptions towards the eHNA varied; some women viewed the eHNA as a research tool for hospital use rather than a beneficial aspect of their care. Several participants felt unable to raise their psychological concerns on the eHNA. Conclusions Although experiences differ, psychological issues remain a key factor for women with breast cancer, lasting long after treatment. The eHNA is not currently used to its potential or recognised by women as a tool to support their care. Further research is needed into how the eHNA can be used effectively to capture psychological concerns and determine best approaches to implementation of the tool to support individualised care.
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Affiliation(s)
- Lydia Briggs
- PhD Student, School of Health Sciences, University of Nottingham, UK
| | - Joanne Cooper
- Assistant Director of Nursing (Research, Innovation and Professional Regulation), Nottingham University Hospitals NHS Trust, UK
| | - Karen Cox
- Vice Chancellor & President, University of Kent, UK
| | - Holly Blake
- Associate Professor of Behavioural Science, Director of Postgraduate Research & Environment, School of Health Sciences, University of Nottingham, UK; NIHR Nottingham Biomedical Research Centre, UK
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Young J, Snowden A. A qualitative study on the perceived impact of using an integrated community-based supportive cancer service. Eur J Cancer Care (Engl) 2019; 28:e13001. [PMID: 30734383 DOI: 10.1111/ecc.13001] [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] [Received: 01/08/2018] [Revised: 09/24/2018] [Accepted: 01/08/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE "Improving the Cancer Journey" (ICJ) is an original, community-based, multidisciplinary service offering holistic support to people diagnosed with cancer in Scotland. It is the first service of its kind in the UK. The aim of this qualitative study was to explore the experiences of people who have used this service. METHOD Twenty service users were purposively sampled to capture a diverse range of age, sex, cancer types, and deprivation status. Semi-structured interviews explored their experiences of using ICJ. Interviews were transcribed verbatim and thematically analysed. RESULTS Thirteen women and seven men (mean age 58 years) were interviewed. Three themes were identified: "one person, one place," "routes to unexpected support" and "safety net." CONCLUSION Improving the Cancer Journey was perceived to be beneficial because it met the holistic needs of the ICJ service users. By helping people address concerns earlier rather than later, it prevented problems becoming unmanageable. Having an accessible expert to guide and support them through a range of services provided reassurance and created the space to self-manage at a time of distress. These original findings are internationally relevant because there is little evidence on the impact of holistic support services from the patient perspective.
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Paterson C, Primeau C, Nabi G. A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers. Eur J Oncol Nurs 2018; 37:65-73. [PMID: 30473053 DOI: 10.1016/j.ejon.2018.10.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 10/25/2018] [Accepted: 10/28/2018] [Indexed: 01/27/2023]
Abstract
PURPOSE Men with metastatic prostate cancer experience high levels of unmet supportive care needs in current healthcare delivery. We set out to determine the effectiveness of a multimodality supportive care (ThriverCare) intervention on the prevalence of unmet supportive care needs for men and their partner/caregivers. METHODS A prospective parallel group, pilot randomised controlled pilot trial in 4 hospitals in Scotland. 38 participants with radiologically proven metastatic prostate cancer disease and 10 partners/caregivers were recruited into the study. A two arm 1:1 study design compared the usual standard of care (SC) approach to SC plus ThriverCare intervention. The primary outcome was the Supportive Care Needs Survey at 3 months of intervention. RESULTS There was no statistical significant difference in the prevalence of unmet supportive care needs between the intervention group and the usual SC group at baseline p = 0.112, however a statistically significant difference was observed at 3 months, indicating that the prevalence of unmet supportive care needs were less in the intervention group (1.13, SD 2.5) compared to the usual SC (6.17, SD 7.05), p = 0.002. CONCLUSION ThriverCare appears to improve the supportive care experience of men with metastatic prostate cancer on hormonal treatment and their partner/caregivers. Our results accentuate that no longer one size of care delivery fits all, care must be responsive and adaptable to meet the individual needs of people affected by cancer to thrive.
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Affiliation(s)
- Catherine Paterson
- School of Nursing and Midwifery, Robert Gordon University, Garthdee, Aberdeen, AB10 7QG, United Kingdom.
| | - Charlotte Primeau
- School of Nursing and Midwifery, Robert Gordon University, Garthdee, Aberdeen, AB10 7QG, United Kingdom
| | - Ghulam Nabi
- School of Medicine, University of Dundee, Dundee, DD1 9SY, United Kingdom
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Anderson B. Bladder cancer: overview and management. Part 2: muscle-invasive and metastatic bladder cancer. ACTA ACUST UNITED AC 2018; 27:S8-S20. [DOI: 10.12968/bjon.2018.27.18.s8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Beverley Anderson
- Macmillan Uro-oncology Clinical Nurse Specialist, Epsom and St Helier University Hospitals NHS Trust
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12
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Soanes L, Gibson F. Protecting an adult identity: A grounded theory of supportive care for young adults recently diagnosed with cancer. Int J Nurs Stud 2018; 81:40-48. [DOI: 10.1016/j.ijnurstu.2018.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 12/15/2022]
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Anderson B. An insight into the patient's response to a diagnosis of urological cancer. ACTA ACUST UNITED AC 2017; 26:S4-S12. [PMID: 29034698 DOI: 10.12968/bjon.2017.26.18.s4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A cancer diagnosis and the patient's response to the news pertains to all types of cancer, however, in this article, the focus is on urological cancer. Intrinsic to the management of this patient group is the urology multidisciplinary team, in which the role of the cancer nurse specialist (CNS) is pivotal. For most people, a cancer diagnosis is arguably their worst fear. It is therefore prudent that a holistic approach is used when determining care and ensuring that appropriate support is forthcoming. This necessitates an assessment of the physical, psychological/emotional, psycho-social, spiritual and cultural components of the individual's healthcare needs, and accordingly, devising a plan of care to secure the best outcomes. This article concentrates on the psychological/emotional component. It outlines a case study of a patient's response to the consultant's question in the joint consultation clinic, examines the CNS's interpretation and understanding of the events, and her perspective on whether factors such as fear, anxiety and distress influence the individual's response to the diagnosis, their comprehension of information and the messages relayed, and consequently, their ability to manage the ensuing issues. It also looks at the support available to cancer patients following the receipt of a cancer diagnosis and its efficacy in addressing their concerns. Integral to this is effective communication, specifically the timely provision of information by health professionals.
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Affiliation(s)
- Beverley Anderson
- Macmillan Uro-Oncology Clinical Nurse Specialist, Epsom and St Helier University Hospitals NHS Trust
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Sandsund C, Towers R, Thomas K, Tigue R, Lalji A, Fernandes A, Doyle N, Jordan J, Gage H, Shaw C. Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods. BMJ Support Palliat Care 2017; 10:e16. [PMID: 28847853 PMCID: PMC7286034 DOI: 10.1136/bmjspcare-2016-001207] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 01/09/2017] [Accepted: 04/01/2017] [Indexed: 12/20/2022]
Abstract
Objectives Holistic needs assessment (HNA) and care planning are proposed to address unmet needs of people treated for cancer. We tested whether HNA and care planning by an allied health professional improved cancer-specific quality of life for women following curative treatment for stage I–III gynaecological cancer. Methods Consecutive women were invited to participate in a randomised controlled study (HNA and care planning vs usual care) at a UK cancer centre. Data were collected by questionnaire at baseline, 3 and 6 months. The outcomes were 6-month change in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (version 3), global score (primary) and, in EORTC subscales, generic quality of life and self-efficacy (secondary). The study was blinded for data management and analysis. Differences in outcomes were compared between groups. Health service utilisation and quality-adjusted life years (QALY) (from Short Form-6) were gathered for a cost-effectiveness analysis. Thematic analysis was used to interpret data from an exit interview. Results 150 women consented (75 per group); 10 undertook interviews. For 124 participants (61 intervention, 63 controls) with complete data, no statistically significant differences were seen between groups in the primary endpoint. The majority of those interviewed reported important personal gains they attributed to the intervention, which reflected trends to improvement seen in EORTC functional and symptom scales. Economic analysis suggests a 62% probability of cost-effectiveness at a £30 000/QALY threshold. Conclusion Care plan development with an allied health professional is cost-effective, acceptable and useful for some women treated for stage I–III gynaecological cancer. We recommend its introduction early in the pathway to support person-centred care.
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Affiliation(s)
- Catherine Sandsund
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Richard Towers
- Lead Nurse Counsellor, Psychological Support Services, The Royal Marsden NHS Foundation Trust, London, UK
| | - Karen Thomas
- Senior Statistician Research Data Management and Statistics Unit, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Ruth Tigue
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Amyn Lalji
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Andreia Fernandes
- Gynaeoncology Unit, Clinical Services Division, The Royal Marsden NHS Foundation Trust, London, UK
| | - Natalie Doyle
- Nurse Consultant in Living With and Beyond Cancer, The Royal Marsden NHS Foundation Trust, London, UK
| | - Jake Jordan
- Surrey Health Economics Centre, School of Economics, University of Surrey, Guildford, UK
| | - Heather Gage
- Surrey Health Economics Centre, School of Economics, University of Surrey, Guildford, UK
| | - Clare Shaw
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
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Affiliation(s)
- Claire Taylor
- Macmillan Nurse Consultant in Colorectal Cancer, London North West Healthcare
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16
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Affiliation(s)
- Paula Simpson
- Uro-Oncology Nurse Specialist, Kent and Canterbury Hospital, East Kent Hospitals University Foundation Trust
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Young J, Cund A, Renshaw M, Quigley A, Snowden A. Improving the care of cancer patients: holistic needs assessment. ACTA ACUST UNITED AC 2015; 24:S17-20. [PMID: 25723367 DOI: 10.12968/bjon.2015.24.sup4.s17] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jenny Young
- Research Assistant, Institute Health, Nursing & Midwifery, University of the West of Scotland
| | - Audrey Cund
- Lecturer, University of the West of Scotland
| | | | | | - Austyn Snowden
- Chair in Mental Health, University of the West of Scotland
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A national survey of healthcare professionals' views on models of follow-up, holistic needs assessment and survivorship care for patients with head and neck cancer. Eur J Cancer Care (Engl) 2015; 24:873-83. [DOI: 10.1111/ecc.12285] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 11/26/2022]
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