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  • Efverman, Anna, et al. (author)
  • Observing the Implementation of Shared Decision-making in Routine Radiotherapy Cancer Nursing : An Explorative Longitudinal Questionnaire Study
  • 2021
  • In: Cancer Nursing. - : Wolters Kluwer. - 0162-220X .- 1538-9804. ; 44:5, s. 369-377
  • Journal article (peer-reviewed)abstract
    • BackgroundHealthcare professionals have driven decision-making in the past. However, shared decision-making has the potential to increase quality of care.ObjectiveTo determine to what degree patients undergoing routine pelvic radiotherapy care perceive decision-making as being shared between patient and healthcare professionals.MethodsThis exploratory longitudinal study covered 193 patients undergoing pelvic radiotherapy, mostly women (n = 161 [84%]) treated for a gynecological (n = 132 [68%]) or colorectal (n = 54 [28%]) cancer. We collected data regarding self-perceived level of shared decision-making at the start of radiotherapy and quality of life (QoL) (91%–95% response rate per week) during the radiotherapy period.ResultsThe patients reported that they shared the decision-making with the healthcare professionals much (n = 137 [71%]), moderately (n = 33 [17%]), a little (n = 12 [6%]), or not at all (n = 11 [6%]). Male patients (P = .048), patients who did not live with their partner (P = .034), patients with higher education (P = .043), and patients with low functional capacity (P = .018) perceived lower levels of shared decision-making. A higher level of shared decision-making was related to higher QoL at baseline and during the first to third weeks of radiotherapy (P ranged from .001 to .044).ConclusionsAlmost 9 of 10 patients reported that they shared the decision-making moderately or much with the healthcare professionals. The study identified subgroups perceiving lower levels of shared decision-making and found that a higher level of shared decision-making was related to better QoL.ImplicationsHealthcare professionals may need to pay extra attention to patients who may perceive that they share decision-making to a low extent.This study was supported by the Swedish Cancer Society, the Vårdal Institute, the Cancer Rehabilitation Foundation, the County Council of Östergötland, and Linköping University, Sweden. 
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2.
  • Enblom, Anna, et al. (author)
  • One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient
  • 2009
  • In: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 17:1, s. 23-32
  • Journal article (peer-reviewed)abstract
    • Objective: To describe the prevalence of nausea and vomiting during radiotherapy and to compare quality of life, psychological and functional status in patients experiencing or not experiencing nausea.Materials and methods: A cross-sectional selection of 368 cancer patients treated with radiotherapy answered a questionnaire (=93% answering rate) regarding nausea, vomiting, actual use of and interest in antiemetic treatment, quality of life and psychological and functional status during the preceding week of radiotherapy. Mean age was 60 years and 66% were women.Main results: Nausea was experienced by 39% ( 145) and vomiting by 7% ( 28) of patients in general, by 63% in abdominal or pelvic fields and by 48% in head/neck/brain fields. Abdominal/pelvic field (Relative risk (RR) 2.0), age <= 40 years (RR 1.9) and previous nausea in other situations (RR 1.8) implied an increased risk for nausea. Antiemetics were used by 17% and 78% were interested in or wanted more information about acupuncture treatment against nausea. Of the 145 nauseous patients only 25% felt that antiemetics had helped them and 34% would have liked additional treatment, although the nausea intensity was mild in 72%. The nauseous patients reported lower well-being and quality of life, lower satisfaction with aspects of daily living and more frequent anxiety and depressed mood than the patients without nausea.Conclusions: Of all patients undergoing radiotherapy, 39% experienced nausea and one third of them would have liked more treatment against the nausea. This study stresses the importance to identify and adequately treat patients with increased risk for nausea related to radiotherapy.
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