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- Charalambous, Andreas, et al.
(author)
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Hospitalized Cancer Patients' Perceptions of Individualized Nursing Care in Four European Countries
- 2015
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In: Cancer Nursing. - 0162-220X .- 1538-9804. ; 38:4S
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Journal article (peer-reviewed)abstract
- As patients are different, only one way of delivering care is neither appropriate nor efficient. Care needs to be tailored according to individual characteristics in more general and extents to include individualized nursing care. Individualized care has a positive impact on patient outcomes and is therefore worth of studies and implementation in clinical practice. The aim of this study was to describe and compare hospitalized cancer patients' perceptions of individualized care, controlled by their socio-demographic characteristics, in four European countries. The quality of individualized nursing care was represented by hospitalized patients' perceptions of the (1) nurses' support of individuality and (2) receipt of individuality as measured by the two-part Individualized Care Scale (ICS). Patients' socio-demographic characteristicsincluded education, age, gender, type of hospital admission, previous hospitalization, and hospital length of stay. Data (n=599) were collected in Cyprus (n=150), Finland (n=158), Greece (n=150) and Sweden (n=141). Multivariate analysis of variance models were constructed. The main effect of country on perceptions of individualized care was analyzed using socio-demographic characteristics as covariates. The level of support of individuality was reported as moderate and receipt of individuality on care as good. The assessments were generally the highest by the respondents in Sweden and the lowest in Greece. Shortcomings in the individualized nursing care were found based on patients' assessments. This study revealed some between-country differences in patients' perceptions of care individualization, controlled by the sample characteristics, and allows the researcher to further analyze the possible reasons for these differences whether conceptual, differences due to the education, clinical practice or organization of nursing care and services
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2. |
- Drott, Jenny, 1976-, et al.
(author)
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Oxaliplatin-Induced Neurotoxic Side Effects and Their Impact on Daily Activities
- 2019
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In: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 42:6, s. E40-E48
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Journal article (peer-reviewed)abstract
- Background: Oxaliplatin (OXA) is frequently used in the treatment of patients with colorectal cancer, and OXA-induced neurotoxic side effects are common. Reports on real-time patient-reported neurotoxic side effects and impact on the patient's daily activities are sparse in existing studies. Objective: The aim of this study was to identify and assess patient-reported OXA-induced neurotoxic side effects and their impact on the patient's daily activities, during and after chemotherapy. Methods: In a multicenter prospective longitudinal study, 46 chemo-naïve patients with colorectal cancer treated with postoperative adjuvant OXA-based chemotherapy were monitored during treatment and at 3-, 6-, 9-, and 12-month follow-ups. Patients were recruited from September 2013 to June 2016. In total, 370 Oxaliplatin-Associated Neurotoxicity Questionnaire responses were available for analysis. A mobile phone-based system was used to receive real-time assessments. Results: All patients reported neurotoxic side effects and impact on daily activities during treatment. The side effects changed in character and body location over time and had an impact on the daily activities. Conclusions: The high prevalence of OXA-induced neurotoxic side effects significantly interfered with the patients' daily activities. We found significant differences between baseline data and follow-up time points for neurotoxicity, and the patients had not returned to baseline after 1 year. Implications for Practice: The real-time assessment using mobile phone technology seems to be a valuable tool for monitoring patient-reported neurotoxicity and interventions for tailored care. Effectively identifying neurotoxicity and its impact on the patient's daily activities is important in supportive cancer care.
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3. |
- Hauffman, Anna, et al.
(author)
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The development of a Nurse-led Internet-based Learning and Self-care program for cancer patients with symptoms of anxiety and depression : a part of U-CARE
- 2017
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In: Cancer Nursing. - 0162-220X .- 1538-9804. ; 40:5, s. E9-E16
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Journal article (peer-reviewed)abstract
- BACKGROUND:Having access to information about the disease and being encouraged to participate in self-care activities may reduce anxiety and depression symptoms in cancer patients. Internet-based interventions may be one way to support effective self-care strategies to improve emotional well-being and health-related quality of life.OBJECTIVE:The aim of this study was to describe the development and acceptance of an Internet-based program intended to support cancer patients with anxiety and depression symptoms.METHODS:A structured collaboration between patients, clinicians, and researchers was used to develop a theory- and evidence-based interactive health communication application (IHCA) based on Orem's self-care deficit nursing theory with influences from Bandura's social learning theory and psychoeducation.RESULTS:The result is an IHCA described as a Nurse-led, Internet-based Learning and Self-care program that helps patients to perform self-care using different types of material in interaction with patients and healthcare staff. The acceptance of the program is consistent with the results of similar studies.CONCLUSIONS:Collaboration between patients, clinicians, and researchers seems to be a fruitful approach in the development of an IHCA aiming to support cancer patients' self-care strategies. Well-designed intervention studies are needed to evaluate the effects of the IHCA.IMPLICATIONS FOR PRACTICE:This article suggests a theoretical foundation for an IHCA and allows researchers and healthcare providers to take part in the discussion regarding format and content of IHCAs.
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4. |
- Hellerstedt-Börjesson, Susanne, et al.
(author)
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Women Treated for Breast Cancer Experiences of Chemotherapy-Induced Pain Memories, Any Present Pain, and Future Reflections
- 2016
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In: Cancer Nursing. - 0162-220X .- 1538-9804. ; 39:6, s. 464-472
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Journal article (peer-reviewed)abstract
- Background: Breast cancer survivors make up a growing population facing treatment that poses long-standing adverse effects including chemotherapy-related body function changes and/or pain. There is limited knowledge of patients' lived experiences of chemotherapy-induced pain (CHIP). Objective: The aim of this study was to explore CHIP and any long-standing pain experiences in the lifeworld of breast cancer survivors. Methods: Fifteen women participated in a follow-up interview a year after having experienced CHIP. They were interviewed from a lifeworld perspective; the interviews were analyzed through guided phenomenology reflection. Results: A past perspective: CHIP is often described in metaphors, leads to changes in a patient's lifeworld, and impacts lived time. The women become entirely dependent on others but at the same time feel isolated and alone. Existential pain was experienced as increased vulnerability. Present perspective: Pain engages same parts of the body, but at a lower intensity than during CHIP. The pain creates time awareness. Expected normality in relationships/daily life has not yet been achieved, and a painful existence emerges in-between health and illness. Future perspective: There are expectations of pain continuing, and there is insecurity regarding whom to turn to in such cases. A painful awareness emerges about one's own and others' fragile existence. Conclusions: Experiencing CHIP can impact the lifeworld of women with a history of breast cancer. After CHIP, there are continued experiences of pain that trigger insecurity about whether one is healthy. Implications for Practice: Cancer survivors would likely benefit from communication and information about and evaluation of CHIP.
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5. |
- Hellerstedt-Börjesson, Susanne, et al.
(author)
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Women With Breast Cancer : Experience of Chemotherapy-Induced Pain: Triangulation of Methods
- 2015
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In: Cancer Nursing. - 0162-220X .- 1538-9804. ; 38:1, s. 31-39
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Journal article (peer-reviewed)abstract
- BACKGROUNDChemotherapy treatment for cancer diseases can cause body pain during adjuvant therapy.OBJECTIVEThe aim was to describe the perceived impact of adjuvant chemotherapy-induced pain (CHIP) on the daily lives of women with newly diagnosed breast cancer, using triangulation.METHODFifty-seven women scheduled for chemotherapy in doses of 75 mg/m2 or greater of epirubicin and/or docetaxel participated. Twenty-two of these women registered pain with values of 4 or more on the visual analog scale on day 10 following chemotherapy. Of these 22, 16 participated in an interview and colored a printed body image. A qualitative thematic stepwise analysis of the interviews was performed.RESULTSChemotherapy-induced pain had a profound impact on daily life. Ten women reported the worst possible pain, with visual analog scale scores of 8 to 10. Three different categories crystallized: perception (A) of manageable pain, which allowed the women to maintain their daily lives; perception (B) of pain beyond imagination, whereby the impact of pain had become more complex; and perception (C) of crippling pain, challenging the women's confidence in survival.CONCLUSIONSThe findings highlight the inability to capture CHIP with 1 method only; it is thus necessary to use complimentary methods to capture pain. We found that pain had a considerable impact on daily life, with surprisingly high scores of perceived pain, findings that to date have been poorly investigated qualitatively.IMPLICATIONS FOR PRACTICENurses need to (1) better identify, understand and treat CHIP, using instruments and protocols; and (2) provide improved communication about pain and pain management.
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7. |
- Holm, M., et al.
(author)
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Characteristics of the Family Caregivers Who Did Not Benefit From a Successful Psychoeducational Group Intervention During Palliative Cancer Care A Prospective Correlational Study
- 2017
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In: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 40:1, s. 76-83
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Journal article (peer-reviewed)abstract
- Background: Although there has been a steady increase in intervention studies aimed toward supporting family caregivers in palliative cancer care, they often report modest effect sizes and there is a lack of knowledge about possible barriers to intervention effectiveness. Objective: The aim of this study is to explore the characteristics of family caregivers who did not benefit from a successful psychoeducational group intervention compared with the characteristics of those who did. Intervention/Methods: A psychoeducational intervention for family caregivers was delivered at 10 palliative settings in Sweden. Questionnaires were used to collect data at baseline and following the intervention. The Preparedness for Caregiving Scale was the main outcome for the study and was used to decide whether or not the family caregiver had benefited from the intervention (Preparedness for Caregiving Scale difference score <= 0 vs >= 1). Results: A total of 82 family caregivers completed the intervention and follow-up. Caregivers who did not benefit from the intervention had significantly higher ratings of their preparedness and competence for caregiving and their health at baseline compared with the group who benefited. They also experienced lower levels of environmental burden and a trend toward fewer symptoms of depression. Conclusions: Family caregivers who did not benefit from the intervention tended to be less vulnerable at baseline. Hence, the potential to improve their ratings was smaller than for the group who did benefit. Implications for Practice: Determining family caregivers in cancer and palliative care who are more likely to benefit from an intervention needs to be explored further in research.
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8. |
- Holm, Maja, et al.
(author)
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Characteristics of the Family Caregivers Who Did Not Benefit From a Successful Psychoeducational Group Intervention During Palliative Cancer Care A Prospective Correlational Study
- 2017
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In: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 40:1, s. 76-83
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Journal article (peer-reviewed)abstract
- Background: Although there has been a steady increase in intervention studies aimed toward supporting family caregivers in palliative cancer care, they often report modest effect sizes and there is a lack of knowledge about possible barriers to intervention effectiveness. Objective: The aim of this study is to explore the characteristics of family caregivers who did not benefit from a successful psychoeducational group intervention compared with the characteristics of those who did. Intervention/Methods: A psychoeducational intervention for family caregivers was delivered at 10 palliative settings in Sweden. Questionnaires were used to collect data at baseline and following the intervention. The Preparedness for Caregiving Scale was the main outcome for the study and was used to decide whether or not the family caregiver had benefited from the intervention (Preparedness for Caregiving Scale difference score <= 0 vs >= 1). Results: A total of 82 family caregivers completed the intervention and follow-up. Caregivers who did not benefit from the intervention had significantly higher ratings of their preparedness and competence for caregiving and their health at baseline compared with the group who benefited. They also experienced lower levels of environmental burden and a trend toward fewer symptoms of depression. Conclusions: Family caregivers who did not benefit from the intervention tended to be less vulnerable at baseline. Hence, the potential to improve their ratings was smaller than for the group who did benefit. Implications for Practice: Determining family caregivers in cancer and palliative care who are more likely to benefit from an intervention needs to be explored further in research.
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9. |
- Högberg, Karin, et al.
(author)
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The meaning of web-based communication for support: From the patients' perspective within a hematological healthcare setting
- 2015
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In: Cancer Nursing. - 0162-220X .- 1538-9804. ; 38:2, s. 145-154
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Journal article (peer-reviewed)abstract
- BACKGROUND:Being critically ill with a hematological disease is a challenge, sometimes causing a need for support in the adjustment to the stressful life situation. By providing Web-based communication for support from a nurse, patients get access to an alternative and untraditional way to communicate their issues.OBJECTIVE:The aim was to describe the meaning of using Web-based communication for support from a patient perspective.METHODS:A comprehensive randomized pilot study (n = 30) was conducted, allowing 15 patients in the experimental group to have access to the Web-based communication, to evaluate feasibility. Of these 15 participants, 10 were interviewed, focusing on their experiences. An empirical hermeneutical approach was used and the interpretive analysis focused on the meanings.RESULTS:Web-based communication for support means a space for patients to have their say, consolidation of a matter, an extended caring relationship, access to individual medical assessment, and an opportunity for emotional processing. The main interpretation indicates that the patient's influence on the communication strengthens according to the asynchronous, faceless, and written communication. The increased, and in some sense constant, access to an individual medical and caring assessment, in turn, implies a feeling of safety.CONCLUSION:Web-based communication for support seems to have the potential to enhance patients' participation on their own terms.IMPLICATIONS FOR PRACTICE:To achieve the possible advantages of Web-based communication for support, nurses must acquire knowledge about caring writing. It requires respect for the patient and articulated accuracy and attention in the response given.
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10. |
- Högberg, Karin, et al.
(author)
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The meaning of web-based support : from the patients' perspective within a hematological healthcare setting.
- 2015
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In: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 38:2, s. 145-154
-
Journal article (peer-reviewed)abstract
- Background: Being critically ill with a hematological disease is a challenge, sometimes causing a need for support in the adjustment to the stressful life situation. By providing Web-based communication for support from a nurse, patients get access to an alternative and untraditional way to communicate their issues. Objective: The aim was to describe the meaning of using Web-based communication for support from a patient perspective. Methods: A comprehensive randomized pilot study (n = 30) was conducted, allowing 15 patients in the experimental group to have access to the Web-based communication, to evaluate feasibility. Of these 15 participants, 10 were interviewed, focusing on their experiences. An empirical hermeneutical approach was used and the interpretive analysis focused on the meanings. Results: Web-based communication for support means a space for patients to have their say, consolidation of a matter, an extended caring relationship, access to individual medical assessment, and an opportunity for emotional processing. The main interpretation indicates that the patient's influence on the communication strengthens according to the asynchronous, faceless, and written communication. The increased, and in some sense constant, access to an individual medical and caring assessment, in turn, implies a feeling of safety. Conclusion: Web-based communication for support seems to have the potential to enhance patients' participation on their own terms. Implications for Practice: To achieve the possible advantages of Web-based communication for support, nurses must acquire knowledge about caring writing. It requires respect for the patient and articulated accuracy and attention in the response given.
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11. |
- Oksholm, Trine, et al.
(author)
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Transfer Between Hospitals Is a Risk Situation for Patients After Lung Cancer Surgery
- 2018
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In: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 41:3, s. E49-E55
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Journal article (peer-reviewed)abstract
- BACKGROUND: Patients with lung cancer often undergo surgery shortly after diagnosis. Despite undergoing extensive operation, many patients are transferred to a local hospital a few days after surgery. Transitions between different levels of care are risky due to common medication and follow-up errors.OBJECTIVE: The study purpose was to explore patients' experiences of transfer between hospitals after lung cancer surgery. The study aim was to improve the quality of transitional care.METHODS: In-depth interviews with 14 patients with lung cancer (6 men, 8 women) were conducted in the patients' homes. Interviews were audiotaped, transcribed, and analyzed using the hermeneutic analysis method.RESULTS: Patients' experience of transfer between hospitals after lung cancer surgery is one of being in a caregiver gap characterized by feeling unprepared and uncertain, feeling unprotected and not being cared for, and suffering because of inadequate organization. Patients are vulnerable and at risk of injury before and during transfer, as well as after arrival at local hospitals.CONCLUSIONS: Study findings highlight a rarely considered risk of inadequate care before, during, and after hospital transfer of vulnerable patients. Transition between hospitals after lung cancer surgery is a part of patient care for which there are no policies or care plans and a time during which the borders of responsibility between caregivers are unclear.IMPLICATIONS FOR PRACTICE: It is important to develop guidelines for clearly defined responsibilities during transfer between hospitals. Healthcare providers need to plan transfers with the same rigor as they do hospital care.
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12. |
- Olsson, Cecilia, 1971-, et al.
(author)
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Patients Treated for Hematologic Malignancies : Affected Sexuality and Health Related Quality of Life
- 2015
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In: Cancer Nursing. - : Wolters Kluwer. - 0162-220X .- 1538-9804. ; 38:2, s. 99-110
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Journal article (peer-reviewed)abstract
- Background: Sexuality in relation to Health- Related Quality of Life (HRQoL) is mostly studied with younger patients as participants who have undergone bone marrow transplantation and concerns fertility and/or sexual function. However, patients with hematologic malignancies such as DLBCL, CLL or AML most often are above their fifties and are treated with chemo- or chemoimmunotherapy.Objective: The aim was to examine how sexuality and HRQoL was affected in patients with hematologic malignancies, at baseline compared to one month after chemo- or chemoimmunotherapy.Methods: Data were collected twice with a longitudinal design, using The Sexual Adjustment Questionnaire - S and EORTC QLQ C30.Results: Thirty-two patients responded. The importance of sexuality, sexual desire and sexual ability decreased one month after treatment and distressing symptoms such as feelings of tiredness occurred more frequently, compared to baseline. At the same time improvement in Global health status/QoL as well as affected functions in HRQoL was reported.Conclusion: The findings are of significance for nurses in cancer care as it highlights that sexuality and HRQoL needs to be considered also in older patients with hematologic malignancies when fertility issues are of less importance. Implication for practice:In order to meet these patients’ needs regarding sexuality and HRQoL the care must provide greater consistency and continuity. One way is to organize the care in a patient-centered way where patients continuously meet a nurse guided by the idea of holistic individual nursing care throughout the care trajectory.
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13. |
- Pascoe, Elizabeth C., et al.
(author)
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Psychological Characteristics and Traits for Finding Benefit From Prostate Cancer Correlates and Predictors
- 2016
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In: Cancer Nursing. - 0162-220X .- 1538-9804. ; 39:6, s. 446-454
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Journal article (peer-reviewed)abstract
- Background: Although beginning evidence suggests that the capacity to derive benefit from cancer-associated experiences may be influenced by some individual psychological characteristics and traits, little is known about predictors for finding benefit from prostate cancer.Objective: The aim of this study was to explore the correlates and predictors for finding benefit from prostate cancer among a sample of men undergoing androgen deprivation.Methods: Pearson correlation and multiple linear regression modeling were performed on data collected in an acute tertiary hospital outpatient setting (N = 209) between July 2011 and December 2013 to determine correlates and predictors for finding benefit from prostate cancer.Results: Multiple linear regression modeling showed that while the 6 predictors of self-reported coping, depression, anxiety, distress, resilience, and hope explained 38% of the variance in finding benefit, coping provided the strongest and statistically significant predictive contribution.Conclusions: Self-reported coping was strongly predictive of finding benefit from prostate cancer, but questions remain about if subtypes of coping strategies can be more or less predictive of finding benefit. Self-reported levels of depression, anxiety, distress, resilience, and hope had a less predictive and nonsignificant role in finding benefit from prostate cancer and raise questions about their function in this subpopulation.Implications for Practice: The findings suggest that coping strategies can maximize finding benefit from prostate cancer. Knowledge of influential coping strategies for finding benefit from prostate cancer can be immensely valuable to support men in rebuilding positive meaning amid a changed illness reality. Developing practice initiatives that foster positive meaning-making coping strategies seems valuable.
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14. |
- Schildmeijer, Kristina, 1959-, et al.
(author)
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Not a straight line : patient's experiences of prostate cancer and their journey through the healthcare system
- 2019
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In: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 42:1, s. E36-E43
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Journal article (peer-reviewed)abstract
- BackgroundCancer and its treatment can severely impact quality of life, giving rise to complex needs with respect to follow-up care. To support patient needs and increase efficiency of care with limited resources, the Swedish government has launched national reforms to redesign cancer care pathways.ObjectiveThe aim of this study was to explore how prostate cancer patients experience their journey through the healthcare system when their care is provided according to the standardized care pathway, as described in healthcare policy documents.MethodsA qualitative, descriptive approach with individual interviews was used. A template of a standardized prostate cancer pathway, created together with healthcare professionals, was used during interviews. Fourteen interviews were conducted with prostate cancer patients all operated on at a midsized hospital in southeast Sweden between October 2015 and April 2016. The interviews were analyzed with qualitative content analysis and illustrated in a patient journey map.ResultsWe identified an overall theme, “walking a tightrope,” consisting of 4 categories: “waiting,” “becoming familiar with a troublesome body,” “adjusting to a different life,” and “information challenges.”ConclusionsThe clinical implementation of the standardized care pathway is described as a straight path through care, but patients described their experiences as walking a tightrope. Lack of information, especially about cancer treatment and its adverse effects, was the most common experience.Implications for PracticeOur findings indicate areas where further healthcare tools could improve patient experiences of cancer treatment. This could include offering individualized information and tools to increase patient empowerment, as well as patient/caregiver collaboration (co-care).
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15. |
- Thalén-Lindström, Annika, et al.
(author)
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Identification of distress in oncology patients : a comparison of the Hospital Anxiety and Depression Scale and a thorough clinical assessment
- 2016
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In: Cancer Nursing. - 0162-220X .- 1538-9804. ; 39:2, s. E31-E39
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Journal article (peer-reviewed)abstract
- Background:Screening is recommended to identify cancer patients with distress,anxiety, and depression. The ability of current methods to identify distress inoncology patients is of high importance.Objective:We compared the HospitalAnxiety and Depression Scale (HADS) with a thorough clinical assessment.Furthermore, we explored the agreement of HADS with clinical assessment outcomesas a function of age, sex, and treatment intention.Methods:One hundredforty-six oncology patients, representing both sexes, different ages (<65/Q65 years),and treatment intention (curative/palliative), completed the HADS before the clinicalassessment. Two study team members (blind to the HADS results) completedclinical assessments of anxiety, depression, and distress analogous to categoriesused in the HADS.Results:The HADS identified 49 participants and the clinicalassessment 71 participants as having anxiety, depression, or distress. The overall agreement between the HADS and the clinical assessment was moderate. The greatest differences were found to be a function of participant sex and age.Agreement between the methods was better for females than for males in relation to distress and anxiety and better for the older (Q65 years) than younger participants in relation to depression. By treatment intention, agreement was equal for alldomains.Conclusion:Especially male and young participants appear to have potential problems that the HADS fails to identify.
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16. |
- Ångström-Brännström, Charlotte, et al.
(author)
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Staff's Experiences of Preparing and Caring for Children With Cancer and Their Families During the Child's Radiotherapy
- 2019
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In: Cancer Nursing. - : Wolters Kluwer. - 0162-220X .- 1538-9804. ; 42:5, s. E10-E18
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Journal article (peer-reviewed)abstract
- Background: Approximately one-third of children diagnosed with cancer are treated with radiotherapy (RT). Staff experiences of preparing and distracting the children and their families during a child’s RT are sparsely described.Objective: The aim of this study was to describe staff experiences of preparing and caring for children with cancer and their families during the child’s RT.Intervention/Methods: Semistructured interviews with staff were performed at 3 Swedish RT centers. The interviews were analyzed using inductive qualitative content analysis.Results: The analysis revealed 5 categories summarizing the staff members’ experiences. These include the following: experiences of various emotions; care for the child and the child’s family; commitments before, during, and after RT; organizational issues; and experiences of the intervention and suggestions for improvement.Conclusions: The preparatory intervention facilitated the ability of staff members to conduct their work, although the intervention should be specifically tailored to each child. Meeting children and their families and providing care to both during RT were challenging. The staff strived to provide optimal care for each child and family. Interdisciplinary teamwork and organizational acceptance for the importance of preparation and distraction were essential.Implications for Practice: A future challenge will be to provide opportunities for all staff involved in the treatment of children with cancer to develop their skills continuously in order to provide high-quality preparation and distraction to all children undergoing RT, regardless of the geographical location of the RT center.
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