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Sample records for cancer qualitative aspects

  1. Evaluating beauty care provided by the hospital to women suffering from breast cancer: qualitative aspects.

    Amiel, Philippe; Dauchy, Sarah; Bodin, Julie; Cerf, Céline; Zenasni, Franck; Pezant, Elisabeth; Teller, Anne-Marie; André, Fabrice; DiPalma, Mario

    2009-07-01

    Cancer patients are offered more and more access to beauty care during their stay in the hospital. This kind of intervention has not been evaluated yet. Primary objective of our research was to determine what type of evaluation strategy to be implemented (as a supportive care with quality of life and/or medical benefits; as a service providing immediate comfort); intermediate objective was to investigate in scientific terms (psychological, sociological) the experience of beauty care by patients. Sixty patients (all users of beauty care provided by hospital, 58 female, most of them treated for breast cancer, two male, mean age 53 years) and 11 nurses and physicians, from four French cancer centres were included. We used direct observation and semi-structured interviews, conducted by a sociologist and a psychologist; different types of beauty care were concerned. All the interviewed patients were satisfied. Patients appreciated acquiring savoir-faire on how to use make-up and on personal image enhancement. Psychological and social well-being benefits were mentioned. The beauty care was not alleged to be reducing the side effects of the treatments, but it had helped patients to accept or bear the burden of them. Providing care beyond that which is directly curative was appreciated by the patients as a sign that they were treated as a "whole" person. The survey brings valuable clues concerning beauty care experience by cancer patients; it suggests the relevance of quantitative evaluation of the immediate and long-term effects on the quality of life.

  2. Psychological aspects of cancer patients

    Graça Cardoso

    2014-06-01

    Full Text Available Cancer is accompanied by important psychological distress experienced by both patient and family. From the moment of the diagnosis on, the patient has to develop a great number of mechanisms and tasks of adjustment to the illness and its circumstances. The high prevalence of anxiety and depressive disorders during the course of cancer increases in the end stage disea‐ se. Therefore, a global plan of intervention integrating somatic and psychological/ psychiatric care throughout all the phases of the illness is crucial in the treatment of these patients. Health professionals working on this field can also experience emotional reactions to their patients’ suffering. They should be aware of the emotional aspects involved and develop training to help them intervene adequately with the patient and the family. The articulation between oncologists, palliative care professionals, and mental health care teams can be of great help in providing good quality of care to cancer patients.

  3. Understanding coping with cancer: how can qualitative research help?

    Chittem, Mahati

    2014-01-01

    Research in psycho-oncology investigates the psycho-social and emotional aspects of cancer and how this is related to health, well-being and overall patient care. Coping with cancer is a prime focus for researchers owing to its impact on patients' psychological processing and life in general. Research so far has focused mainly on quantitative study designs such as questionnaires to examine the coping strategies used by cancer patients. However, in order to gain a rich and deep understanding of the reasons, processes and types of strategies that patients use to deal with cancer, qualitative study designs are necessary. Few studies have used qualitative designs such as semi-structured interviews to explore coping with cancer. The current paper aims to review the suitability and benefits of using qualitative research designs to understand coping with cancer with the help of some key literature in psycho-oncology research.

  4. Some aspects of cancer epidemiology

    Lilienfeld, A.M.

    1982-01-01

    Epidemiolgic studies have strongly suggested that a vast majority (80-90%) of cancers are caused by radiation, chemical and biologic agents; the remainder result from endogenous or genetic factors. Biologically, cancer is most probably the end result of a complex multistage process and therefore may be due to a sequence of exposures to different agents at each of these stages. This emphasizes the need to stress the study of interactions in epidemiologic studies to a greater extent than has been done thus far. Examples of the importance of interactions in several types of cancer are presented

  5. Aspects of enteral nutrition in cancer chemotherapy

    Smit, Jitske Martha

    1985-01-01

    This thesis deals with several aspects of the influences of intensive cancer chemotherapy on the nutritional status, the metabolism, and the gastrointestinal tract of the host and describes whether these results can be influenced by enteral hyperalimentation, We studied these aspects in patients

  6. QUALITATIVE ASPECTS OF CRIŞUL REPEDE RIVER

    VIGH MELINDA

    2012-03-01

    Full Text Available Qualitative aspects of Crisul Repede River. The evolution of water quality over the Crişul Repede River is atypical because of natural and anthropic factors. The most significant factors are the geological substrate, and the settlements with their agricultural and industrial activity. The study was performed at three gauging stations for the period 1996-2006, taking into account the annual average values. The considered elements were: the discharge values, temperature, suspensions, oxygen regime, nutrients and phosphorus, taking into consideration their temporal and spatial variation. By comparing them with the admitted limits we could enroll them in various quality classes.

  7. Pathological and Biological Aspects of Colorectal Cancer Treatment.

    Gosens, M.J.E.M.

    2008-01-01

    Pathological and biological aspects of colorectal cancer treatment. This thesis describes several pathological and biological aspects of colorectal cancer treatment. Different patient populations were investigated including patients with mobile rectal cancer enrolled in the Dutch TME trial, patients

  8. Qualitative aspects of nonlinear wave motion: Complexity and simplicity

    Engelbrecht, J.

    1993-01-01

    The nonlinear wave processes possess many qualitative properties which cannot be described by linear theories. In this presentation, an attempt is made to systematize the main aspects of this fascinating area. The sources of nonlinearities are analyzed in order to understand why and how the nonlinear mathematical models are formulated. The technique of evolution equations is discussed then as a main mathematical tool to separate multiwave processes into single waves. The evolution equations give concise but in many cases sufficient description of wave processes in solids permitting to analyze spectral changes, phase changes and velocities, coupling of waves, and interaction of nonlinearities with other physical effects of the same order. Several new problems are listed. Knowing the reasons, the seemingly complex problems can be effectively analyzed. 61 refs

  9. Psychosomatic Aspects of Cancer: An Overview.

    Murray, John B.

    1980-01-01

    It is suggested in this literature review on the psychosomatic aspects of cancer that psychoanalytic interpretations which focused on intrapsychic elements have given way to considerations of rehabilitation and assistance with the complex emotional reactions of patients and their families to terminal illness and death. (Author/DB)

  10. Qualitative Aspects of Bone Marrow Adiposity in Osteoporosis

    Clifford J Rosen

    2016-10-01

    Full Text Available The function of marrow adipocytes and their origin has not been defined although considerable research has centered on their presence in certain conditions such as osteoporosis. Less work has focused on the qualitative aspects of marrow fat. Bone marrow serum is composed of multiple nutrients that almost certainly relate to functional aspects of the niche. Previous studies using non-­‐invasive techniques have shown that osteoporotic individuals have more marrow fat and that the ratio of saturated: unsaturated fatty acid is high. We recently reported that bone marrow sera from osteoporotic patients with fracture showed a switch toward decreased content of total saturated versus unsaturated fatty acids, compared to patients without fracture highlighting a dynamic relationship between the composition of fatty acids in the bone microenvironment and the metabolic requirements of cells. The relative distribution of fatty acids differed considerably from that in the serum providing further evidence that energy utilization is high and that marrow adipocytes may contribute to this pool. Whether these lipids can affect osteoblast function in a positive or negative manner is still not certain but will require further investigation.

  11. Cancer Patients' Informational Needs: Qualitative Content Analysis.

    Heidari, Haydeh; Mardani-Hamooleh, Marjan

    2016-12-01

    Understanding the informational needs of cancer patients is a requirement to plan any educative care program for them. The aim of this study was to identify Iranian cancer patients' perceptions of informational needs. The study took a qualitative approach. Semi-structured interviews were held with 25 cancer patients in two teaching hospitals in Iran. Transcripts of the interviews underwent conventional content analysis, and categories were extracted. The results came under two main categories: disease-related informational needs and information needs related to daily life. Disease-related informational needs had two subcategories: obtaining information about the nature of disease and obtaining information about disease prognosis. Information needs related to daily life also had two subcategories: obtaining information about healthy lifestyle and obtaining information about regular activities of daily life. The findings provide deep understanding of cancer patients' informational needs in Iran.

  12. Endocrine aspects of cancer gene therapy.

    Barzon, Luisa; Boscaro, Marco; Palù, Giorgio

    2004-02-01

    The field of cancer gene therapy is in continuous expansion, and technology is quickly moving ahead as far as gene targeting and regulation of gene expression are concerned. This review focuses on the endocrine aspects of gene therapy, including the possibility to exploit hormone and hormone receptor functions for regulating therapeutic gene expression, the use of endocrine-specific genes as new therapeutic tools, the effects of viral vector delivery and transgene expression on the endocrine system, and the endocrine response to viral vector delivery. Present ethical concerns of gene therapy and the risk of germ cell transduction are also discussed, along with potential lines of innovation to improve cell and gene targeting.

  13. Spiritual needs of cancer patients: A qualitative study

    Khadijeh Hatamipour

    2015-01-01

    Full Text Available Introduction: Diagnosis of cancer can cause huge spiritual crisis in a person and affect different aspects of life. At this stage, patients have certain spiritual needs. Aim: This study was conducted to explain spiritual needs of cancer patients in Iran. Materials and Methods: In this qualitative study, 18 cancer patients, referred to the Cancer Institute of Imam Khomeini Hospital in Tehran were selected using purposive sampling method, and their spiritual needs emerged out of conventional content analysis of interviews conducted with them. Results: From 1850 initial codes, 4 themes (connection, peace, meaning and purpose, and transcendence were identified that contained categories of social support, normal behavior, inner peace, seeking forgiveness, hope, acceptance of reality, seeking meaning, ending well, change of life meaning, strengthening spiritual belief, communication with God, and prayer. Conclusions: Spiritual needs of cancer patients should be recognized, realized, and considered in care of patients by the medical team. An all-out support of health system policy makers to meet patients′ spiritual needs is particularly important.

  14. Qualitative aspects of learning, recall, and recognition in dementia

    Ranjith Neelima

    2010-01-01

    Full Text Available Objective: To determine whether learning and serial position effect (SPE differs qualitatively and quantitatively among different types of dementia and between dementia patients and controls; we also wished to find out whether interference affects it. Materials and Methods: We administered the Malayalam version of the Rey Auditory Verbal Learning Test (RAVLT to 30 cognitively unimpaired controls and 80 dementia patients [30 with Alzheimer′s disease (AD, 30 with vascular dementia (VaD, and 20 with frontotemporal dementia (FTD] with mild severity on the Clinical Dementia Rating Scale. Results: All groups were comparable on education and age, except the FTD group, who were younger. Qualitatively, the learning pattern and SPE (with primacy and recency being superior to intermediate was retained in the AD, VaD, and control groups. On SPE in free recall, recency was superior to intermediate in the FTD group (P < 0.01 using Bonferroni correction. On recognition, the AD and VaD groups had more misses (P < 0.01, while the FTD group had more false positives (P < 0.01. Conclusion: Quantitative learning is affected by dementia. The pattern of qualitative learning remains unaltered in dementia in the early stages.

  15. Positive Aspects of International Student Transitions: A Qualitative Inquiry

    Moores, Lisa; Popadiuk, Natalee

    2011-01-01

    Despite the considerable growth of the international student population, positive aspects of their experience have received little attention. The current study combines a Critical Incident Technique methodology and a positive psychology lens to explore the cross-cultural transition of seven international students, focusing on facilitative factors,…

  16. Radiotherapy in skin cancer - present day aspects

    Gocheva, L.

    2009-01-01

    Skin carcinomas (SC) are the leading ones in the structure of oncological morbidity in both genders in Bulgaria, as well as in white populations in the world. Regardless of their high frequency, their treatment is successful and mortality due to SC has been reduced by 20 - 30% during the last decades. In Bulgaria SC in 2003 comprise 9.3% of all oncological diseases in men and women. According to their frequency they occupy the second phase after lung cancer in men and breast cancer in women. The treatment of SC is realized applying various therapeutic approaches, distinguished as basic (radical) and alternative ones. The first include surgical treatment and radiotherapy (RT) (definitive or adjuvant) and the alternative ones - curettage and electro-coagulation, cryotherapy, local chemotherapy and immunotherapy, systemic chemotherapy, etc. When defining the therapeutic approach, the method affording the best chances of curing with acceptable cosmetic results should be selected. The present review is aimed at considering the contemporary aspects in RT of SC, including used radiotherapy methods and techniques, volumes, doses, fractionation, and achieved therapeutic effects. The indications for implementing definitive and adjuvant RT are given in detail. The applied radiotherapy methods - external beam RT and brachytherapy, are also discussed. The used planned radiotherapy volumes, doses, fractionation schemes, attained therapeutic effects and possible radiation reactions are considered as well. The curability of SC is high, exceeding 90% after adequate treatment. Regardless of the fact that RT has partially ceded its leading role in SC treatment, it still remains to be one of the basic and successful therapeutic approaches

  17. Exploring aspects of physiotherapy care valued by breast cancer patients.

    Pidlyskyj, K; Roddam, H; Rawlinson, G; Selfe, J

    2014-06-01

    To explore the reported value of physiotherapy care received by patients who had accessed a Specialist Breast Care Physiotherapy Service. Exploratory qualitative study using in-depth interviews to explore aspects of physiotherapy care valued by breast cancer patients. Thematic network analysis was used to interpret the data and bring together the different experiences of the participants and identify common themes. Physiotherapy Department at a NHS Foundation Trust Teaching Hospital. Nineteen participants were recruited and three were selected to take part in the in-depth interviews. All participants had received physiotherapy care from a Specialist Breast Care Physiotherapy Service and had been discharged within the last six months. Participants valued a patient-centred holistic approach to care and access to a Specialist Service with an experienced clinician. In particular the importance of the therapeutic alliance and the value of psychological, emotional and educational support emerged, with the participants feeling empowered in their recovery. Participants reported an overall positive experience of their physiotherapy care. This study supports the need for service providers to evaluate their current physiotherapy provision and subsequently develop Specialised Services to meet the physiotherapy needs of breast cancer patients throughout all stages of their treatment pathway from the delivery of pre-operative care through to post-treatment follow-up. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  18. Cancer de la Vessie au Togo : Aspects Diagnostiques Et ...

    Mots clés : cancer de la vessie, diagnostic, traitement ;. ABSTRACT. Cancer of the Bladder in Togo. Clinical and Management Aspects at the Teaching Hospital of Sylvanus Olympio. Objective: to describe the clinical and management features in patients followed for bladder cancer at the teaching hospital of Sylvanus ...

  19. Patentability aspects of computational cancer models

    Lishchuk, Iryna

    2017-07-01

    Multiscale cancer models, implemented in silico, simulate tumor progression at various spatial and temporal scales. Having the innovative substance and possessing the potential of being applied as decision support tools in clinical practice, patenting and obtaining patent rights in cancer models seems prima facie possible. What legal hurdles the cancer models need to overcome for being patented we inquire from this paper.

  20. Cancer diagnosis by infrared spectroscopy: methodological aspects

    Jackson, Michael; Kim, Keith; Tetteh, John; Mansfield, James R.; Dolenko, Brion; Somorjai, Raymond L.; Orr, F. W.; Watson, Peter H.; Mantsch, Henry H.

    1998-04-01

    IR spectroscopy is proving to be a powerful tool for the study and diagnosis of cancer. The application of IR spectroscopy to the analysis of cultured tumor cells and grading of breast cancer sections is outlined. Potential sources of error in spectral interpretation due to variations in sample histology and artifacts associated with sample storage and preparation are discussed. The application of statistical techniques to assess differences between spectra and to non-subjectively classify spectra is demonstrated.

  1. Epidemiogic aspects of skin cancer in organ-transplant recipients

    Wisgerhof, Hermina Christina

    2011-01-01

    The risk of (skin) cancer is highly increased in organ-transplant recipients who are kept on immunesuppressive drugs to prevent graft rejection. This thesis dealt with the epidemiologic aspects and risk factors for cancer focused on cutaneous squamous cell carcinoma and basal cell carcinoma.

  2. Metabolic and nutritional aspects of cancer.

    Krawczyk, Joanna; Kraj, Leszek; Ziarkiewicz, Mateusz; Wiktor-Jędrzejczak, Wiesław

    2014-08-22

    Cancer, being in fact a generalized disease involving the whole organism, is most frequently associated with metabolic deregulation, a latent inflammatory state and anorexia of various degrees. The pathogenesis of this disorder is complex, with multiple dilemmas remaining unsolved. The clinical consequences of the above-mentioned disturbances include cancer-related cachexia and anorexia-cachexia syndrome. These complex clinical entities worsen the prognosis, and lead to deterioration of the quality of life and performance status, and thus require multimodal treatment. Optimal therapy should include nutritional support coupled with pharmacotherapy targeted at underlying pathomechanisms of cachexia. Nevertheless, many issues still need explanation, and efficacious and comprehensive therapy of cancer-related cachexia remains a future objective.

  3. Biophysical aspects of cancer - Electromagnetic mechanism

    Pokorný, Jiří; Hašek, Jiří; Vaniš, Jan; Jelínek, František

    2008-01-01

    Roč. 46, č. 5 (2008), s. 310-321 ISSN 0019-5189 Institutional research plan: CEZ:AV0Z20670512; CEZ:AV0Z50200510 Keywords : Electromagnetic Fields * Biophysics * Cancer Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering Impact factor: 0.599, year: 2008

  4. Vitamin D and cancer: Clinical aspects

    Woloszynska-Read, Anna; Johnson, Candace S.; Trump, Donald L.

    2015-01-01

    There are substantial preclinical and epidemiologic data that suggest that vitamin D plays a role in the prevention and treatment of cancer. Numerous observational studies have shown that low blood levels of 25(OH) vitamin D (cholecalciferol), estimated by geographical location, diet and activity assessment or measured serum levels are associated with a higher risk of cancer and worse cancer-specific survival as well as numerous morbidities to e.g. cardiovascular disease, stroke, infection, autoimmune disease, and neuromuscular dysfunction among large populations. A considerable number of in vitro and in vivo studies indicate that the most active metabolite of vitamin D – 1,25-dihydroxycholecalciferol or calcitriol – has anti-proliferative, pro-apoptotic, pro-differentiating, and anti-angiogenic properties. Combined treatment of calcitriol and many types of cytotoxic agents has synergistic or at least additive effects. However, clinical trials testing these hypotheses have been less encouraging, though a number of methodological, pharmacological, and pharmaceutical issues confound all trials ever conducted. In order to properly assess the clinical value of vitamin D, its metabolites and analogs in cancer prevention and treatment, more studies are needed. PMID:21872802

  5. [Multiple primary colorectal cancer: Clinical aspects].

    Soldatkina, N V; Kit, O I; Gevorkyan, Yu A; Milakin, A G

    to define some clinical characteristics of synchronous and metachronous colorectal cancer (CRC). The investigation was concerned with the data of 150 patients with T1-4N0-2M0-1 multiple primary CRC. The clinical, biological, and morphological characteristics of synchronous and metachronous tumors were analyzed. Multiple primary tumors were 6.01% of all the cases of CRC. There was a preponderance of synchronous CRC (63.75%) with the tumor localized in the sigmoid colon and rectum. In women, synchronous colorectal tumors were more often concurrent with breast tumors; metachronous ones were detected after treatment for genital tumors. In men, synchronous colorectal tumors were more frequently concurrent with kidney cancer; metachronous ones were identified after treatment for gastric cancer. The found characteristics of multiple primary colorectal tumors may be taken in account in programs for both primary diagnosis and follow-up after treatment for malignant tumors, which will be able to improve the early detection of cancer patients and their treatment results.

  6. Cultural aspects of communication in cancer care.

    Surbone, A

    2006-01-01

    Cancer is increasing in incidence and prevalence worldwide, and the WHO has recently included cancer and its treatments as a health priority in developed and developing countries. The cultural diversity of oncology patients is bound to increase, and cultural sensitivity and competence are now required of all oncology professionals. A culturally competent cancer care leads to improved therapeutic outcome and it may decrease disparities in medical care. Cultural competence in medicine is a complex multilayered accomplishment, requiring knowledge, skills and attitudes whose acquisition is needed for effective cross-cultural negotiation in the clinical setting. Effective cultural competence is based on knowledge of the notion of culture; on awareness of possible biases and prejudices related to stereotyping, racism, classism, sexism; on nurturing appreciation for differences in health care values; and on fostering the attitudes of humility, empathy, curiosity, respect, sensitivity and awareness. Cultural competence in healthcare relates to individual professionals, but also to organizations and systems. A culturally competent healthcare system must consider in their separateness and yet in there reciprocal influences social, racial and cultural factors. By providing a framework of reference to interpret the external world and relate to it, culture affects patients' perceptions of disease, disability and suffering; degrees and expressions of concern about them; their responses to treatments and their relationship to individual physicians and to the healthcare system. Culture also influences the interpretation of ethical norms and principles, and especially of individual autonomy, which can be perceived either as synonymous with freedom or with isolation depending on the cultural context. This, in turn, determines the variability of truth-telling attitudes and practices worldwide as well as the different roles of family in the information and decision-making process of

  7. Cultural aspects of communication in cancer care.

    Surbone, Antonella

    2008-03-01

    Cultural competence in oncology requires the acquisition of specific knowledge, clinical skills, and attitudes that facilitate effective cross-cultural negotiation in the clinical setting, thus, leading to improved therapeutic outcomes and decreased disparities in cancer care. Cultural competence in oncology entails a basic knowledge of different cultural attitudes and practices of communication of the truth and of decision-making styles throughout the world. Cultural competence always presupposes oncology professionals' awareness of their own cultural beliefs and values. To be able to communicate with cancer patients in culturally sensitive ways, oncologists should have knowledge of the concept of culture in its complexity and of the risks of racism, classism, sexism, ageism, and stereotyping that must be avoided in clinical practice. Oncologists should develop a sense of appreciation for differences in health care values, based on the recognition that no culture can claim hegemony over others and that cultures are evolving under their reciprocal influence on each other. Medical schools and oncology training can teach communication skills and cultural competence, while fostering in all students and young doctors those attitudes of humility, empathy, curiosity, respect, sensitivity, and awareness that are needed to deliver effective and culturally sensitive cancer care.

  8. Human pancreatic cancer xenografts recapitulate key aspects of cancer cachexia.

    Delitto, Daniel; Judge, Sarah M; Delitto, Andrea E; Nosacka, Rachel L; Rocha, Fernanda G; DiVita, Bayli B; Gerber, Michael H; George, Thomas J; Behrns, Kevin E; Hughes, Steven J; Wallet, Shannon M; Judge, Andrew R; Trevino, Jose G

    2017-01-03

    Cancer cachexia represents a debilitating syndrome that diminishes quality of life and augments the toxicities of conventional treatments. Cancer cachexia is particularly debilitating in patients with pancreatic cancer (PC). Mechanisms responsible for cancer cachexia are under investigation and are largely derived from observations in syngeneic murine models of cancer which are limited in PC. We evaluate the effect of human PC cells on both muscle wasting and the systemic inflammatory milieu potentially contributing to PC-associated cachexia. Specifically, human PC xenografts were generated by implantation of pancreatic cancer cells, L3.6pl and PANC-1, either in the flank or orthotopically within the pancreas. Mice bearing orthotopic xenografts demonstrated significant muscle wasting and atrophy-associated gene expression changes compared to controls. Further, despite the absence of adaptive immunity, splenic tissue from orthotopically engrafted mice demonstrated elevations in several pro-inflammatory cytokines associated with cancer cachexia, including TNFα, IL1β, IL6 and KC (murine IL8 homologue), when compared to controls. Therefore, data presented here support further investigation into the complexity of cancer cachexia in PC to identify potential targets for this debilitating syndrome.

  9. B metastases in breast cancer. Clinical, diagnostic and therapeutic aspects

    Ferrigno, R.; Petitto, J.V.

    1989-01-01

    Osseous metastases are the most frequent sites of dissemination in breast cancer and diminish the quality of patients life, being one of the most serious problems of the disease. The authors discuss the clinical, diagnosis and therapeutic aspects, based on their own experience and data from the literature. (author)

  10. Clinical Aspects of Hypoxia-inducible Factors in Colorectal Cancer

    Havelund, Birgitte Mayland; Spindler, Karen-Lise Garm; Sørensen, Flemming Brandt

    2010-01-01

    Clinical Aspects of Hypoxia-inducible Factors in Colorectal Cancer  Birgitte Mayland Havelund1,4 MD, Karen-Lise Garm Spindler1,4 MD, PhD, Flemming Brandt Sørensen2,4 MD, DMSc, Ivan Brandslund3 MD, DMSc, Anders Jakobsen1,4 MD, DMSc.1Department of Oncology, 2Pathology and 3Biochemistry, Vejle...... Hospital, Vejle, Denmark4Institute of Regional Health Services Research, University of Southern Denmark, Odense DenmarkBackgroundPrognostic and predictive markers are needed for individualizing the treatment of colorectal cancer. Hypoxia-inducible factor 1α (HIF-1α) is a transcription-inducing factor which...... the predictive and prognostic value of HIF-1α in colorectal cancer.Materials and MethodsThe project is divided into 3 substudies:1. Biological and methodological aspects. The expression of HIF-1α measured by immunohistochemistry in paraffin embedded tissue is related to single nucleotide polymorphism (SNP...

  11. Clinical Aspects of Hypoxia-inducible Factors in Colorectal Cancer

    Havelund, Birgitte Mayland; Spindler, Karen-Lise Garm; Sørensen, Flemming Brandt

    Clinical Aspects of Hypoxia-inducible Factors in Colorectal Cancer  Birgitte Mayland Havelund1,4 MD, Karen-Lise Garm Spindler1,4 MD, PhD, Flemming Brandt Sørensen2,4 MD, DMSc, Ivan Brandslund3 MD, DMSc, Anders Jakobsen1,4 MD, DMSc.1Department of Oncology, 2Pathology and 3Biochemistry, Vejle...... activates transcription of numerous genes associated with angiogenesis, ATP-metabolism, cell-proliferation, glycolysis and apoptosis. HIF-1α is over expressed in many malignant tumors and is reported to play an important role in tumor invasion and progression. The aim of this Ph.D. project is to investigate...... the predictive and prognostic value of HIF-1α in colorectal cancer.Materials and MethodsThe project is divided into 3 substudies:1. Biological and methodological aspects. The expression of HIF-1α measured by immunohistochemistry in paraffin embedded tissue is related to single nucleotide polymorphism (SNP...

  12. Ethnicity and the prostate cancer experience: a qualitative metasynthesis.

    Rivas, Carol; Matheson, Lauren; Nayoan, Johana; Glaser, Adam; Gavin, Anna; Wright, Penny; Wagland, Richard; Watson, Eila

    2016-10-01

    To summarize black and minority ethnic (BME) patients' and partners experiences of prostate cancer by examining the findings of existing qualitative studies. We undertook a systematic metasynthesis of qualitative studies using a modified version of Noblit and Hare's "meta-ethnography" approach, with a 2000-2015 search of 7 databases. Thirteen studies of men from US and UK BME groups were included. We explored constructs with BME-specific features. Health care provider relationships, formation of a spiritual alliance with God (which enhanced the participants' feeling of empowerment and ability to cope with the cancer), and living on for others (generally to increase cancer awareness), often connected to spiritual regrowth, were the 3 constructs most commonly reported. A magnified effect from erectile dysfunction was also common. Initially, this affected men's disclosure to others about their cancer and their sexual problems, but eventually men responded by shifting their conceptualizations of masculinity to sustain self and social identities. There was also evidence of inequality resulting from financial constraints and adversity that necessitated resilience in coping. The prostate cancer experience of BME men and their partners is affected by a complex intersection of ethnicity with other factors. Health care services should acknowledge this. If providers recognize the men's felt masculinities, social identities, and spiritual beliefs and their shifting nature, services could be improved, with community as well as individual benefits. More studies are needed in diverse ethnic groups. © 2016 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

  13. Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

    Victoria K Fort

    2011-03-01

    Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

  14. Topometric and clinicodosimetric aspects of radiotherapy of stomatopharyngeal cancer

    Choudkhuri, F.A.; Vorob'eva, L.V.

    1988-01-01

    The use of modern diagnostic facilities led to a study of the physicodosimetric, topometric and clinical aspects of radiotherapy of stomatopharyngeal cancer. The most effective approaches to therapy of stomatopharyngeal tumors with account of their site, spread and degrees of differentiation were developed. The most effective method was shown to be the combination of γ-beam therapy (50 Gy) with electron-photon radiation (20 Gy) of an accelerator of 18-20 MeV, radiation exposure of normal tissues being lowered by approximately 10-20 % as compared to that in γ-beam therapy used alone. The use of the above method in 45 stomatopharyngeal cancer patients resulted in an early clinical effect (disappearance of a tumor and regional metastases (if any) in 60 % of the patients. The 2-year survival rate calculated by acturial curves, was 62±10 %

  15. Latent period and temporal aspects of lung cancer among miners

    Sun Shiquan; Yang Xiaoou; Yang Lan; Meng Xianyu; Liu Shengen; You Zhanyun

    1984-01-01

    Data of lung cancer happened in the miners of this reported mine area is of great value to investigate the temporal aspects of miner's lung cancer, owing to its plenty of cases, longterm follow up and mining as child miners in early years before liberation of China. This preliminary analysis showed that the induction-latent period increased with the decrease of age at the year-of-first-employment in this mine and the protraction of follow up. In other words, even they were exposed since childhood, the excess of lung cancer never appeared until certain age for carcinogenesis. Therefore, the long-term follow up and comprehensive analysis of induction-latent period, underground duration-of-employment, time and age at start of mining would be helpful to properly estimating risk level, discovering the cause and predicting the trend of lung cancer incidence. There is no evidence to show whether child miners are more sensitive than adult miners working at the same exposure conditions

  16. Coping with breast cancer: a qualitative analysis of reflective journals.

    Gonzalez, Lois O; Lengacher, Cecile A

    2007-05-01

    Non-disclosure of emotions has been shown to inhibit individuals' adjustment to illness and formulation of adequate coping mechanisms. The purpose of this qualitative study was to examine responses to the diagnosis and treatment of breast cancer and patterns of coping through an analysis of written reflective journals. Eight women submitted their journals to the researchers for analysis. Issues identified were (1) the assumption of an adaptive position; (2) the need for tangible evidence of love and support with three divergent responses, and (3) the need for something more. Specific patterns were identified within each issue.

  17. Experiences of adolescents living with cancer: A descriptive qualitative study.

    Ang, Sin Hui; Koh, Serena Siew Lin; Lee, Xiu Hua Hideka Tamamura; Shorey, Shefaly

    2018-01-01

    This study aimed to explore the experiences of adolescents from Singapore, aged 10-18 years old, living with cancer and their perceptions on how their psychosocial outcomes can be improved. A descriptive qualitative study design was used. Convenience sampling was used to recruit 10 participants from a pediatric oncology ward in a Singapore hospital. Individual semi-structured interviews were conducted. Thematic analysis was used to analyze the data. Five major themes emerged: (1) experience of physical symptoms, (2) emotional response to their condition, (3) changes in social dynamics, and (4) falling behind in academics. The psychosocial outcomes of Singaporean adolescents with cancer could be improved by thorough pain assessments and creating a more conducive hospital environment.

  18. Radiologic aspects of breast cancers detected through a breast cancer screening program

    Azavedo, E.; Svane, G.

    1991-01-01

    Early detection in breast cancer and reduced mortality in women with this disease is today attributed to widespread use of mammography. High-quality performance is essential in all steps of breast cancer screening programs in order to avoid unnecessary anxiety and surgery in the women concerned. This report presents radiologic aspects of screening cancers. A total of 8370 asymptomatic women aged 50-69 years were screened with 2-view mammography, of which only 70 (0.84 percent) were selected for surgery after a thorough work-up. Cancers were verified histologically in 61 women and 9 showed non-malignant histology, giving a cancer detection rate of 7.3 cancers per thousand screened asymptomatic women. The benign/malignant ratio in the operated cases is thus approximately 1:7. The cancers detected showed all existing types of mammographic features where 77 percent (47 cases) showed rather typical findings, such as spiculated densities both with and without microcalcifications. The results indicate that surgery can be minimized without impairing the breast cancer detection rate. Radiologists in screening programs should be aware that a large proportion of non-palpable breast cancers present in rather unconventional forms. This point is important in order to maintain a high cancer detection rate and thereby justify the widespread use of mammography as a screening tool for breast cancer in asymptomatic women. (author). 20 refs.; 1 tab

  19. Cancer patients' needs during hospitalisation: a quantitative and qualitative study

    Greco Margherita

    2003-04-01

    Full Text Available Abstract Background The evaluation of cancer patients needs, especially during that delicate period when they are hospitalized, allows the identification of those areas of care that require to be improved. Aims of the study were to evaluate the needs in cancer inpatients and to improve the understanding of the meanings of the needs expressed. Methods The study was conducted during a "sample day", with all the cancer patients involved having been hospitalized at the Istituto Nazionale Tumori of Milan (INT for at least 48 hours beforehand. The study was carried out using quantitative and qualitative methodologies. The quantitative part of the study consisted in making use of the Needs Evaluation Questionnaire (NEQ, a standardized questionnaire administered by the INT Psychology Unit members, supported by a group of volunteers from the Milan section of the Italian League Against Cancer. The aim of the qualitative part of the study, by semi-structured interviews conducted with a small sample of 8 hospitalized patients, was to improve our understanding of the meanings, implications of the needs directly described from the point of view of the patients. Such an approach determines the reasons and conditions of the dissatisfaction in the patient, and provides additional information for the planning of improvement interventions. Results Of the 224 eligible patients, 182 (81% completed the questionnaire. Four of the top five needs expressed by 40% or more of the responders concerned information needs (diagnosis, future conditions, dialogue with doctors, economic-insurance solutions related to the disease. Only one of the 5 was concerned with improved "hotel" services (bathrooms, meals, cleanliness. Qualitative analysis showed that the most expressed need (to receive more information on their future conditions has the meaning to know how their future life will be affected more than to know his/her actual prognosis. Conclusions Some of the needs which

  20. Encouraging smoking cessation among disadvantaged groups: a qualitative study of the financial aspects of cessation.

    Bonevski, Billie; Bryant, Jamie; Paul, Christine

    2011-07-01

    This study aimed to explore perceptions about financial aspects of smoking cessation among a group of disadvantaged welfare agency clients and their carers. Qualitative focus groups and in-depth interviews were supplemented with participant exit surveys about preferred smoking cessation strategies. Each discussion was audiotaped, transcribed and analysed using a thematic analysis. The setting was six non-government community welfare service organisations operating in New South Wales, Australia. Eleven social services offered by these organisations participated. Thirty two clients participated in six client focus groups, 35 staff participated in six staff focus groups and eight manager telephone interviews were conducted. Clients indicated that the cost of nicotine replacement therapy was a barrier to its use and that financial incentives were acceptable. Of the 16 possible strategies listed in the exit survey, the three selected as the most preferred by clients incorporated financial or non-financial assistance. By contrast, staff and managers selected financial and non-financial incentives as the least preferred and least feasible strategies. The study found high acceptance of incentives as a smoking cessation strategy among a disadvantaged group of non-government welfare service clients. The comparatively low level of desirability and feasibility from the perspective of service staff and managers suggests implementation of such an approach within the community service setting requires careful further testing. © 2010 Australasian Professional Society on Alcohol and other Drugs.

  1. Exploration of the administrative aspects of the delivery of home health care services: a qualitative study.

    Shahsavari, Hooman; Nasrabadi, Alireza Nikbakht; Almasian, Mohammad; Heydari, Heshmatolah; Hazini, Abdolrahim

    2018-01-01

    Because of the variety of services and resources offered in the delivery of home health care, its management is a challenging and difficult task. The purpose of this study was to explore the administrative aspects of the delivery of home health care services. This qualitative study was conducted based on the traditional content analysis approach in 2015 in Iran. The participants were selected using the purposeful sampling method and data were collected through in-depth semi-structured personal interviews and from discussions in a focus group. The collected data were analyzed using the Lundman and Graneheim method. 23 individuals participated in individual interviews, and the collected data were categorized into the two main themes of policymaking and infrastructures, each of which consisted of some subcategories. Health policymakers could utilize the results of this study as baseline information in making decisions about the delivery of home health care services, taking into account the contextual dimensions of home care services, leading to improvements in home health care services.

  2. Aspects of mental health dysfunction among survivors of childhood cancer.

    Fidler, Miranda M; Ziff, Oliver J; Wang, Sarra; Cave, Joshua; Janardhanan, Pradeep; Winter, David L; Kelly, Julie; Mehta, Susan; Jenkinson, Helen; Frobisher, Clare; Reulen, Raoul C; Hawkins, Michael M

    2015-09-29

    Some previous studies have reported that survivors of childhood cancer are at an increased risk of developing long-term mental health morbidity, whilst others have reported that this is not the case. Therefore, we analysed 5-year survivors of childhood cancer using the British Childhood Cancer Survivor Study (BCCSS) to determine the risks of aspects of long-term mental health dysfunction. Within the BCCSS, 10 488 survivors completed a questionnaire that ascertained mental health-related information via 10 questions from the Short Form-36 survey. Internal analyses were conducted using multivariable logistic regression to determine risk factors for mental health dysfunction. External analyses were undertaken using direct standardisation to compare mental health dysfunction in survivors with UK norms. This study has shown that overall, childhood cancer survivors had a significantly higher prevalence of mental health dysfunction for 6/10 questions analysed compared to UK norms. Central nervous system (CNS) and bone sarcoma survivors reported the greatest dysfunction, compared to expected, with significant excess dysfunction in 10 and 6 questions, respectively; the excess ranged from 4.4-22.3% in CNS survivors and 6.9-15.9% in bone sarcoma survivors. Compared to expected, excess mental health dysfunction increased with attained age; this increase was greatest for reporting 'limitations in social activities due to health', where the excess rose from 4.5% to 12.8% in those aged 16-24 and 45+, respectively. Within the internal analyses, higher levels of educational attainment and socio-economic classification were protective against mental health dysfunction. Based upon the findings of this large population-based study, childhood cancer survivors report significantly higher levels of mental health dysfunction than those in the general population, where deficits were observed particularly among CNS and bone sarcoma survivors. Limitations were also observed to increase

  3. REPRODUCTIVE ASPECTS ASSOCIATED WITH PRECURSOR LESIONS FOR CERVICAL CANCER

    Rogério Ferrari

    2013-05-01

    Full Text Available To investigate the relationship between reproductive variables and theprecursor lesions for cervical cancer in women attended the clinic of the lower genitaltract pathology and colposcopy (PTGIC, packed in the complex regional healthCaceres city, southwest of Mato Grosso, in the year 2009.Methods:We conducted across sectional study with data collection from medical records of 142 women withabnormal cytology, colposcopy and positive underwent directed biopsy, taking intoaccount the reproductive variables.Results:indicate that the minimum age at menarchewas 9 years and maximum age was 17 years, mean 12.6 years; on the average paritywas 3.4 children, the use of hormonal contraceptive method corresponds to 34 5% and38.1% female sterilization research, 46.5% are or have use of contraception for a periodgreater than five years, with a mean of 4.7 years and 67.2% of women surveyed do notuse condoms. The variables were not significantly associated to cervical cancer.Conclusion:the characteristics of the women studied may serve as a basis for workdirected to this population in order to seek to minimize this problem.Although the dataobtained were satisfactory, it was possible to trace the profile of the reproductiveaspects of women in the Clinic ofPTGIC, there is a lack of association betweenreproductive aspects and findings of the cervical biopsy, it may be associated with somelimiting factors of the study that need to be balanced

  4. Knowledge and perceptions of cancer and cancer prevention among Malaysian traditional healers: a qualitative study.

    Al-Naggar, Redhwan A; Bobryshev, Yuri V; Abdulghani, Mahfoudh Al-Musali Mohammed; Rammohan, Subramanian; Al-Jashamy, Karim

    2012-01-01

    The objective of this study was to explore the knowledge and perceptions of Malaysian tradition healers towards cancer and cancer prevention. A total of 25 participants agreed to participate in this qualitative study during the period from 20th July 2011 until 24th of September 2011. The proposal of this study was approved by the Ethics Committee of Management and Science University (MSU). Once the participant agreed to be interviewed, date, time and place of the interviews were determined. Consent form was obtained from participants before the interview began. Participants were briefed about the study and its purpose, and after asking their permission, their replies were recorded. The data was organized into themes and analyzed manually. Twenty-five Malaysian traditional healers participated in this qualitative study. The age of participants ranged between 26 to 78 years old. The majority were in the age group of 31-60 years old, male, Chinese, degree holders with a monthly income ranging from 1,000-5,000 Ringgit Malaysia (RM) and were married (56%, 80%, 48%, 52%, 68%, 84% respectively). The majority defined cancer as having high cholesterol or abscess accumulation. A few of them defined cancer as a type of cell growth. The majority mentioned that food and unhealthy lifestyles are the primary causes of cancer. Surprisingly some of them mentioned that cancer is caused by interference by ghosts. Regarding the diagnosis of cancer, the majority mentioned that they refer their patients to modern physicians' medical report when it comes to diagnosing or treating patients with cancer. The most common cancers that many patients came to seek treatment were breast cancers, followed by colon cancers, liver and lung cancers. Despite good knowledge about the causes of cancer among traditional healers, misconceptions still exist. Insufficient knowledge about the definition of cancer was noted among the traditional healers. This urges immediate action by the Ministry of Health

  5. A qualitative exploration of Malaysian cancer patients’ perceptions of cancer screening

    Farooqui Maryam

    2013-01-01

    Full Text Available Abstract Background Despite the existence of different screening methods, the response to cancer screening is poor among Malaysians. The current study aims to examine cancer patients’ perceptions of cancer screening and early diagnosis. Methods A qualitative methodology was used to collect in-depth information from cancer patients. After obtaining institutional ethical approval, patients with different types and stages of cancer from the three major ethnic groups (Malay, Chinese and Indian were approached. Twenty semi-structured interviews were conducted. All interviews were audiotaped, transcribed verbatim, and translated into English for thematic content analysis. Results Thematic content analysis yielded four major themes: awareness of cancer screening, perceived benefits of cancer screening, perceived barriers to cancer screening, and cues to action. The majority of respondents had never heard of cancer screening before their diagnosis. Some participants reported hearing about mammogram and Pap smear tests but did not undergo screening due to a lack of belief in personal susceptibility. Those who had negative results from screening prior to diagnosis perceived such tests as untrustworthy. Lack of knowledge and financial constraints were reported as barriers to cancer screening. Finally, numerous suggestions were given to improve screening behaviour among healthy individuals, including the role of mass media in disseminating the message ‘prevention is better than cure’. Conclusions Patients’ narratives revealed some significant issues that were in line with the Health Belief Model which could explain negative health behaviour. The description of the personal experiences of people with cancer could provide many cues to action for those who have never encountered this potentially deadly disease, if incorporated into health promotion activities.

  6. [Challenges for home care services in the pain management of cancer patients : A qualitative study].

    Gnass, I; Krutter, S; Nestler, N

    2018-03-21

    People with cancer are increasingly supported by home care services. Pain is a relevant symptom of these diseases and nurses of home care services are involved in the treatment. The German National Expert Standard "Pain management in nursing" includes evidence-based recommendations for the implementation of adequate pain management. Considering the given structural conditions of home care services, nurses describe both barriers and challenges with the implementation. By means of five guideline-based discussion groups, nurses of 14 home care services were questioned about the challenges they had experienced in pain management. The questioning focuses on the level of implementation of the recommendation for each aspect: pain assessment, pharmacological pain therapy, non-pharmacological pain therapy, pain-related side effects, information, training, and counseling in the care of people with cancer. A qualitative content analysis was conducted. On the one hand, the results illustrate a need for further knowledge and possibilities, e.g., for the assessment of pain as a multidimensional phenomenon and, on the other hand, that the conditions for continuous pain monitoring of cancer patients in home care services are limited. The need for short-term reconciliation with the treatment team and the practitioners proved to be more difficult than the cooperation with the palliative care network. Involvement of family members is important to ensure uninterrupted treatment. Beside knowledge and competencies regarding nursing care, structures and processes for interprofessional pain management need further development and research.

  7. Functioning and health in patients with cancer on home-parenteral nutrition: a qualitative study.

    Mueller, Martin; Lohmann, Stefanie; Thul, Paul; Weimann, Arved; Grill, Eva

    2010-04-16

    Malnutrition is a common problem in patients with cancer. One possible strategy to prevent malnutrition and further deterioration is to administer home-parenteral nutrition (HPN). While the effect on survival is still not clear, HPN presumably improves functioning and quality of life. Thus, patients' experiences concerning functioning and quality of life need to be considered when deciding on the provision of HPN. Currently used quality of life measures hardly reflect patients' perspectives and experiences. The objective of our study was to investigate the perspectives of patients with cancer on their experience of functioning and health in relation to HPN in order to get an item pool to develop a comprehensive measure to assess the impact of HPN in this population. We conducted a series of qualitative semi-structured interviews. The interviews were analysed to identify categories of the International Classification of Functioning, Disability and Health (ICF) addressed by patients' statements. Patients were consecutively included in the study until an additional patient did not yield any new information. We extracted 94 different ICF-categories from 16 interviews representing patient-relevant aspects of functioning and health (32 categories from the ICF component 'Body Functions', 10 from 'Body Structures', 32 from 'Activities & Participation', 18 from 'Environmental Factors'). About 8% of the concepts derived from the interviews could not be linked to specific ICF categories because they were either too general, disease-specific or pertained to 'Personal Factors'. Patients referred to 22 different aspects of functioning improving due to HPN; mainly activities of daily living, mobility, sleep and emotional functions. The ICF proved to be a satisfactory framework to standardize the response of patients with cancer on HPN. For most aspects reported by the patients, a matching concept and ICF category could be found. The development of categories of the component

  8. Functioning and health in patients with cancer on home-parenteral nutrition: a qualitative study

    Lohmann Stefanie

    2010-04-01

    Full Text Available Abstract Background Malnutrition is a common problem in patients with cancer. One possible strategy to prevent malnutrition and further deterioration is to administer home-parenteral nutrition (HPN. While the effect on survival is still not clear, HPN presumably improves functioning and quality of life. Thus, patients' experiences concerning functioning and quality of life need to be considered when deciding on the provision of HPN. Currently used quality of life measures hardly reflect patients' perspectives and experiences. The objective of our study was to investigate the perspectives of patients with cancer on their experience of functioning and health in relation to HPN in order to get an item pool to develop a comprehensive measure to assess the impact of HPN in this population. Methods We conducted a series of qualitative semi-structured interviews. The interviews were analysed to identify categories of the International Classification of Functioning, Disability and Health (ICF addressed by patients' statements. Patients were consecutively included in the study until an additional patient did not yield any new information. Results We extracted 94 different ICF-categories from 16 interviews representing patient-relevant aspects of functioning and health (32 categories from the ICF component 'Body Functions', 10 from 'Body Structures', 32 from 'Activities & Participation', 18 from 'Environmental Factors'. About 8% of the concepts derived from the interviews could not be linked to specific ICF categories because they were either too general, disease-specific or pertained to 'Personal Factors'. Patients referred to 22 different aspects of functioning improving due to HPN; mainly activities of daily living, mobility, sleep and emotional functions. Conclusions The ICF proved to be a satisfactory framework to standardize the response of patients with cancer on HPN. For most aspects reported by the patients, a matching concept and ICF category

  9. Communicating about cancer through Facebook: a qualitative analysis of a breast cancer awareness page.

    Abramson, Karley; Keefe, Brian; Chou, Wen-Ying Sylvia

    2015-01-01

    Social media channels are increasingly being used for health communication and promotion. Social networking sites such as Facebook have become popular platforms for organizations to communicate health messages and encourage user participation around health topics. While the evaluation of social media's effectiveness in health promotion is beginning to emerge in the literature, few studies have examined actual interactions and user behaviors on Facebook Pages hosted by health organizations. The authors present a qualitative case study of a popular Facebook Page from a nonprofit organization devoted to raising awareness about breast cancer. With the goal of identifying the functions and uses of the Page, our study analyzes the content of Wall posts during Breast Cancer Awareness Month, October 2010. Common themes and characteristics are identified, including open mic communication, scarcity of health information, the commodification of breast cancer, unpredictable locations of conversation, and the use of gendered images and language. The findings have potential implications for health promotion efforts using social media platforms.

  10. Psychosocial aspects of breast cancer treatement in Accra, Ghana ...

    Objectives: To evaluate psychosocial influences and effects of breast cancer treatment. Design: Cohort questionnaire survey. Setting: Surgical Outpatient Department, Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Subjects: Women previously treated for breast cancer, including those still on hormonal therapy.

  11. Clinical and biological aspects of mucinous colorectal cancer

    Hugen, N.

    2016-01-01

    In the Netherlands approximately 5% of all people will develop colorectal cancer during his or her life. The rapid development of individualized therapy for cancer patients has led to an increased interest in tumor subtypes. Currently, colorectal cancer patients are treated in the same way

  12. Cancer and air pollution. Aspects of geographical pathology

    Garbe, E; Brunet, M

    1970-01-01

    Data on deaths from all cancers in France (both sexes) for 1961-1963 (inclusive), 1966 and 1967 were compared with data relating to air pollution levels, including consumption of petroleum and petroleum products, per capita consumption of fossil fuels, population density and the urbanization coefficients for each of the departments of France, obtained at various times from 1951 through 1966. Significant correlations were found between cancer death rates and parameters of air pollution, including a highly significant correlation between the 1961-1963 data on cancer deaths and the 1951-1953 data per capita fossil fuel consumption. A comparison of crude cancer mortality rates/100,000 population (av for 1961-1963) and rates of petroleum consumption per unit surface area (1951-1953) showed significant correlations between petroleum consumption and cancer of the larynx, lung and oral cavity in males, breast cancer in females and leukemia in both sexes. When the 1961-1963 data on lung cancer in males (used as an index of urbanization) were compared with similar data for other tumor types in both sexes, the results suggested an urban predominance for cancer of the lung and the rural predominance for cancer of the prostate, stomach and upper g.i and respiratory tracts in males, breast and cervix cancer in females and leukemia in both sexes, and a esophagus in males. The results suggest that industrialization and air pollution are not the only factors of importance in the epidemiology of cancer in urban areas.

  13. Clinicopathological aspects and prevalence of human papillomavirus in anal cancer

    Marina Tayla Mesquita Aguiar

    2014-04-01

    Full Text Available Anal cancer is relatively rare; however, its incidence has increased in recent years. Several risk factors are associated with the development of anal cancer, including age older than 50 years, low-fiber diet, chronic anal fistulas, smoking, multiple partners, anal intercourse practice, Human Immunodeficiency Virus infection and immunosuppression. However, the presence of human papillomavirus represents the main risk factor for the development of anal cancer. The aim of this study was to evaluate the clinicopathological aspects of a series of patients with anal carcinomas diagnosed in Hospital Araújo Jorge, Goiânia-Goiás, as well as the prevalence of human papillomavirus genome in these tumors. Clinical, pathological and socio-demographic data were collected from the respective medical files and paraffin blocks containing anal carcinomas specimens were used for DNA extraction and detection of human papillomavirus, by means of polymerase chain reaction, using short PCR fragment primers. Forty-three cases were selected and had the data analyzed, while 38 cases were tested for human papillomavirus genome detection. Among the evaluated patients, 62.8% were women; 53.4% of tumors were squamous cell carcinoma and 46.5% of the patients were aged between 60 and 75 years. Risk factors, such as smoking (39.5% and alcoholism (20.9% were recorded in the studied group. Lymph node metastases were detected in 30.2% of cases and 7.0% had distant metastasis. The detection of human papillomavirus DNA was positive in 76% of cases assessed and this was significantly associated with squamous cell carcinomas. Aggressive behavior and advanced stage of anal cancer described in this study highlight the need for preventive measures that contemplate these tumors, including vaccination against human papillomavirus. Resumo: O câncer anal é relativamente raro, entretanto, sua incidência aumentou nos últimos anos. Vários fatores de risco são associados ao

  14. Some Aspects Of Adjuvant Treatment Of Colorectal Cancer

    Hlavata, Z.

    2008-01-01

    Colorectal cancer is one of the most common cancers in Europe and in North America. Cornerstone of the treatment of localized colorectal cancer is surgical resection followed by chemotherapy or radio-chemotherapy in indicated cases. For patients with Stage III colon cancer recent data have shown efficacy through the combining fluorouracil-based chemotherapy with oxaliplatin into adjuvant treatment program. For patients with Stage II colon cancer, the use of adjuvant chemotherapy remains controversial, but may be appropriate in a subset of individuals at high risk for disease recurrence. Current randomized clinical trials in the adjuvant therapy of colorectal cancer are examining the value of adding agents known to be active in metastatic disease, including those that modify specific molecular targets. (author)

  15. Music as a method of coping with cancer: A qualitative study among cancer patients in Sweden.

    Ahmadi, Fereshteh

    2013-06-01

    Background : This study investigated patients' understanding of the role of music in coping and in influencing their well-being. Methods : A qualitative study was conducted based on semi-structured interviews with 17 cancer patients. Participants were chosen from a group of patients who had listened to or played music as a means of coping with their illness. Results : The study shows the importance of considering the roles that different kinds of music play in coping with cancer. The music of nature, healing music, religious music and cheerful music each have different benefits for patients. Conclusions : A patient's situation and his or her individual characteristics determine the types of music that can act as a useful or harmful coping strategy. Therefore, it is essential to investigate the types of individual characteristics that can make listening to different kinds of music a helpful or harmful coping method.

  16. Music as a method of coping with cancer: A qualitative study among cancer patients in Sweden

    Ahmadi, Fereshteh

    2013-01-01

    Background: This study investigated patients’ understanding of the role of music in coping and in influencing their well-being. Methods: A qualitative study was conducted based on semi-structured interviews with 17 cancer patients. Participants were chosen from a group of patients who had listened to or played music as a means of coping with their illness. Results: The study shows the importance of considering the roles that different kinds of music play in coping with cancer. The music of nature, healing music, religious music and cheerful music each have different benefits for patients. Conclusions: A patient's situation and his or her individual characteristics determine the types of music that can act as a useful or harmful coping strategy. Therefore, it is essential to investigate the types of individual characteristics that can make listening to different kinds of music a helpful or harmful coping method. PMID:23805166

  17. EMMPRIN in gynecologic cancers: pathologic and therapeutic aspects.

    Liu, Dan-tong

    2015-07-01

    The highly glycosylated transmembrane protein extracellular matrix metalloproteinase inducer (EMMPRIN) is associated with several pathological conditions, including various types of cancers. In different gynecological malignancies, such as ovarian, cervical, and endometrial cancers, EMMPRIN plays significant roles in cell adhesion modulation, tumor growth, invasion, angiogenesis, and metastasis by inducing the production of various molecules, including matrix metalloproteinases and vascular endothelial growth factor. Because of its high level of expression, EMMPRIN can possibly be used as a diagnostic marker of gynecological cancers. Recent studies have showed that targeting EMMPRIN, especially by RNA interference (RNAi) technology, has promising therapeutic potential in basic research on gynecological cancer treatments, which make a platform for the future clinical success. This review study focused on the association of EMMPRIN in gynecological cancers in the perspectives of pathogenesis, diagnosis, and therapeutics.

  18. Ovarian cancer: Novel molecular aspects for clinical assessment.

    Palmirotta, Raffaele; Silvestris, Erica; D'Oronzo, Stella; Cardascia, Angela; Silvestris, Franco

    2017-09-01

    Ovarian cancer is a very heterogeneous tumor which has been traditionally characterized according to the different histological subtypes and differentiation degree. In recent years, innovative molecular screening biotechnologies have allowed to identify further subtypes of this cancer based on gene expression profiles, mutational features, and epigenetic factors. These novel classification systems emphasizing the molecular signatures within the broad spectrum of ovarian cancer have not only allowed a more precise prognostic prediction, but also proper therapeutic strategies for specific subgroups of patients. The bulk of available scientific data and the high refinement of molecular classifications of ovarian cancers can today address the research towards innovative drugs with the adoption of targeted therapies tailored for single molecular profiles leading to a better prediction of therapeutic response. Here, we summarize the current state of knowledge on the molecular bases of ovarian cancer, from the description of its molecular subtypes derived from wide high-throughput analyses to the latest discoveries of the ovarian cancer stem cells. The latest personalized treatment options are also presented with recent advances in using PARP inhibitors, anti-angiogenic, anti-folate receptor and anti-cancer stem cells treatment approaches. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Important Aspects of Nutrition in Children with Cancer1

    Bauer, Jacqueline; Jürgens, Heribert; Frühwald, Michael C.

    2011-01-01

    Adequate nutrition during cancer plays a decisive role in several clinical outcome measures, such as treatment response, quality of life, and cost of care. However, the importance of nutrition in children and young adults with malignancies is still an underestimated topic within pediatric oncology. The importance of our work is to reinforce and indicate that malnutrition in children with cancer should not be accepted at any stage of the disease or tolerated as an inevitable process. Unique to our manuscript is the close collaboration, the exchange of knowledge and expertise between pediatric oncologists and a nutritional specialist, as well as the comprehension of the mechanisms during cancer cachexia and malnutrition. We provide a critical review of the current state of research and new knowledge related to nutritional management in childhood cancer. PMID:22332035

  20. Important Aspects of Nutrition in Children with Cancer1

    Bauer, Jacqueline; Jürgens, Heribert; Frühwald, Michael C.

    2011-01-01

    Adequate nutrition during cancer plays a decisive role in several clinical outcome measures, such as treatment response, quality of life, and cost of care. However, the importance of nutrition in children and young adults with malignancies is still an underestimated topic within pediatric oncology. The importance of our work is to reinforce and indicate that malnutrition in children with cancer should not be accepted at any stage of the disease or tolerated as an inevitable process. Unique to...

  1. Legal aspects of cancer deseases prophylactics: patients rights context.

    Tatsiy, Vasyl; Gutorova, Nataliya; Pashkov, Vitalii

    Introduction: In accordance with Resolution on Cancer Control WHA58.22 Cancer prevention and control The Fifty-eighth World Health Assembly it is obvious technology for diagnosis and treatment of cancer is mature, and that many cases of cancer may be cured, especially if detected earlier Some key points on concept of legal regulation of abovementioned sphere is a base of this study. However, the problems of using an effective mechanism for protecting the rights of patients in certain types of disease, in particular cancer patients, by providing early diagnosis, are not fully developed by medical law specialists. The aim of the article is to determine the means of ensuring the right to health and life of cancer patients in particular through early diagnosis. Material and Methods: This study is based on regulation acts, World health report (2013), The Fifty-eighth World Health Assembly, WHA58.22 Cancer prevention and control, Universal Declaration of Human Rights, International Covenant on Civil and Political Rights, International Covenant on Economic, Social and Cultural Rights, European Convention for the Protection of Human Rights and Fundamental Freedoms, Charter of Fundamental Rights of the European Union, research papers and views of progressive-minded people in this sphere. Article is grounded on dialectical, comparative, analytic, synthetic and comprehensive research methods. Review: Most countries have declared a compliance of their national legislation with international standards regarding the right to life and health. The analysis of the abovementioned international acts in context of protection of the rights of patients with cancer leads to the conclusion that countries that have undertaken international legal obligations to protect the right to life are required to take the necessary measures to ensure the effective treatment of cancer patients. Taking into account that the lack of such treatment due to the specificity of the disease entails the death

  2. The pathology of familial breast cancer: Morphological aspects

    Lakhani, Sunil R

    1999-01-01

    A small proportion of breast cancers are due to a heritable predisposition. Recently, two predisposition genes, BRCA1 and BRCA2, have been identified and cloned. The morphological features of tumours from patients harbouring mutations in the BRCA1 and BRCA2 genes differ from each other and from sporadic breast cancers. Both are of higher grade than are sporadic cases. An excess of medullary/atypical medullary carcinoma has been reported in patients with BRCA1 mutations. Multifactorial analysis, however, shows that the only features independently associated with BRCA1 mutations are a high mitotic count, pushing tumour margins and a lymphocytic infiltrate. For BRCA2 mutation, an association with tubular/lobular carcinoma has been suggested, but not substantiated in a larger Breast Cancer Linkage Consortium study. In multifactorial analysis, the independent features were a lack of tubule formation and pushing tumour margins only. The morphological analysis has implications for clinical management of patients

  3. Qualitative and quantitative analysis of micro and macro aspects of agricultural finance

    Veselinović Branislav

    2014-01-01

    Full Text Available The epicenter of this analysis is to provide an overview of the current situation in micro and macro agricultural finance in Serbia and the EU. One of the goals of this research is to consider the weaknesses and potentials of agricultural policy in Serbia, through comparison with more developed countries. In this qualitative and quantitative analysis, authors used comparation method, analysis and synthesis method, inductive and deductive method, and a local and international literature review. There are several important conclusions which can be drawn from this manuscript. Access to finance among farmers and agricultural SMEs is among the poorest of any sector in Serbia. The Serbian financial sector offers a poor range of loan products to the agricultural sector. Therefore, existing mechanisms for micro and macro agricultural finance in Serbia are not adequate and a change should be made in approach.

  4. ASPECT OF LANGUAGE ON A QUALITATIVE ANALYSIS OF STUDENT’S EVALUATION INSTRUMENT

    Ismanto Ismanto

    2016-11-01

    Full Text Available This article examined the characteristics of good student’s evaluation instrument. There are at least two requirements that must be met. Those are valid and reliable. The validity of the instrument can be seen from the instrument's ability to measure what should be measured. The fact the existence of the validity of an instrument may be a grain fill, the response process, internal structure, relationship with other variables, and the consequences of the implementation of the charging instrument. Analysis of the content is then known as content validity, i.e. rational analysis of the domain to be measured to determine the representation of each item on the instrument with the ability to be measured. Content validity is submitting pieces of blue print and items of the instrument to the experts to be analyzed quantitatively and qualitatively.

  5. ASPECTS REGARDING THE USE OF SOCIAL MEDIA IN QUALITATIVE MARKETING RESEARCH

    Mirela Cristina VOICU

    2015-07-01

    Full Text Available In order to carry out an efficient marketing activity, it is well known that entrepreneurs have to find out, first of all, where and how consumers spend their time, what are the communication channels and forms they prefer and then try to interact with the customers on their territory and on their own terms. The forms of communication that are gaining momentum currently, are taking place online, especially in the social media. A growing number of consumers have become open towards and familiar with social media, sharing their opinions daily through these means. Since the emergence of the social media phenomenon, its use has grown and has become widespread in a short period of time. In response to this phenomenon, social media marketing has developed at a similar pace and in a similar direction, and this is also reflected in the existing opportunities for using social media in qualitative marketing research.

  6. Personal, situational and organizational aspects that influence the impact of patient safety incidents: A qualitative study.

    Van Gerven, E; Deweer, D; Scott, S D; Panella, M; Euwema, M; Sermeus, W; Vanhaecht, K

    2016-07-01

    When a patient safety incident (PSI) occurs, not only the patient, but also the involved health professional can suffer. This study focused on this so-called "second victim" of a patient safety incident and aimed to examine: (1) experienced symptoms in the aftermath of a patient safety incident; (2) applied coping strategies; (3) the received versus needed support and (4) the aspects that influenced whether one becomes a second victim. Thirty-one in-depth interviews were performed with physicians, nurses and midwives who have been involved in a patient safety incident. The symptoms were categorized under personal and professional impact. Both problem focused and emotion focused coping strategies were used in the aftermath of a PSI. Problem focused strategies such as performing a root cause analysis and the opportunity to learn from what happened were the most appreciated, but negative emotional responses such as repression and flight were common. Support from colleagues and supervisors who were involved in the same event, peer supporters or professional experts were the most needed. A few individuals described emotional support from the healthcare institution as unwanted. Rendered support was largely dependent on the organizational culture, a stigma remained among healthcare professionals to openly discuss patient safety incidents. Three aspects influenced the extent to which a healthcare professional became a second victim: personal, situational and organizational aspects. These findings indicated that a multifactorial approach including individual and emotional support to second victims is crucial. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. A qualitative analysis of aspects of treatment that adolescents with anorexia identify as helpful.

    Zaitsoff, Shannon; Pullmer, Rachelle; Menna, Rosanne; Geller, Josie

    2016-04-30

    This study aimed to identify aspects of treatment that adolescents with anorexia nervosa (AN) believe are helpful or unhelpful. Adolescent females receiving treatment for AN or subthreshold AN (n=21) were prompted during semi-structured interviews to generate responses to open-ended questions on what they felt would be most helpful or unhelpful in treating adolescents with eating disorders. Eight codes were developed and the two most frequently endorsed categories were (1) Alliance, where the therapist demonstrates clinical expertise and also expresses interest in the patient (n=21, 100.0%), and (2) Client Involvement in treatment (n=16, 76.2%). These top two categories were shared by participants with AN versus subthreshold AN and participants with high versus low readiness to change their dietary restriction behaviours. Development of the coding scheme and sample participant responses will be discussed. The integration of identified factors into empirically supported treatments for adolescent AN, such as Family-based Treatment, will be considered. This study provides initial information regarding aspects of treatment that adolescents identify as most helpful or unhelpful in their treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Engaging men with penile cancer in qualitative research: reflections from an interview-based study.

    Witty, Karl; Branney, Peter; Bullen, Kate; White, Alan; Evans, Julie; Eardley, Ian

    2014-01-01

    To explore the challenges of engaging men with penile cancer in qualitative interview research. Qualitative interviewing offers an ideal tool for exploring men's experiences of illness, complementing and providing context to gendered health inequalities identified in epidemiological research on men. But conducting interviews with men can be challenging and embarking on a qualitative interview study with males can feel like a daunting task, given the limited amount of practical, gender-sensitive guidance for researchers. Reflecting on a researcher's experience of conducting qualitative research on men with penile cancer, this paper explores the potential challenges of interviewing this group, but also documents how engagement and data collection were achieved. This is a reflective paper, informed by the experiences of a male researcher (KW) with no nurse training, who conducted 28 interviews with men who had been treated for penile cancer. The researcher's experiences are reported in chronological order, from the methodological challenges of recruitment to those of conducting the interview. The paper offers a resource for the novice researcher, highlighting some advantages and disadvantages of conducting qualitative interview research as a nurse researcher, as well as recommendations on how to overcome challenges. Engaging men with penile cancer in qualitative interview raises practical, methodological, ethical and emotional challenges for the researcher. However, when these challenges are met, men will talk about their health. Methodological procedures must enable an open and ongoing dialogue with clinical gatekeepers and potential participants to promote engagement. Support from colleagues is essential for any interviewer, no matter how experienced the researcher is.

  9. Comparison of qualitative and quantitative approach to prostate MR spectroscopy in peripheral zone cancer detection

    Klijn, Stijn; De Visschere, Pieter J.; De Meerleer, Gert O.; Villeirs, Geert M.

    2012-01-01

    Objective: To compare the diagnostic performance of a qualitative (pattern recognition) and a quantitative (numerical assessment) approach to magnetic resonance spectroscopy (MRS) in the diagnosis of peripheral zone prostate cancer. Methods: 185 patients (131 with histopathologically proven cancer, 54 normal/benign after at least 12 months follow-up) were prospectively evaluated with qualitative MRS using a 4-point scale between 3/2004 and 1/2008, and retrospectively reassessed using a prototype quantitative postprocessing software in April 2008. Based on pathology and follow-up data, diagnostic performance parameters were calculated. Results: The qualitative and quantitative approaches were concordant in 78.9% (146/185) of cases. The difference between the areas under the ROC curve (0.791 versus 0.772, respectively) was not statistically significant. The sensitivity, specificity and accuracy were 55.7%, 94.4% and 67.0% for the qualitative approach, and 55.0%, 83.3% and 63.2% for the quantitative approach. The sensitivity for high grade tumours (Gleason 4 + 3 or higher) was 85.2% (23/27) for both approaches. All cancers missed on either one approach separately (31/31) and 91% of cancers missed on both approaches together (23/27) were of lower grade (Gleason 3 + 4 or lower). Conclusions: Qualitative and quantitative approaches to MRS yield similar diagnostic results. Discordances in tumour detection only occurred in lower grade cancers.

  10. Aspekte der Erwachsenenbildung in qualitativer Forschung Aspects of Adult Education in Qualitative Research

    Heide von Felden

    2006-03-01

    Full Text Available Das Buch gibt interessante Einblicke in verschiedene Projekte, die am Lehrstuhl für Erwachsenenbildung an der Universität Duisburg-Essen entstehen. Untersucht werden insbesondere Karriereverläufe von weiblichen Führungskräften, Aspekte der Arbeit an Volkshochschulen und die Frage, wie Berufsrückkehrerinnen mit dem Faktor Zeit umgehen.The book provides interesting perspectives into the varying projects being developed in the department of adult and continuing education at the University of Duisburg-Essen. It examines in particular the career paths of female executives, aspects of work at community colleges, and the question as to how those returning to careers manage the factor of time.

  11. Perceptions of lung cancer and potential impacts on funding and patient care: a qualitative study.

    Tran, Kim; Delicaet, Kendra; Tang, Theresa; Ashley, Leslie Beard; Morra, Dante; Abrams, Howard

    2015-03-01

    The objective of this study was to explore health-care professionals', health administrators', and not-for-profit cancer organization representatives' perceptions of lung cancer-related stigma and nihilism and the perceived impacts on funding and patient care. This is a qualitative descriptive study using semi-structured interviews, which was conducted in Ontario, Canada. Seventy-four individuals from medical oncology, radiation oncology, thoracic surgery, respirology, pathology, radiology, primary care, palliative care, nursing, pharmacy, social work, genetics, health administration, and not-for-profit cancer organizations participated in this study. Participants described lung cancer-related stigma and nihilism and its negative impact on patients' psychological health, lung cancer funding, and patient care. The feeling of guilt and shame experienced by lung cancer patients as a result of the stigma associated with the disease was described. In terms of lung cancer funding, stigma was described as a reason lung cancer receives significantly less research funding compared to other cancers. In terms of patient care, lung cancer-related nihilism was credited with negatively impacting physician referral patterns with the belief that lung cancer patients were less likely to receive referrals for medical treatment. Health-care professionals, health administrators, and not-for-profit cancer organization representatives described lung cancer-related stigma and nihilism with far-reaching consequences. Further work is needed to increase education and awareness about lung cancer to reduce the stigma and nihilism associated with the disease.

  12. Cancer-related aspects of regeneration research: a review

    Donaldson, D.J.; Mason, J.M.

    1975-01-01

    Tissue regeneration is simply the replacement of lost cells of a tissue by those remaining. Epimorphic regeneration involves dedifferentiation of many tissues and their organization into a blastema which eventually differentiates into the missing part, usually an appendage. A detailed comparison of the cell membrane changes occurring in epimorphic regeneration, tissue regeneration and cancer can contribute to greater understanding of the differences between normal and tumor cells. Further, there is evidence that epimorphic regeneration fields may in some instances suppress tumor induction and control existing tumors. This influence may be mediated by bioelectric fields, which are ubiquitous in nature and appear to control many cellular events. Disruption of these bioelectric fields suppresses epimorphic regeneration and may lead to cancer in mammals, while applied electric fields alter regenerative events and cause tumor regression. Studies on x-radioinduced regeneration suppression in relation to mutagenesis are also reviewed

  13. Doctors' tacit knowledge on coping processes of oral cancer patients: A qualitative study.

    Rana, Madiha; Czens, Franziska; Wingartz, Franziska; Gellrich, Nils-Claudius; Rana, Majeed

    2016-12-01

    The implicit knowledge of doctors about coping, quality of life and factors which have an influence on these aspects were investigated. In addition, they were asked about the need for psychological support in clinical practice. Doctors (n = 40) working in the field of oral and maxillofacial surgery, otorhinolaryngology and oncology were interviewed about coping and quality of life of patients, the course of therapy and experiences in the doctor-patient interaction based on a semi-structured interview. The data were analyzed using qualitative content analysis. Hundred percent of the doctors pointed out that patients with oral cancer are a special clientele which definitely needs to have psycho-oncological support. Eighty seven percent of the doctors divide their patients based on their style of coping into two groups: the one who are depressive and do not cope well and active patients who are able to stand their diagnosis. Ninety five percent of the doctors cite personality and social support as key factors affecting the quality of life and style of coping. Lack of time and lack of support from psychologists were given as the main obstacle for holistic treatment. Doctors have very specific ideas about the coping mechanisms and problems of their patients. These theories may have an impact on the doctor-patient relationship and should be considered in more detail. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  14. Nonimaging aspects of follow-up in breast cancer reconstruction.

    Wood, W C

    1991-09-01

    Follow-up of patients with breast cancer is directed to the early detection of recurrent or metastatic disease and the detection of new primary breast cancer. The survival benefit of early detection is limited to some patients with local failure or new primary tumors. That imaging is not used in follow-up of patients who have had breast cancer reconstruction is related to possible interference with this putative benefit by the reconstructive procedure. Such follow-up is accomplished by the patient's own surveillance, clinical examination, and laboratory testing supplemented by imaging studies. Clinical follow-up trials of women who have undergone breast reconstructive surgery show no evidence that locally recurrent breast carcinoma is masked when compared with follow-up of women who did not undergo reconstructive procedures. Reshaping of the contralateral breast to match the reconstructed breast introduces the possibility of interference with palpation as well as mammographic distortion in some women. This is an uncommon practical problem except when complicated by fat necrosis.

  15. LEGAL ASPECTS AND UNCONVENTIONAL METHODS OF CANCER TREATMENT

    S. V. Sidorov

    2018-01-01

    Full Text Available Background: The current legislation on the provision of medical assistance fixes the patient’s right to health care and medical assistance (Article 41 of the Constitution of the Russian Federation. Hence it follows that the patient has the opportunity to receive advice on the use of different treatment methods not only from his/her attending physician, but also from other doctors, to use available reference information, and to consider options for using methods of alternative medicine. Patients have the right to refuse treatment if they consider that the treatment options offered by the attending physician are inappropriate for them. Physicians have no right to treat patients without a patient’s informed consent. It is necessary to determine the actual legal model of the relationship between the attending physician and the patient, who may have different options for further treatment. The purpose of the study was to analyze the legislation on the protection of public health, which allows the attending physician to refuse further treatment of a patient, informing the chief physician about the reasons for the refusal.Results. In cases when cancer hospitals and centers refuse to treat patients who decline conventional cancer treatment and require alternative medicine instead, a signed mutual refusal of medical care is documented: the patient’s refusal of the treatment and the cancer institution’s refusal of the treatment options offered by the patient.

  16. [Modern aspects of surgical treatment of locally advanced pelvic cancer].

    Solovyov, I A; Vasilchenko, M V; Lychev, A B; Ambartsumyan, S V; Alekseev, V V

    2015-09-01

    The aim of investigation is to improve surgical treatment of patients with locally advanced pelvic cancer. The basis of investigation is 186 patients with locally advanced pelvic cancer. The average age of patients is 65.2 ± 5.2 years (from 43.7 to 88.4 years). Among them are 112 women and 74 men. In the period from 2007 to 2015 they were carried out combined (101 patients) and expanded (85 patients) surgical intervention in the department of naval surgery of the Military medical academy after S.M.Kirov. Pelvic evisceration was performed in 63 cases. Both patients were performed isolated vascular hyperthermic chemical pelvic perfusion. Indications for plastic surgery of peritoneum pelvic were: total infralitoral pelvic evisceration (9 patients), dorsal infralitoral pelvic evisceration (11 cases) and expanded abdominoperineal rectum extirpation (34 patients). Plastic surgery with autogenouse tissues was performed to 43 patients, with reticulate explants--to 11 patients. The rate of postoperative complications was 40.2%. The rate of postoperative lethality was 8%. Expanded and combined operations of pelvic at patients with locally advanced cancer without absolute contra-indications can be performed irrespective of age. Plastic surgery of peritoneum pelvic after total and dorsal infralitoral pelvic evisceration and expanded abdominoperineal rectum extirpation indicated in all cases. The easiest method is plastic surgery with greater omentum or peritoneum pelvic. Plastic surgery with reticulate explants is performed when autoplastic is impossible.

  17. Using qualitative methods to understand non-technological aspects of domestic energy efficiency

    Ambrose, Aimee Rebecca

    The overall aim of the collected published works is to investigate how different policy interventions in the field of energy efficiency (including zero carbon homes, low carbon heat networks, and domestic energy efficiency schemes) are experienced and made sense of by a range of key actors. A further aim is to understand these interventions in the context of existing theories within the field of domestic energy efficiency including socio-technical theory and Actor Network Theory. More specifically, this research advances existing knowledge in the following areas: The nature of the socio-technical challenges encountered in the introduction of more energy efficient buildings, and the importance of achieving a balance between socially acceptable and technically optimal environments. (Papers 2, 3, 4, 6 and 8). The value of qualitative research in gaining a more nuanced understanding of our relationship with the home and the implications of this for domestic energy efficiency interventions and the design of low energy buildings (all papers). The influence of tenure as determinant of access to a more energy efficient home and in particular, the stubborn and complex barriers to achieving higher standards of energy performance within the private rented sector. (Papers 1, 2, 3 and 4). The significance of identity, setting and notions of home in the context of domestic energy efficiency interventions. (Papers 1 and 4). As these themes suggest, this PhD is not just concerned with carbon reduction and energy saving as technical objects, but as a way of life. More specifically, it considers the interactions between the two and contends that technical or policy instruments, no matter how sophisticated, cannot succeed if they are not compatible with our ways of life (and ways of doing businesss) or if our ways of life cannot be reasonably adapted to acoomodate them.

  18. Risk communication with Arab patients with cancer: a qualitative study of nurses and pharmacists.

    Wilbur, Kerry; Babiker, Alya; Al-Okka, Maha; Jumaat, Ebaa; Al-Yafei, Sumaya M Al Saadi; Nashwan, Abdulqadir J

    2015-04-01

    To explore pharmacist and nurse views and experiences in educating patients regarding their treatment safety and tolerability as well as the roles of other professions in this regard. In this qualitative study, six focus group discussions were conducted. The National Center for Cancer Care and Research in Qatar. Eleven pharmacists and 22 nurses providing direct patient care. Concepts related to three key themes were drawn from the seeding questions and included factors for determining the level of risk they communicated: the specific treatment regimen in question; the patient; and their assessment of the patient. Patient-related considerations arose from additional subthemes; both nurses and pharmacists described aspects related to the perceived psychological health status of the patient, as well as anticipated comprehension, as ascertained by demonstrated education and language abilities. In all discussions, it was noted that physician and family non-disclosure of cancer diagnosis to the patient profoundly influenced the nature of information they provided. While a high level of cohesion in safety communication prioritisation among these two health disciplines was found, a number of pharmacists asserted a more formal role compared to informal and repeated teaching by nurses. Nurses and pharmacists in this Middle East healthcare environment were not reluctant to discuss treatment side effects with patients and draw on similar professional judgements in prioritising treatment risk information. We found that they did not always recognise each other's informal educational encounters and that there are opportunities to explore increased collaboration in this regard to enhance the patient care experience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Development of Trust in an Online Breast Cancer Forum: A Qualitative Study.

    Lovatt, Melanie; Bath, Peter A; Ellis, Julie

    2017-05-23

    Online health forums provide peer support for a range of medical conditions including life-threatening and terminal illnesses. Trust is an important component of peer-to-peer support, although relatively little is known about how trust forms within online health forums. The aim of this paper is to examine how trust develops and influences sharing among users of an online breast cancer forum. An interpretive qualitative approach was adopted. Data were collected from forum posts from 135 threads on 9 boards on the UK charity, Breast Cancer Care (BCC). Semistructured interviews were conducted with 14 BCC forum users. Both datasets were analyzed thematically using Braun and Clarke's approach and combined to triangulate analysis. Trust operates in 3 dimensions, structural, relational, and temporal, and these intersect with each other and do not operate in isolation. The structural dimension relates to how the affordances and formal rules of the site affected trust. The relational dimension refers to how trust was necessarily experienced in interactions with other forum users: it emerged within relationships and was a social phenomenon. The temporal dimension relates to how trust changed over time and was influenced by the length of time users spent on the forum. Trust is a process that changes over time and which is influenced by structural features of the forum, as well as informal but collectively understood relational interactions among forum users. The study provides a better understanding of how the intersecting structural, relational, and temporal aspects that support the development of trust facilitate sharing in online environments. These findings will help organizations developing online health forums. ©Melanie Lovatt, Peter A Bath, Julie Ellis. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.05.2017.

  20. Lived experiences of breast cancer survivors after diagnosis, treatment and beyond: qualitative study

    Williams, Faustine; Jeanetta, Stephen C.

    2015-01-01

    Abstract Background The number of breast cancer survivors has increased since 1990 due to advances in biomedical technology that lead to an increase in early diagnosis and treatment. Research on survivorship has focused on the psychological and treatment aspects of the disease. The goal of this study was focused on exploring the lived experiences of breast cancer survivors from diagnosis, treatment and beyond. Objective To understand the lived experiences of women who are breast cancer surviv...

  1. Children's understanding of maternal breast cancer: A qualitative study.

    Huang, Xiaoyan; O'Connor, Margaret; Hu, Yan; Gao, Hongyun; Lee, Susan

    2018-06-01

    To explore how children understand their mother's diagnosis of and treatment for breast cancer. Interpretive description was adopted as the methodology in this study. Eight children aged 8-18 years old, whose mother has been diagnosed with non-terminal breast cancer, were interviewed individually and six of them drew a picture to express their understanding of maternal breast cancer. Four themes were identified in this study: "the cancer word is scary" - children's understanding of cancer; "scars and tubes" - children's understanding of surgery; "hair loss" - children's understanding of chemotherapy, and "I can't explain it" - children's understanding of other treatments. Children's understanding of maternal breast cancer and its treatment was relatively realistic, although sometimes inaccurate. Individual evaluation and appropriate explanation is significant to further children's understanding of their mother's illness. Future studies with larger sample size are needed to explore the understanding for children of different ages, in order to provide specific help for these children. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. [Etiological aspects of occupational cancer in printing industry].

    Il'icheva, S A; Zaridze, D G

    2004-01-01

    Research of oncology lethality from workplace exposures is one of the most effective approaches to studying the etiology of malignant neoplasms. However, certain problems of methodology compromise the informative value of such research whose purpose is to identify the carcinogens. Addition of data on morbidity and lethality in heterogeneous industrial categories, whose typical feature are inhomogeneous exposures, is a major methodological problem. The fact that the studied occupational populations are limited to male subjects is another important problem. The most adequate epidemiological study projects were analyzed and compared with the results of our own case study, which dealt, for the first time in the history of our country, with investigating the lethality causes of 1552 males and 3473 females occupied as compositors, printers and bookbinders at two major printing enterprises in the city of Moscow. According to the authors, an exposure to polycyclic aromatic hydrocarbons, e.g. benzopirin, could be a reliably higher risk of mortality of melanoma and of ovarian cancer among female press operators. With regard for experimental and epidemiological research, the authors believe it appropriate to put forward the below hypothesis: a many-year exposure to minimal quantities of asbestos contained in the paper dust was the key trigger inducing the malignant mesothelioma and ovarian cancer in bookbinders and printers.

  3. Emotions and coping of patients with head and neck cancers after diagnosis: A qualitative content analysis.

    Jagannathan, A; Juvva, S

    2016-01-01

    Patients suffering with head and neck cancers are observed to have a relatively high risk of developing emotional disturbances after diagnosis and treatment. These emotional concerns can be best understood and explored through the method of content analysis or qualitative data. Though a number of qualitative studies have been conducted in the last few years in the field of psychosocial oncology, none have looked at the emotions experienced and the coping by head and neck cancer patients. Seventy-five new cases of postsurgery patients of head and neck cancers were qualitatively interviewed regarding the emotions experienced and coping strategies after diagnosis. Qualitative content analysis of the in-depth interviews brought out that patients experienced varied emotions on realizing that they were suffering from cancer, the cause of which could be mainly attributed to three themes: 1) knowledge of their illness; 2) duration of untreated illness; and 3) object of blame. They coped with their emotions by either: 1) inculcating a positive attitude and faith in the doctor/treatment, 2) ventilating their emotions with family and friends, or 3) indulging in activities to divert attention. The results brought out a conceptual framework, which showed that an in-depth understanding of the emotions - Their root cause, coping strategies, and spiritual and cultural orientations of the cancer survivor - Is essential to develop any effective intervention program in India.

  4. Gender-related aspects of transmasculine people's vocal situations: insights from a qualitative content analysis of interview transcripts.

    Azul, David

    2016-11-01

    Transmasculine people assigned female gender at birth but who do not identify with this classification have traditionally received little consideration in the voice literature. Existing analyses tend to be focused on evaluating speaker voice characteristics, whereas other factors that contribute to the production of vocal gender have remained underexplored. Most studies rely on researcher-centred perspectives, whereas very little is known about how transmasculine people themselves experience and make sense of their vocal situations. To explore how participants described their subjective gender positionings; which gender attributions they wished to receive from others; which gender they self-attributed to their voices; which gender attributions they had received from others; and how far participants were satisfied with the gender-related aspects of their vocal situations. Transcripts of semi-structured interviews with 14 German-speaking transmasculine people served as the original data corpus. Sections in which participants described the gender-related aspects of their vocal situations and that were relevant to the current research objectives were selected and explored using qualitative content analysis. The analysis revealed diverse accounts pertaining to the factors that contribute to the production of vocal gender for individual participants and variable levels of satisfaction with vocal gender presentation and attribution. Transmasculine people need to be regarded as a heterogeneous population and clinical practice needs to follow a client-centred, individualized approach. © 2016 Royal College of Speech and Language Therapists.

  5. Understanding the breast cancer experience: a qualitative study of Malaysian women.

    Yusuf, Azlina; Ab Hadi, Imi Sairi; Mahamood, Zainal; Ahmad, Zulkifli; Keng, Soon Lean

    2013-01-01

    Breast cancer is the most common and leading cause of cancer mortality among Malaysian women. Despite good survival rates, the diagnosis of cancer still invokes the feeling of stress, fear and uncertainty. Because very little is known about the experiences of Malaysian women with breast cancer, a qualitative study using semi- structured interviews to explore the lived experience of newly diagnosed breast cancer. Using a purposive sampling method, 20 Malaysian women newly diagnosed with breast cancer, including Malays (n=10) and Chinese (n=10) were recruited in two main public hospitals in Kelantan. Similarities and divergence in women's experience were identified through thematic analysis of interview transcripts. Three themes emerged from the data: uncertainty experience of the illness, transition process and fatalistic view of breast cancer. In many ways, these findings were parallel with previous studies, suggesting that the experience of breast cancer is to a certain extent similar among women newly diagnosed with breast cancer. This study adds to the sparse literature concerning the experience of illness following breast cancer diagnosis among the Malays and Chinese. More importantly, this study addressed areas that were previously lacking, specifically in depth information on breast cancer experience from a developing country with a multi-ethnic population. The results of this investigation provide preliminary information to healthcare professionals on the impact of illness and cultural influence on survivorship to plan for appropriate education and supportive programme in order to meet the needs of breast cancer women more effectively.

  6. [Economic and political aspects of prostate cancer prevention].

    Durand-Zaleski, I

    2008-04-01

    Deciding on a health policy in practice means dedicating human and financial resources and prioritising spendings. The economic evaluation of prevention strategies attempts to establish a relationship between the medical benefit of prevention and its additional cost (or in some cases cost reduction) compared to no prevention. Decisions on reimbursing drugs, interventions or funding health programmes do not usually follow efficiency criteria which define economic rationality. Politics may for example decide to make prostate cancer a public health priority if mortality in a country or in some regions of the country appears to be excessively high. Economic rationality alone is not an appropriate factor on which to base a decision which may be purely political, reflecting the actual values of the society at a given point in time.

  7. Younger British men's understandings of prostate cancer: A qualitative study.

    Grogan, Sarah; Parlane, Victoria L; Buckley, Emily

    2017-05-01

    The purpose of this study was to explore young British men's understandings of prostate health and cancer of the prostate. A total of 16 White-British men between 31-50 years of age took part in interviews face-to-face or through computer-mediated communication. Thematic analysis broadly informed by grounded theory identified two key themes; 'limited knowledge about the prostate' and 'early detection & unpleasant procedures'. Accounts are discussed with reference to implications for improving men's understandings of prostate cancer, and likelihood of self-referral for prostate screening where necessary.

  8. Ethnocultural women's experiences of breast cancer: a qualitative meta-study.

    Howard, A Fuchsia; Balneaves, Lynda G; Bottorff, Joan L

    2007-01-01

    A growing number of studies have been conducted that explore the breast cancer experiences of women from diverse ethnocultural groups. To advance knowledge and provide a foundation for future research, a synthesis was conducted of 15 qualitative research studies focusing on women from ethnocultural groups diagnosed with breast cancer. A qualitative meta-study approach was used that included analysis of the theoretical orientations and methodological approaches underlying the research, and an interpretive synthesis of research findings. Ethnocultural groups represented in the studies included Asian American, Aboriginal, Hispanic, and African American women. The synthesis revealed diverse experiences within and among these ethnocultural groups represented in 5 major themes: (a) the "othered" experience of a breast cancer diagnosis, (b) the treatment experience as "other," (c) losses associated with breast cancer, (d) the family context of breast cancer experiences, and (e) coping with cancer through spirituality and community involvement. The integration of findings from the 15 studies also revealed how methodological and theoretical approaches to conducting this research influenced understandings of the experiences of breast cancer. Further experiential breast cancer research with ethnocultural groups is needed, as well as the use of research methods that illuminate the ways that ethnicity, class, age, and gender relations are played out in healthcare settings.

  9. Undifferentiated nasopharyngeal cancer (UCNT): current diagnostic and therapeutic aspects

    Altun, M.; Fandi, A.; Dupuis, O.; Cvitkovic, E.; Krajina, Z.; Eschwege, F.

    1995-01-01

    Undifferentiated carcinoma of the nasopharynx (UCNT) is a particular head and neck epidermoid lineage tumor related to the Epstein Barr Virus (EBV). It has geographically selective endemic epidemiologic features, without relation to external carcinogens. Its systemic aggressiveness is the source of most disease-related demises, because radiotherapy achieves excellent local control and a significant percentage of cure in patients with exclusive locoregional disease. Differences in the staging systems currently in use, the recent changes in imaging and radiotherapy technology, and the lack of distinction between UCNT and squamous cell carcinoma (SCC) of the nasopharynx in Western literature reports make for some difficulty in therapeutic results evaluation when analyzing available literature. Its chemosensitivity is a relatively recent acknowledged fact, and its use in metastatic patients results in a high percentage of objective responses, many of long duration. Neoadjuvant cisplatin-based chemotherapy seems to be of benefit, but outstanding controversies in this regard will be soon answered through ongoing phase III trials. After a review of the current literature of all the above-mentioned aspects of this fascinating nosologic entity, our own experience, both in metastatic and locoregional disease patients is analyzed

  10. Prognostic Aspects of DCE-MRI in Recurrent Rectal Cancer

    Gollub, M.J.; Gultekin, D.H.; Sohn, M. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Cao, K. [Peking University Cancer Hospital and Institute, Department of Radiology, Beijing (China); Kuk, D.; Gonen, M. [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Schwartz, L.H. [Columbia University Medical Center/New York Presbyterian Hospital, Department of Radiology, New York, NY (United States); Weiser, M.R.; Temple, L.K.; Nash, G.M.; Guillem, J.G.; Garcia-Aguilar, J.; Paty, P.B. [Memorial Sloan-Kettering Cancer Center, Department of Surgery, New York, NY (United States); Wang, M. [Fudan University Shanghai Cancer Center, Department of Colorectal Surgery, Shanghai (China); Goodman, K. [Memorial Sloan-Kettering Cancer Center, Department of Radiation Oncology, New York, NY (United States)

    2013-12-15

    To explore whether pre-reoperative dynamic contrast-enhanced (DCE)-MRI findings correlate with clinical outcome in patients who undergo surgical treatment for recurrent rectal carcinoma. A retrospective study of DCE-MRI in patients with recurrent rectal cancer was performed after obtaining an IRB waiver. We queried our PACS from 1998 to 2012 for examinations performed for recurrent disease. Two radiologists in consensus outlined tumour regions of interest on perfusion images. We explored the correlation between K{sup trans}, K{sub ep}, V{sub e}, AUC90 and AUC180 with time to re-recurrence of tumour, overall survival and resection margin status. Univariate Cox PH models were used for survival, while univariate logistic regression was used for margin status. Among 58 patients with pre-treatment DCE-MRI who underwent resection, 36 went directly to surgery and 18 had positive margins. K{sup trans} (0.55, P = 0.012) and K{sub ep} (0.93, P = 0.04) were inversely correlated with positive margins. No significant correlations were noted between K{sup trans}, K{sub ep}, V{sub e}, AUC90 and AUC180 and overall survival or time to re-recurrence of tumour. K{sup trans} and K{sub ep} were significantly associated with clear resection margins; however overall survival and time to re-recurrence were not predicted. Such information might be helpful for treatment individualisation and deserves further investigation. (orig.)

  11. Prognostic Aspects of DCE-MRI in Recurrent Rectal Cancer

    Gollub, M.J.; Gultekin, D.H.; Sohn, M.; Cao, K.; Kuk, D.; Gonen, M.; Schwartz, L.H.; Weiser, M.R.; Temple, L.K.; Nash, G.M.; Guillem, J.G.; Garcia-Aguilar, J.; Paty, P.B.; Wang, M.; Goodman, K.

    2013-01-01

    To explore whether pre-reoperative dynamic contrast-enhanced (DCE)-MRI findings correlate with clinical outcome in patients who undergo surgical treatment for recurrent rectal carcinoma. A retrospective study of DCE-MRI in patients with recurrent rectal cancer was performed after obtaining an IRB waiver. We queried our PACS from 1998 to 2012 for examinations performed for recurrent disease. Two radiologists in consensus outlined tumour regions of interest on perfusion images. We explored the correlation between K trans , K ep , V e , AUC90 and AUC180 with time to re-recurrence of tumour, overall survival and resection margin status. Univariate Cox PH models were used for survival, while univariate logistic regression was used for margin status. Among 58 patients with pre-treatment DCE-MRI who underwent resection, 36 went directly to surgery and 18 had positive margins. K trans (0.55, P = 0.012) and K ep (0.93, P = 0.04) were inversely correlated with positive margins. No significant correlations were noted between K trans , K ep , V e , AUC90 and AUC180 and overall survival or time to re-recurrence of tumour. K trans and K ep were significantly associated with clear resection margins; however overall survival and time to re-recurrence were not predicted. Such information might be helpful for treatment individualisation and deserves further investigation. (orig.)

  12. Perceptions of Malaysian colorectal cancer patients regarding dietary intake: a qualitative exploration.

    Yusof, Afzaninawati Suria; Isa, Zaleha Md; Shah, Shamsul Azhar

    2013-01-01

    Changes in dietary practices are known to be associated with changes in the health and disease pattern of a population. This study aimed to qualitatively explore the perception of colorectal cancer patients regarding causes of colorectal cancer and the influence of diet. Twelve respondents from three major ethnicities in Malaysia were selected from the quantitative study on dietary pattern and colorectal cancer carried out earlier in this study. In-depth interviews (IDI), conducted from April until June 2012, were mainly in the Malay language with additional use of English and continued until the saturation point was reached. All interviews were autorecorded so that verbatim transcriptions could be created. Causes of colorectal cancer were categorized into internal and external factors. The majority of respondents agreed that there is an association between Western foods and colorectal cancer. Malaysian traditional diet was not related to colorectal cancer as less preservative agents were used. Malaysian diet preparation consisting of taste of cooking (spicy, salty and sour foods) plus type of cooking (fry, grilled and smoked) were considered causes of colorectal cancer. All respondents changed their dietary pattern to healthy food after being diagnosed with colorectal cancer. Advice from doctors regarding suitable food for colorectal cancer was useful in this regard. Eating outside, use of food flavoring ingredients and preservative agents were considered to be the main factors causing colorectal cancer. All respondents admitted that they changed to a healthy diet after being diagnosed with colorectal cancer.

  13. A systematic review of qualitative evidence of cancer patients' attitudes to mindfulness.

    Tate, K J; Newbury-Birch, D; McGeechan, G J

    2018-03-01

    Mindfulness has been described as a non-elaborative, non-judgmental, present-centred awareness in which each thought, feeling or sensation is acknowledged and accepted. The aim of the present study was to systematically search and synthesise qualitative evidence of cancer patients' attitudes to mindfulness. A systematic review of qualitative evidence was conducted following the SPICE framework. All cancers were included. Medline, Cinahl, Science Direct, O-Alster and New Bank were searched from the first available year to August 2016 using the search terms; wellbeing, mindfulness, qualitative. Two reviewers independently screened titles and abstracts; potentially relevant articles were retrieved and assessed independently by two reviewers. Data were extracted and quality assessed using Critical Appraisal Skills Programme (CASP) qualitative research checklist. In total, 233 studies conducted between 2005 and 2015 were identified with six included in the final analysis. Four themes were identified: Coping strategies developed through mindfulness course; Positive outcomes of mindful practice; Challenges with engaging in mindful practice; and Group identification and shared experience. The current evidence supports the view that mindfulness is an effective intervention to help people adjust to living with and beyond cancer however, more qualitative work is needed in this area. © 2017 John Wiley & Sons Ltd.

  14. Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer

    Coolbrandt, A.; Dierckx de Casterle, B.; Wildiers, H.; Aertgeerts, B.; Elst, E. Van der; Achterberg, T. van; Milisen, K.

    2016-01-01

    Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with

  15. Lung cancer, caring for the caregivers. A qualitative study of providing pro-active social support targeted to the carers of patients with lung cancer.

    Ryan, P J; Howell, V; Jones, J; Hardy, E J

    2008-04-01

    Carers of patients with lung cancer often have a short time to access the support they require. The Macmillan Carers Project (MCP) was set up to provide non-clinical social support targeted in the community to the carers of patients with lung cancer and this study describes its evaluation. Prospective case study using interviews with the carers, project workers and health and social care professionals to obtain qualitative data for thematic analysis. 81 patients' carers received support from the MCP; 20 carers, 2 MCP workers and their manager and 10 other professionals (chest consultant physician, lung cancer clinical nurse specialist, GP, four Macmillan nurses, hospice social worker and two community social workers) were interviewed. Patients were predominantly male (62%), mean age 71 years and carers were predominantly female (70%) mean age 63 years. Carers identified the MCP as providing emotional support, more time, practical help, financial advice, information and back-up for a myriad of problems. Although there was some overlap with other services, the MCP was valued by carers and professionals as filling a gap in social care. The unique aspect of this study was support targeted to the carers of a single cancer site (lung) rather than generic cancer support. As lung cancer may progress rapidly, patients and their carers have a short time to gather new information, access services and adjust to their new circumstances and roles. By focusing on the needs of carers from the time of lung cancer diagnosis, we have shown that the MCP was a valued additional service, well received by carers, patients and professionals.

  16. Emotional Aspects of Childhood Cancer and Leukemia: A Handbook for Parents.

    Spinetta, John J.; And Others

    Written for parents of children with cancer and leukemia, the booklet considers the psychosocial aspect of the conditions as well as the effects on the family and child. Part I reviews emotions experienced by parents at the time of the initial diagnosis and through the course of the illness. Marriage strain, support sources, and relatives are…

  17. Metacognitive aspects influence subjective well-being in parents of children with cancer.

    Toffalini, Enrico; Veltri, Alessia; Cornoldi, Cesare

    2015-02-01

    Research suggests that metacognitive beliefs may be involved in psychological distress and even in the pathogenesis of emotional disorders. The present research is a first attempt to investigate how certain metacognitive aspects operate as favorable or adverse factors influencing subjective wellbeing (SWB) in the parents of children with cancer. Thirty parents of children being treated for cancer completed questionnaires on their metacognitive beliefs (Metacognition Questionnaire), sensitivity to autobiographical memory, and self-reported measures of positive and negative affect (Positive and Negative Affect Schedule). Results in the study group were compared with those obtained from 36 control parents of children being treated for acute, not life-threatening illnesses (hospitalized control group) and from 30 control parents of healthy children (healthy control group). Parents in both the study group and the hospitalized control group reported less SWB than the healthy control group. Most important, metacognitive aspects explained up to 77% of the variance in SWB in parents of children with cancer, as opposed to only 23% in hospitalized control group and 33% in the healthy control group. Differentmetacognitive aspects have a crucial role—both negative and positive—inSWB of parents of children with cancer. It is suggested that the psychological support for parents copingwith a child suffering from oncological disease should assess such aspects and try to address them in clinical practice.

  18. Open Oncology Notes: A Qualitative Study of Oncology Patients' Experiences Reading Their Cancer Care Notes.

    Kayastha, Neha; Pollak, Kathryn I; LeBlanc, Thomas W

    2018-04-01

    Electronic medical records increasingly allow patients access to clinician notes. Although most believe that open notes benefits patients, some suggest negative consequences. Little is known about the experiences of patients with cancer reading their medical notes; thus we aimed to describe this qualitatively. We interviewed 20 adults with metastatic or incurable cancer receiving cancer treatment. The semistructured qualitative interviews included four segments: assessing their overall experience reading notes, discussing how notes affected their cancer care experiences, reading a real note with the interviewer, and making suggestions for improvement. We used a constant comparison approach to analyze these qualitative data. We found four themes. Patients reported that notes resulted in the following: (1) increased comprehension; (2) ameliorated uncertainty, relieved anxiety, and facilitated control; (3) increased trust; and (4) for a subset of patients, increased anxiety. Patients described increased comprehension because notes refreshed their memory and clarified their understanding of visits. This helped mitigate the unfamiliarity of cancer, addressing uncertainty and relieving anxiety. Notes facilitated control, empowering patients to ask clinicians more questions. The transparency of notes also increased trust in clinicians. For a subset of patients, however, notes were emotionally difficult to read and raised concerns. Patients identified medical jargon and repetition in notes as areas for improvement. Most patients thought that reading notes improved their care experiences. A small subset of patients experienced increased distress. As reading notes becomes a routine part of the patient experience, physicians might want to elicit and address concerns that arise from notes, thereby further engaging patients in their care.

  19. Public perceptions of cancer: a qualitative study of the balance of positive and negative beliefs.

    Robb, Kathryn A; Simon, Alice E; Miles, Anne; Wardle, Jane

    2014-07-10

    Cancer's insidious onset and potentially devastating outcomes have made it one of the most feared diseases of the 20th century. However, advances in early diagnosis and treatment mean that death rates are declining, and there are more than 30 million cancer survivors worldwide. This might be expected to result in more sanguine attitudes to the disease. The present study used a qualitative methodology to provide an in-depth exploration of attitudes to cancer and describes the balance of negative and positive perspectives. A qualitative study using semistructured interviews with thematic analysis. A university in London, UK. 30 participants (23-73 years), never themselves diagnosed with cancer. Accounts of cancer consistently incorporated negative and positive views. In almost all respondents, the first response identified fear, trauma or death. However, this was followed-sometimes within the same sentence-by acknowledgement that improvements in treatment mean that many patients can survive cancer and may even resume a normal life. Some respondents spontaneously reflected on the contradictions, describing their first response as a 'gut feeling' and the second as a more rational appraisal-albeit one they struggled to believe. Others switched perspective without apparent awareness. People appear to be 'in two minds' about cancer. A rapid, intuitive sense of dread and imminent death coexists with a deliberative, rational recognition that cancer can be a manageable, or even curable, disease. Recognising cancer's public image could help in the design of effective cancer control messages. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Generation of domestic waste electrical and electronic equipment on Fernando de Noronha Island: qualitative and quantitative aspects.

    Araujo, Dhiego Raphael Rodrigues; de Oliveira, José Diego; Selva, Vanice Fragoso; Silva, Maisa Mendonça; Santos, Simone Machado

    2017-08-01

    The accelerated growth trajectory of waste electrical and electronic equipment (WEEE) is a matter of concern for governments worldwide. In developing countries, the problem is more complex because municipal waste management is still a challenge for municipalities. Fernando de Noronha Island, an environmentally protected area, has a transfer station for solid waste before it is sent to the final destination abroad, which is different waste management model to most urban areas. In order to check the specifics of management of WEEE, this study aimed to qualitatively and quantitatively evaluate the generation of this type of waste on the main island of Fernando de Noronha, taking into consideration aspects related to consumption habits and handling of waste. During the in situ research, a questionnaire was applied to a sample of 83 households. The results provide a picture of the generation of WEEE for a period of 1 year, when a production of 1.3 tons of WEEE was estimated. Relationships between education level and monthly income and between education level and number of plasma/LCD TVs and washing machines were confirmed. Another important result is that only two socioeconomic variables (monthly income and education level) are related to two recycling behavior variables. In addition, the population and government treat WEEE as ordinary waste, ignoring its contaminant potential. Despite the existence of relevant legislation concerning the treatment and disposal of WEEE, additional efforts will be required by the government in order to properly manage this type of waste on the island.

  1. Factors influencing suicidal ideation among Chinese patients with stomach cancer: qualitative study.

    Zhang, X K; Procter, N G; Xu, Q; Chen, X Y; Lou, F L

    2017-09-01

    The aim of this qualitative descriptive study was to explore the influencing factors of suicidal ideation in Chinese patients diagnosed with stomach cancer. More recently, links have been made between suicide and cancer. For inpatients with cancer, nurses are at the front line to cope with suicidal issues in clinical settings. This study was part of a larger study that investigated psychological strains and related factors associated with suicidal ideation. Thirty-two patients with stomach cancer participated in a face-to-face interview. Thematic analysis was used to analyse the qualitative data. Four themes were identified as protective factors against suicidal ideation: suicidal denial and fears of stigmatization; positive coping skills; family connectedness; and desire to live well and longer. Consistent with previous research, these four protective factors may encourage participants to think more positively about life and cancer. Our findings suggest four protective factors for targeted suicide prevention, which may play an important role in future suicide-prevention programmes for Chinese patients diagnosed with stomach cancer. Nurses may help reduce patients' risk for suicidal ideation more effectively by discussing beliefs, family and meaning in life perspectives, as well as offering health education about positive coping skills. Clinical nurses, hospitals and the government should work collaboratively with each other. It is suggested that Chinese national guidelines for working with the high-risk suicide populations should be considered within a future mental health working plan. © 2016 International Council of Nurses.

  2. Music's relevance for children with cancer: music therapists' qualitative clinical data-mining research.

    O'Callaghan, Clare; Dun, Beth; Baron, Annette; Barry, Philippa

    2013-01-01

    Music is central in most children's lives. Understanding its relevance will advance efficacious pediatric supportive cancer care. Qualitative clinical data-mining uncovered four music therapists' perspectives about music and music therapy's relevance for pediatric oncology patients up to 14 years old. Inductive and comparative thematic analysis was performed on focus group transcripts and qualitative interrater reliability integrated. Music can offer children a safe haven for internalizing a healthy self-image alongside patient identity. Music therapy can calm, relieve distress, promote supportive relationships, enable self-care, and inspire playful creativity, associated with "normalcy" and hope. Preferred music and music therapy should be available in pediatric oncology.

  3. Exploring the role of physician communication about adjuvant endocrine therapy among breast cancer patients on active treatment: a qualitative analysis.

    Farias, Albert J; Ornelas, India J; Hohl, Sarah D; Zeliadt, Steven B; Hansen, Ryan N; Li, Christopher I; Thompson, Beti

    2017-01-01

    To better understand how physicians communicate with breast cancer patients about adjuvant endocrine therapy (AET), we explored, from the breast cancer patient's perspective, dimensions of the patient-provider communication among women who were on active AET treatment. Qualitative methods using semi-structured in-depth interviews were conducted with breast cancer patients (n = 22) who filled a prescription for AET in the previous 12 months. Interview questions aimed to elicit experiences with AET. We reviewed and coded interview transcripts using qualitative principles of inductive reasoning to identify concepts and themes from interview data. We grouped emergent themes into four major functions of physician-patient communication: (1) information exchange, (2) decision-making to take and continue AET, (3) enabling patient self-management and monitoring potential side effects, and (4) emotional support. Physicians exchanged information with patients in a way that they understood and enhanced patient's health literacy regarding the benefits and knowledge of AET. Physicians empowered patients to make decisions about their care. Patients expressed trust and confidence in their physician which helped them seek care when needed. Patients reported a high degree of self-efficacy to self-manage AET and were continuing treatment despite potential side effects. The results from our study suggest that women's interactions and communication with their physician may be an important factor that contributes to the continued use of AET. Physicians who can communicate information about AET treatment benefits, purpose, and expectations in a way that patients can understand is a critical aspect of care that needs to be further studied.

  4. Knowledge, facilitators and barriers to cervical cancer screening among women in Uganda: a qualitative study.

    Ndejjo, Rawlance; Mukama, Trasias; Kiguli, Juliet; Musoke, David

    2017-06-11

    To explore community knowledge, facilitators and barriers to cervical cancer screening among women in rural Uganda so as to generate data to inform interventions. A qualitative study using focus group discussions and key informant interviews. Discussions and interviews carried out in the community within two districts in Eastern Uganda. Ten ( 10) focus group discussions with 119 screening-eligible women aged between 25 and 49 years and 11 key informant interviews with healthcare providers and administrators. Study participants' knowledge about cervical cancer causes, signs and symptoms, testing methods and prevention was poor. Many participants attributed the cause of cervical cancer to use of contraception while key informants said that some believed it was due to witchcraft. Perceptions towards cervical cancer and screening were majorly positive with many participants stating that they were at risk of getting cervical cancer. The facilitators to accessing cervical cancer screening were: experiencing signs and symptoms of cervical cancer, family history of the disease and awareness of the disease/screening service. Lack of knowledge about cervical cancer and screening, health system challenges, fear of test outcome and consequences and financial constraints were barriers to cervical cancer screening. Whereas perceptions towards cervical cancer and screening were positive, knowledge of study participants on cervical cancer was poor. To improve cervical cancer screening, effort should be focused on reducing identified barriers and enhancing facilitators. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Men's perspectives of prostate cancer screening: A systematic review of qualitative studies.

    Laura J James

    Full Text Available Prostate cancer is the most commonly diagnosed non-skin cancer in men. Screening for prostate cancer is widely accepted; however concerns regarding the harms outweighing the benefits of screening exist. Although patient's play a pivotal role in the decision making process, men may not be aware of the controversies regarding prostate cancer screening. Therefore we aimed to describe men's attitudes, beliefs and experiences of prostate cancer screening.Systematic review and thematic synthesis of qualitative studies on men's perspectives of prostate cancer screening. Electronic databases and reference lists were searched to October 2016.Sixty studies involving 3,029 men aged from 18-89 years, who had been screened for prostate cancer by Prostate Specific Antigen (PSA or Digital Rectal Examination (DRE and not screened, across eight countries were included. Five themes were identified: Social prompting (trusting professional opinion, motivation from family and friends, proximity and prominence of cancer; gaining decisional confidence (overcoming fears, survival imperative, peace of mind, mental preparation, prioritising wellbeing; preserving masculinity (bodily invasion, losing sexuality, threatening manhood, medical avoidance; avoiding the unknown and uncertainties (taboo of cancer-related death, lacking tangible cause, physiological and symptomatic obscurity, ambiguity of the procedure, confusing controversies; and prohibitive costs.Men are willing to participate in prostate cancer screening to prevent cancer and gain reassurance about their health, particularly when supported or prompted by their social networks or healthcare providers. However, to do so they needed to mentally overcome fears of losing their masculinity and accept the intrusiveness of screening, the ambiguities about the necessity and the potential for substantial costs. Addressing the concerns and priorities of men may facilitate informed decisions about prostate cancer screening

  6. Brief preoperative smoking cessation counselling in relation to breast cancer surgery: a qualitative study

    Thomsen, Thordis; Esbensen, Bente Appel; Samuelsen, Susanne

    2009-01-01

    of cancer diagnosis was difficult for some women. They relapsed to smoking as an ingrown response to emotional distress. The smoking intervention heightened the women's awareness of their addiction to smoking; however, they expressed a need for prolonged smoking cessation support. For others, the smoking......AIM: To describe how women smokers with newly diagnosed breast cancer experienced brief preoperative smoking cessation intervention in relation to breast cancer surgery. BACKGROUND: Preoperative smoking cessation intervention is relevant for short- and long-term risk reduction in newly diagnosed...... cancer patients. Our knowledge of how patients with malignant diagnoses experience preoperative smoking intervention is however scarce. METHODS: A qualitative descriptive study that collected data through one-time individual, semi-structured interviews with 11 Danish women. Ricoeur's theory...

  7. How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research.

    Fielden, Hannah G; Brown, Stephen L; Saini, Pooja; Beesley, Helen; Salmon, Peter

    2017-09-01

    Risk-reducing procedures can be offered to people at increased cancer risk, but many procedures can have iatrogenic effects. People therefore need to weigh risks associated with both cancer and the risk-reduction procedure in their decisions. By reviewing relevant literature on breast cancer (BC) risk reduction, we aimed to understand how women at relatively high risk of BC perceive their risk and how their risk perceptions influence their decisions about risk reduction. Synthesis of 15 qualitative studies obtained from systematic searches of SCOPUS, Web of Knowledge, PsychINFO, and Medline electronic databases (inception-June 2015). Women did not think about risk probabilistically. Instead, they allocated themselves to broad risk categories, typically influenced by their own or familial experiences of BC. In deciding about risk-reduction procedures, some women reported weighing the risks and benefits, but papers did not describe how they did so. For many women, however, an overriding wish to reduce intense worry about BC led them to choose aggressive risk-reducing procedures without such deliberation. Reasoning that categorisation is a fundamental aspect of risk perception, we argue that patients can be encouraged to develop more nuanced and accurate categorisations of their own risk through their interactions with clinicians. Empirically-based ethical reflection is required to determine whether and when it is appropriate to provide risk-reduction procedures to alleviate worry. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

  8. Clinical aspects of forecasting results of treatments of patients with rectum cancer

    Kas'yanova, T.S.; Rusinovich, V.M.; Mirilenko, L.V.; Kizina, L.I.

    1990-01-01

    To predict the outcome of surgical treatment of patients with rectum cancer and the efficiency of the radiation component of multimodality treatment, some clinical aspects, having the prognostic meaning, are proposed. It is established that the prognostically significant signs for rectum cancer are: the disease stage, the status of the regional lymphatic system, the invasion degree and tumor growth form, tumor differentiation degree, its propagation over the circle, the availability or absence of ileus symptoms, the anamnesis period and some hemogram characters. 8 refs.; 1 tab

  9. Theoretical, clinical and pharmacokinetic aspects of cancer chemotherapy administered by continuous infusion

    Sikic, B.I.

    1986-01-01

    This chapter reviews some of the theoretical and empirical aspects of the administration of anti-cancer drugs by continuous intravenous infusion in conjunction with radiation therapy. The variables contributing to schedule dependence of anti-cancer drugs are discussed. A table shows the improved therapeutic index of Bleomycin by continuous infusion in mice. The use of Cytarabine, a pyrimidine anti-metabolite which kills cells during S-phase or DNA synthesis, is examined. Fluorouracil and Doxorubicin are examined and several other drugs including vincristine, vinblastine, etoposide, and cisplatin are discussed

  10. Barriers to cancer symptom presentation among people from low socioeconomic groups: a qualitative study

    Grace McCutchan

    2016-10-01

    Full Text Available Abstract Background Socioeconomic inequalities in cancer survival can in part be explained by long patient intervals among people from deprived groups; however, the reasons for this are unclear. This qualitative study explores the actual and anticipated barriers to cancer symptom presentation in the context of socioeconomic deprivation. Methods Thirty participants were recruited through the International Cancer Benchmarking Partnership Welsh database (n = 20, snowball sampling (n = 8 and community partners (n = 2. Semi-structured qualitative interviews were conducted with symptomatic and asymptomatic adults over the age of 50 years, who were identified as being from a low socioeconomic group based on multiple individual and group level indicators. Transcripts were analysed using a Framework approach based on the COM-B model (Capability, Opportunity, Motivation-Behaviour. Results There was evidence of poor awareness of non-specific cancer symptoms (Capability, fearful and fatalistic beliefs about cancer (Motivation, and various barriers to accessing an appointment with the family physician (Opportunity and full disclosure of symptoms (Capability. These in combination were associated with a lengthened patient interval among participants. Social networks (Opportunity were influential on the formation of knowledge and beliefs about cancer. Participants’ behavioural and normative beliefs were usually formed and reinforced by people they knew with cancer, and such beliefs were considered to lengthen the patient interval. Discussing symptoms with a family member or friend before a visit to the family physician was the norm, and could act as a barrier or facilitator depending on the quality of advice given (Opportunity. Economic hardship meant fulfilling basic day-to-day needs such as finding money for food were prioritised over medical help seeking (Opportunity. Conclusions The complex interaction between individual characteristics and

  11. Exploring educational needs and design aspects of internet-enabled patient education for persons with diabetes: a qualitative interview study.

    Jafari, Javad; Karimi Moonaghi, Hosein; Zary, Nabil; Masiello, Italo

    2016-10-31

    The objective of this article is to explore the educational needs and design aspects of personalised internet-enabled education for patients with diabetes in Iran. Data were collected using semistructured interviews and then qualitatively analysed using inductive content analysis. 9 patients with type 2 diabetes were included. Inclusion criteria were access to and knowledge on how to use the internet. The selection ensured representation based on gender, age, occupation and educational background. The sample population was patients with diabetes who were admitted to an outpatient diabetes clinic in Mashhad, a large city of Iran with about 3 million inhabitants. 4 core categories emerged from the data: (1) seeking knowledge about diabetes, including specific knowledge acquisition, patient's interactions and learning requirements; (2) teaching and learning, including using different teaching methods and different ways to learn about the disease; (3) facilitators, including internet and mobile phone use to learn about the disease; and (4) barriers, including lack of internet access, uncertainty of access to the internet and lack of website in the local language and also perceived cultural barriers, such as patients' fears of the internet, lack of time and awareness. This study provides a better understanding of the patient's educational expectations and technical needs in relation to internet-enabled education. This knowledge will inform the development of functional mock-ups in the next research phase using a design-based research approach in order to design internet-enabled patient education for self-management of diabetes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Psychosocial aspects of hereditary cancer (PAHC) questionnaire: development and testing of a screening questionnaire for use in clinical cancer genetics.

    Eijzenga, W; Bleiker, E M A; Hahn, D E E; Kluijt, I; Sidharta, G N; Gundy, C; Aaronson, N K

    2014-08-01

    Up to three-quarters of individuals who undergo cancer genetic counseling and testing report psychosocial problems specifically related to that setting. The objectives of this study were to develop and evaluate the screening properties of a questionnaire designed to assess specific psychosocial problems related to cancer genetic counseling. We adopted the European Organisation for Research and Treatment of Cancer Quality of Life Group guidelines to develop the Psychosocial Aspects of Hereditary Cancer (PAHC) questionnaire, a 26-item questionnaire organized into six problem domains: genetics, practical issues, family, living with cancer, emotions, and children. The Distress Thermometer and a question per domain on the perceived need for extra psychosocial services were included as well. We administered the questionnaire and the Hospital Anxiety and Depression Scale to 127 counselees at the time of genetic counseling and 3 weeks after DNA test disclosure. As a gold standard to evaluate the screening properties of the questionnaire, participants underwent a semi-structured interview with an experienced social worker who assessed the presence and severity of problems per domain. A cutoff score representing responses of 'quite a bit' or 'very much' to one or more items within a given problem domain yielded moderate to high sensitivity across domains. A cutoff of 4 on the Distress Thermometer yielded high sensitivity. The questions regarding the perceived need for extra psychosocial services yielded high specificity and negative predictive values. The Psychosocial Aspects of Hereditary Cancer questionnaire in combination with the Distress Thermometer can be used as a first-line screener for psychosocial problems within the cancer genetic counseling setting. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Awareness of cervical cancer prevention among mothers of adolescent daughters in Korea: qualitative research.

    Kim, Hae Won; Kim, Duck Hee

    2015-05-14

    Korean adolescent girls are unprepared for cervical cancer prevention due to the lack of a mandatory policy regarding human papilloma virus (HPV) vaccination and school health education regarding cervical cancer. The aim of this study was to determine how aware mothers are about cervical cancer prevention in their adolescent daughters, with a view to developing strategies for expanding primary cervical cancer prevention for adolescent girls through the mothers' involvement. A qualitative design was employed. Nine mothers with adolescent daughters participated in this study and were interviewed using open-ended questions. The themes were extracted by content analysis. A general living area in Seoul, South Korea. The snowball method was used to select mothers. Five themes emerged. In general, the mothers' awareness of cervical cancer was not clear, and they exhibited a lack of awareness of the importance of having a regular Papanicolaou screening test. The mothers recognised that they were role models for their daughters, and realised and accepted the necessity of educating their daughters regarding cervical cancer; however, they perceived barriers related to the prevention of cervical cancer in their daughters. The mothers recommended enforcing sex education in schools and the provision of financial support for HPV vaccination. The mothers' awareness and preparedness with respect to the prevention of cervical cancer in their adolescent daughters were low and inadequate. Mothers should be informed and motivated to play a role in the education of their daughters regarding cervical cancer prevention. Strategies for disseminating information regarding early cervical cancer prevention for adolescent girls are recommended by communicating with both the girls and their mothers and providing them with education regarding cervical cancer prevention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  14. The Sexual Adjustment Process of Cancer Patients and Their Partners: A Qualitative Evidence Synthesis.

    Benoot, Charlotte; Saelaert, Marlies; Hannes, Karin; Bilsen, Johan

    2017-10-01

    When confronted with cancer, a prominent challenge for patients and their partners is their changed sexual relationship. An empirically based theoretical model of the sexual adaptation process during cancer might be helpful in guiding the development of adequate interventions for couples who struggle with their sexual relationship. Therefore, the purpose of this study was to synthesize evidence from primary qualitative research studies and to arrive at a detailed description of the process of sexual adjustment during cancer. We conducted a qualitative evidence synthesis of a purposeful sample of 16 qualitative papers, using the meta-ethnography approach to synthesis. We found that the subsequent studies used different theoretical approaches to describe the sexual adaptation process. This led to three divergent sexual adaptation processes: (1) the pathway of grief and mourning, depicting sexual changes as a loss; (2) the pathway of restructuring, depicting the adjustment process toward sexual changes as a cognitive process with a strong focus on the social and cultural forces that shape the values and experiences of sexuality; and (3) the pathway of sexual rehabilitation, depicting sexual changes as a bodily dysfunction that needs treatment and specific behavioral strategies. All three pathways have their own opportunities and challenges. A greater awareness of these different pathways could help healthcare providers to better understand the ways a particular couple might cope with changed sexuality, offering them opportunities to discover alternative pathways for sexual adjustment.

  15. Pain experiences of patients with advanced cancer: A qualitative descriptive study.

    Erol, Ozgul; Unsar, Serap; Yacan, Lale; Pelin, Meryem; Kurt, Seda; Erdogan, Bülent

    2018-04-01

    Uncontrolled pain, especially in patients with advanced cancer, affects quality of life negatively and causes negative physical and psychological conditions. The aim of this study was to explore the pain experiences of patients with advanced cancer and how they manage with pain, and to present a view of pain management approaches of nurses from the perspectives of the patients. This was a qualitative descriptive study of sixteen hospitalized patients with advanced cancer. Data were collected using semi-structured interviews with patients. Data were analysed by Colaizzi's phenomenological method. This study found that patients with advanced cancer who had pain experienced anxiety, helplessness, hopelessness and many restrictions in daily life as well as inability to manage with pain. Most of the patients with advanced cancer were not satisfied with their nursing care with regard to pain management. The themes that emerged were pain perception and experiences, effects of pain on daily life, pain management and management strategies and the patients' perspectives about nursing approaches to pain. This study demonstrated the difficulties of patients with advanced cancer who experienced pain in their daily lives, yet lack pain management strategies. Furthermore, nurses' caring approaches to patients with advanced cancer who experienced pain was found inadequate. Oncology nurses should provide educational interventions in order to enhance knowledge and skills about pain assessment and non-pharmacologic and pharmacologic strategies used in pain management. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Rethinking exercise identity: a qualitative study of physically inactive cancer patients’ transforming process while undergoing chemotherapy

    Adamsen, Lis; Andersen, Christina; Lillelund, Christian; Bloomquist, Kira; Møller, Tom

    2017-01-01

    Objective To explore physically inactive breast and colon cancer patients’ prediagnosis exercise history and attitudes to physical activity (PA) and experiences in initiating PA while undergoing adjuvant chemotherapy. Design An explorative qualitative study guided the interpretive analysis of semistructured, open-ended interviews conducted at initiation of chemotherapy and after 12 weeks. The study was embedded in a pilot randomised controlled trial. Setting Participants were recruited from the Oncological Department at a hospital in Copenhagen, Denmark. Participants 33 patients with cancer, median age 49 years: 25 patients with breast cancer and 8 with colon cancer, 72% with a low cardiac respiratory fitness level and the majority with a high level of education. Patients received adjuvant chemotherapy, oncologist’s PA recommendation and exercise, cancer nurse specialist’s counselling prior to allocation to PA interventions or waitlist control group. Results Prediagnosis exercise had been excluded from patients’ daily lives due to perceptions of exercise as boring, lack of discipline and stressful work conditions for both genders. Recommendations from oncologists and nurses inspired the patients to reconsider their attitudes and behaviour by accepting recruitment and participation in PA interventions during chemotherapy. Despite extensive side effects, most patients adhered to their PA commitment due to their perception of the bodily, emotional and social benefits and support of healthcare professionals, peers and family. Conclusion The patients’ attitude towards exercise transformed from having no priority in patients’ daily lives prediagnosis to being highly prioritised. This study identified four important phases in the exercise transformation process during the patients’ treatment trajectory of relevance to clinicians in identifying, motivating and supporting physically inactive patients with cancer at long-term risk. Clinicians should address

  17. What Do Korean Women Know and Want to Know about Thyroid Cancer? A Qualitative Study.

    Lee, Bomyee; Park, Jae Young; Shin, Hye Young; Park, Sang Hee; Choi, Eun-Bi; Yoo, Jisu; Choi, Kui Son; Jun, Jae Kwan

    2016-01-01

    Despite increasing debate about overdiagnosis and overtreatment of thyroid cancer in Korea, information to guide decisions on whether or not to undergo screening for and treatment of abnormal lesions of the thyroid is lacking. Moreover, studies have yet to outline what lay people know and want to know about thyroid cancer. The primary aim of this study was to explore general awareness of thyroid cancer among Korean women, their sources of information, and their satisfaction with the information they are provided. The secondary aim was to investigate information needs about thyroid cancer. A qualitative study using focus group interviews was conducted. Twenty-nine women were divided into four groups: (1) participants who had never undergone thyroid ultrasound screening; (2) those who had undergone screening, (3) those who continued to undergo regular check-ups with ultrasonography for benign nodules of the thyroid; and (4) participants who had undergone surgery for thyroid cancer. A widespread lack of awareness of information on thyroid cancer was noted among participants in groups 1 and 2 who were not well aware of thyroid cancer and generally recognized it as a'good cancer'. Surprisingly, instead of doctors and medical personnel, most participants reported obtaining information from acquaintances and media outlets. Moreover, most participants described dissatisfaction with their experience with screening and a lack of explanation on treatment and test results from medical personnel. Women in Korea seek reliable information on thyroid cancer that could help them to better understand the disease and make informed decisions regarding screening and treatment. More effort is needed from medical personnel to communicate the implications of thyroid cancer, screening results, and treatments thereof to lay people.

  18. The clinical communication and information challenges associated with the psychosexual aspects of prostate cancer treatment.

    Speer, Susan A; Tucker, Samantha R; McPhillips, Rebecca; Peters, Sarah

    2017-07-01

    Prostate cancer and its treatment have significant sexual side effects that necessitate timely patient information and open communication with healthcare professionals. However, very little is known about men's experiences of talking to clinicians about the psychosexual difficulties associated with the disease. This study aims to advance understanding of men's perceptions of the communication and information challenges associated with the psychosexual aspects of prostate cancer and its treatment. Between October 2013 and April 2014, semi-structured interviews were conducted with 21 men from the UK who had been treated for prostate cancer. Interview transcripts were analysed using thematic analysis. Three themes describe the communication challenges men face: (1) It can be too soon to talk about sex; (2) the psychology of sex is missing; (3) communication is not individually tailored. Clinicians might usefully (1) consider and discuss with patients how their psychosexual communication needs and information processing abilities may fluctuate across the cancer timeline; (2) initiate discussions about the consequences of treatment that extend beyond biological and mechanical aspects to include emotional and relational factors; (3) tailor communication to the dynamic mix of attributes that shape men's individual psychosexual needs, including their relationship status, sexual orientation, sexual motivations and values. Skills-based training in communication and psychosexual awareness may facilitate the proactive and permissive stance clinicians need to discuss sexual side effects with a heterogeneous group of patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Psychosomatic aspects of the behavior of cancer patients that should be considered in the rehabilitation

    S. A. Misiak

    2016-01-01

    Full Text Available The article is dedicated to the psychological aspects of the relationship of the organisms of patients suffering from malignisation, and neoplasms, for further study of the disease during the rehabilitation period after standard treatment. If during the treatment of neoplastic disease doctors are encountering with the consequences of illness then the rehabilitation team need to identify the reasons of the disease occurrence. This helps to give the patient rehabilitation in full to improve the life quality and to provide effective socialization. The article analyzes the problems of the psychological characteristics of the origin and course of cancer, psychosomatic theories to explain the origin of the tumor during the illness. Also theories of the models of the patient’s psychological reactions to the presence of the cancer were studied in the article. The rehabilitation period in the cancer patients should include technological methods of psychotherapy.

  20. Perceptions of patients, families, physicians and nurses regarding challenges in cancer disclosure: A descriptive qualitative study.

    Ehsani, Maryam; Taleghani, Fariba; Hematti, Simin; Abazari, Parvaneh

    2016-12-01

    The findings of numerous studies have illustrated that there is still a high proportion of cancer patients in Eastern and Middle-East countries including Iran, who are not properly informed of their disease due to the concealment atmosphere which still prevails. This descriptive qualitative study is aimed at exploring perceptions of patients, patients' family members, physicians and nurses regarding cancer disclosure challenges. Thirty-five participants (15 patients, 6 family members, 9 physicians, and 5 nurses) were selected through purposive sampling. The data were collected through in-depth interviews; after which they were analyzed using a qualitative content analysis with an inductive approach. Data analysis revealed the following three categories: first, challenges related to healthcare system which deals with the deficiencies, strains and concerns in medical setting and healthcare team training; second, challenges related to family insistence on concealment which includes their fear of cancer disclosure and its negative impact on the patients; and third, challenges related to policy making which consists of deficiencies in legislative and supportive institutions for advocacy of truth telling. Successful move from concealment to effective disclosure attitude in cancer patients in Iran requires a national determination for resolving challenges in medical education as well as other different social, cultural and policy making dimensions. Copyright © 2016. Published by Elsevier Ltd.

  1. Religion as an Alleviating Factor in Iranian Cancer Patients: a Qualitative Study.

    Rahnama, Mozhgan; Khoshknab, Masoud Fallahi; Seyed Bagher Maddah, Sadat; Ahmadi, Fazlollah; Arbabisarjou, Azizollah

    2015-01-01

    After diagnosis of cancer, many patients show more inclination towards religion and religious activities. This qualitative study using semi-structured interviews explored the perspectives and experiences of 17 Iranian cancer patients and their families regarding the role of religion in their adaptation to cancer in one of the hospitals in Tehran and a charity institute. The content analysis identified two themes: "religious beliefs "(illness as God's will, being cured by God's will, belief in God's supportiveness, having faith in God as a relieving factor, and hope in divine healing) and "relationship with God during the illness." In general, relationship with God and religious beliefs had a positive effect on the patients adapting to their condition, without negative consequences such as stopping their treatment process and just waiting to be cured by God. Thus a strengthening of such beliefs, as a coping factor, could be recommended through religious counseling.

  2. Cancer treatment decision-making processes for older patients with complex needs: a qualitative study.

    Bridges, Jackie; Hughes, Jane; Farrington, Naomi; Richardson, Alison

    2015-12-14

    Although older people can experience complex health and social care needs alongside a primary cancer diagnosis, little is understood about how cancer treatment decisions are made for this population. This study aimed to investigate how cancer treatment decisions are formulated for older people with complex health and social care needs and the factors that shape these processes. Qualitative study involving semistructured interviews and non-participant observations. Framework approach used for data analysis. Breast and colorectal cancer services in five English NHS hospital trusts. Interviews: purposive sample of 22 clinicians directly involved in a face-to-face clinical role with patients regarding cancer treatment and care, maximising variation across clinical roles, tumour types and trusts. purposive sample of five cancer multidisciplinary meetings, maximising variation across location, team size and tumour type. The initial stages of cancer treatment decision-making are team-based, medically dominated and focused on the cancer. For patients with complex health and social care needs that extend beyond cancer pathology, later and less visible stages in the decision-making process are more haphazard and may result in less effective and workable treatment plans, as individual clinicians struggle to devise and deliver these plans without breaching time-based targets. Service targets that focus resources solely on the presenting disease can disadvantage older patients with complex health and social care needs that extend beyond this primary diagnosis. Care should be taken to ensure time-based targets do not disincentivise thorough and timely assessment that can lead to the formulation of treatment plans tailored to individual needs and circumstances. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Primary care and communication in shared cancer care: A Qualitative Study

    Sada, Yvonne; Street, Richard L.; Singh, Hardeep; Shada, Rachel; Naik, Aanand D.

    2013-01-01

    Objective To explore perceptions of primary care physicians’ (PCPs) and oncologists’ roles, responsibilities, and patterns of communication related to shared cancer care in three integrated health systems that used electronic health records (EHRs). Study design Qualitative study. Methods We conducted semi-structured interviews with ten early stage colorectal cancer patients and fourteen oncologists and PCPs. Sample sizes were determined by thematic saturation. Dominant themes and codes were identified and subsequently applied to all transcripts. Results Physicians reported that EHRs improved communication within integrated systems, but communication with physicians outside their system was still difficult. PCPs expressed uncertainty about their role during cancer care, even though medical oncologists emphasized the importance of co-morbidity control during cancer treatment. Both patients and physicians described additional roles for PCPs, including psychological distress support and behavior modification. Conclusions Integrated systems that use EHRs likely facilitate shared cancer care through improved PCP-oncologist communication. However, strategies to facilitate a more active role for PCPs in managing co-morbidities, psychological distress and behavior modification, as well as to overcome communication challenges between physicians not practicing within the same integrated system, are still needed to improve shared cancer care. PMID:21615196

  4. Subjective evaluation of a peer support program by women with breast cancer: A qualitative study.

    Ono, Miho; Tsuyumu, Yuko; Ota, Hiroko; Okamoto, Reiko

    2017-01-01

    The aim of this study was to determine the subjective evaluation of a breast cancer peer support program based on a survey of the participants who completed the program. Semistructured interviews were held with 10 women with breast cancer. The responses were subject to a qualitative inductive analysis. Women with breast cancer who participated in the breast cancer peer support program evaluated the features of the program and cited benefits, such as "Receiving individual peer support tailored to your needs," "Easily consulted trained peer supporters," and "Excellent coordination." Also indicated were benefits of the peer support that was received, such as "Receiving peer-specific emotional support," "Obtaining specific experimental information," "Re-examining yourself," and "Making preparations to move forward." The women also spoke of disadvantages, such as "Strict management of personal information" and "Matching limitations." In this study, the subjective evaluation of a peer support program by women with breast cancer was clarified . The women with breast cancer felt that the program had many benefits and some disadvantages. These results suggest that there is potential for peer support-based patient-support programs in medical services that are complementary to the current support that is provided by professionals. © 2016 Japan Academy of Nursing Science.

  5. Radical cystectomy for bladder cancer: a qualitative study of patient experiences and implications for practice.

    Fitch, Margaret I; Miller, Debbie; Sharir, Sharon; McAndrew, Alison

    2010-01-01

    Patients being treated for bladder cancer share issues in common with other cancer patients, but also experience issues that are unique to their surgical treatment. This study used a descriptive qualitative approach to explore the experiences of patients who had undergone radical cystectomy for bladder cancer Twenty-two participants were interviewed in-depth on one occasion and were invited to attend a focus group session following the analysis of the interview transcripts. Participants described the shock of their diagnosis, their lack of information about bladder cancer, the importance of clear communication with care providers, and the types of adjustments they had to make following surgery. Specifically, changes in bodily function, body image, sexual relationships, and intimacy presented challenges for these participants. Although there was a sense of acceptance about the treatment-related events, there were still significant adjustments required by individuals following their surgery. Information, open communication, and support from family and friends were seen as important factors in helping patients adjust after surgery. Patients require clear, concise and consistent information about their cancer, treatment options, and course of care. Nurses caring for patients following surgery for bladder cancer need to understand the unique needs of these patients.

  6. Laparoscopic resection of transverse colon cancer at splenic flexure: technical aspects and results.

    Okuda, Junji; Yamamoto, Masashi; Tanaka, Keitaro; Masubuchi, Shinsuke; Uchiyama, Kazuhisa

    2016-03-01

    Laparoscopic resection of transverse colon cancer at splenic flexure is technical demanding and its efficacy remains controversial. The aim of this study was to investigate its technical aspects such as pitfalls and overcoming them, and to demonstrate the short-term and oncologic long-term outcomes. To overcome the difficulty in laparoscopic resection of transverse colon cancer at splenic flexure, we recognized the following technical tips as essential. First of all, we have to precisely identify major vessels variations feeding tumor. Secondary, anatomical dissection of mesocolon through medial approach is indispensible. Third, safe takedown of splenic flexure to fully mobilization of left hemicolon is mandatory. This cohort study analyzed 95 patients with stage II (43) and III (52) underwent resection of transverse colon cancer at splenic flexure. 61 laparoscopic surgeries (LAC) and 34 conventional open surgeries (OC) from December 1996 to December 2009 were evaluated. Short-term and oncologic long-term outcomes were recorded. Operative time was longer in LAC. However, blood loss was less, recovery of bowel function and hospital stay were shorter in LAC. There was no conversion in LAC and no significant difference in the postoperative complications. Regarding oncologic long-term outcomes, there were no significant differences between OC and LAC. Laparoscopic resection of transverse colon cancer at splenic flexure resulted in acceptable short-term and oncologic long-term outcomes. Once technical tips acquired, laparoscopic resection of transverse colon cancer at splenic flexure could be feasible as minimally invasive surgery.

  7. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.

    Busolo, David; Woodgate, Roberta

    2015-01-01

    , chaplains, home health aides and volunteers.Palliative care needs for cancer patients are numerous and may include needs related to activities of daily living, communication, sexuality, physical needs, psychological needs, fear, spiritual wellbeing, socioeconomic aspects and insufficiency of information. Cancer patients often report of suffering, pain and being in constant need of support. In dealing with their suffering, some patients seek internal motivation by looking at the disease as a life challenge. Other patients turn to external sources of motivation like religion, or peer and family support groups.Patients from different ethnocultural groups report similar as well as dissimilar palliative care needs and experiences. With respect to similarities, a study from the United States found that African American and Caucasian patients alike valued practical assistance from social groups. Participants from both ethnocultural groups valued friends and families that listened to their cancer-related concerns. Similarly, Turkish and Moroccan patients in a study conducted in Netherlands valued friends and family members that were there for them. Additionally, participants particularly of African American descent treasured positive attitudes from people around them and valued support from religion and faith communities. These sentiments are echoed in a palliative care study conducted in the United Kingdom. In the UK study, Caribbean Blacks and British White patients appreciated the significance of social networks and partner or spousal support in their cancer trajectory.In regards to unsupportive palliative care experiences, authors of the United States study report that African Americans and Caucasians had more similarities than differences. Firstly, both ethnocultural groups shared experiences of losing association with family and close friends after they learnt of the patients' diagnosis. These sentiments were also reported by Danish-born and immigrant patients in a study by

  8. Role of quantitative and qualitative characteristics of free circulating DNA in the management of patients with non-small cell lung cancer.

    Ulivi, Paola; Silvestrini, Rosella

    2013-12-01

    The release of DNA into peripheral blood is a common event in cancer patients, occurring as a consequence of necrotic and apoptotic processes typical of tumor cells. However, free circulating DNA (fcDNA) is also present in patients with benign diseases and in healthy individuals. Both quantitative and qualitative aspects of fcDNA have been studied as potential biomarkers in a number of tumor types. In particular, quantitative analysis of fcDNA has been shown to play an important role in the diagnosis of non-small cell lung cancer (NSCLC), because of its ability to discriminate between healthy subjects and individuals with NSCLC. Additionally, fcDNA in cancer patients derives predominantly from tumor tissue and, as such, it can be used for the molecular characterization of the primary tumor. Targeted therapies in NSCLC have, in recent years, produced promising results, highlighting the importance of molecular profiling of the primary cancer lesions. Considering that little or no tumor material is available for at least some of the patients, the possibility of using fcDNA for molecular analysis becomes increasingly important. In the present review we evaluated several quantitative and qualitative aspects of fcDNA that could be instrumental for the differential diagnosis of lung disease. There is ample evidence in the literature to support the possible use of peripheral blood-derived fcDNA in the early diagnosis and molecular characterization of lung cancer. This non-invasive method may also turn out to be valuable in monitoring drug response and in identifying induced mechanisms of drug resistance. Before it can be implemented in routine clinical practice, however, additional efforts are needed to standardize the methodology.

  9. Coping Well with Advanced Cancer: A Serial Qualitative Interview Study with Patients and Family Carers

    Roberts, Diane; Appleton, Lynda; Calman, Lynn; Large, Paul; Lloyd-Williams, Mari; Grande, Gunn

    2017-01-01

    Objectives To understand successful strategies used by people to cope well when living with advanced cancer; to explore how professionals can support effective coping strategies; to understand how to support development of effective coping strategies for patients and family carers. Design Qualitative serial (4–12 week intervals) interview study with people with advanced cancer and their informal carers followed by focus groups. The iterative design had a novel focus on positive coping strategies. Interview analysis focused on patients and carers as individuals and pairs, exploring multiple dimensions of their coping experiences. Focus group analysis explored strategies for intervention development. Participants 26 people with advanced (stage 3–4) breast, prostate, lung or colorectal cancer, or in receipt of palliative care, and 24 paired nominated informal/family carers. Setting Participants recruited through outpatient clinics at two tertiary cancer centres in Merseyside and Manchester, UK, between June 2012 and July 2013. Results 45 patient and 41 carer interviews were conducted plus 4 focus groups (16 participants). People with advanced cancer and their informal/family carers develop coping strategies which enable effective management of psychological wellbeing. People draw from pre-diagnosis coping strategies, but these develop through responding to the experience of living with advanced cancer. Strategies include being realistic, indulgence, support, and learning from others, which enabled participants to regain a sense of wellbeing after emotional challenge. Learning from peers emerged as particularly important in promoting psychological wellbeing through the development of effective ‘everyday’, non-clinical coping strategies. Conclusions Our findings challenge current models of providing psychological support for those with advanced cancer which focus on professional intervention. It is important to recognise, enable and support peoples’ own

  10. The struggle towards 'the New Normal': a qualitative insight into psychosexual adjustment to prostate cancer.

    Hanly, Narelle; Mireskandari, Shab; Juraskova, Ilona

    2014-07-30

    Despite the growing body of literature which highlights the potential for significant and enduring side-effects of prostate cancer treatment, there is limited research exploring the experience of living with the treatment-induced side-effects such as sexual dysfunction, and their repercussions for men and their partners. The aim of this qualitative study was to explore factors influencing psychosexual adjustment, self-perception, and unmet information and support needs of prostate cancer patients and their partners. Twenty-one men, recruited via a prostate cancer support group newsletter, participated in face-to-face semi-structured interviews, which were subjected to thematic analysis. The qualitative analysis revealed three inter-connected main themes which contributed to men's psychosexual adjustment: i) Psychosexual impact, ii) Communication and support, and iii) Integration process. Men reported distressing sexual and urinary difficulties, tainted self-perception and altered intimate relationships. Receiving adequate information and support, and having good communication with their doctors and partners facilitated better adjustment to prostate cancer treatment. Coming to terms with the significant impact of treatment had involved making lifestyle changes, coping with emotional struggles and striving to accept and integrate their post-treatment "new normal" self and sexual life. The importance of adequate communication with health professionals and partners, especially regarding treatment effects on sexual function and rehabilitation options, was highlighted as a key factor facilitating the adjustment process. Prostate cancer patients would benefit from improved access to timely and tailored information and decision-making resources, ongoing multidisciplinary care, and support groups, as well as appropriate referrals for sexual and psychological counselling.

  11. Living with Symptoms: A Qualitative Study of Black Adults with Advanced Cancer Living in Poverty.

    Yeager, Katherine A; Quest, Tammie E; Vena, Catherine; Sterk, Claire E

    2018-02-01

    Cancer is associated with disease-related and treatment-related symptoms. Little is known about the symptom experience of black individuals with advanced cancer especially those with limited financial resources. Therefore, the purpose of this study was to explore the symptom experience of black adults with advanced cancer living in poverty. This qualitative descriptive study focused on the perspectives of the participants experiencing at least two symptoms related to cancer. A purposive sample of 27 individuals receiving care at a public hospital in a southeastern city participated in the study. Semi-structured audiotaped interviews were conducted by two research interviewers. Content analysis was used to develop themes to describe the symptom experience. Two main themes emerged in terms of the participants' symptom experiences: (1) "living in pain," which included the overwhelming experience of pain, both physical and emotional, and (2) "symptoms associated with functioning in everyday life." Participants frequently used the context of activities in their daily lives to explain symptoms, including the effect of symptoms on the activities of eating, moving and doing, and communicating. People with advanced cancer work to negotiate a high frequency of multiple distressful symptoms of severe-to-moderate severity. Information gained from this study can help guide research in symptom science and provide direction for clinicians working with this minority group. Copyright © 2017 American Society for Pain Management Nursing. All rights reserved.

  12. The stressors and vulnerabilities of young single childless women with breast cancer: a qualitative study.

    Corney, Roslyn; Puthussery, Shuby; Swinglehurst, Jane

    2014-02-01

    Marital or partnership status is seldom investigated as a primary contributing factor to women's wellbeing after a diagnosis of breast cancer. It has been suggested, however, that single childless women with breast cancer may face unique stressors. This paper explores the stressors and vulnerabilities of young single childless women with a first episode of breast cancer. A qualitative descriptive method was used. As part of a larger study examining fertility concerns of young childless women with first episode of breast cancer, in-depth semi-structured interviews were conducted with 10 single women. Recorded interviews were analysed using the framework approach. Findings cover three main themes: partnership worries; fertility concerns; and views about emotional and practical support received. Partnership worries included concerns about having to undergo treatment without a partner to support them; the fear of rejection by potential partners; and feelings about the precious time lost in diagnosis and treatment. Fertility concerns included dilemmas about having children and feelings about the options of pursuing Assisted Reproductive Techniques. Views about the emotional and practical support received included the overall support received as well as perceptions about the attitudes of health professionals towards fertility issues. Findings indicate that single childless women with breast cancer face additional vulnerabilities and may benefit from tailored support from health care professionals and interventions specifically targeted at them. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Everyday life in breast cancer survivors experiencing challenges: A qualitative study.

    Jakobsen, Klara; Magnus, Eva; Lundgren, Steinar; Reidunsdatter, Randi J

    2017-05-31

    Early diagnosis and treatment of breast cancer results in an increasing number of survivors, some of whom face new challenges in their transition to daily life. Based on these experiences, the aim of this study was to describe the everyday life in breast cancer survivors experiencing challenges. Eleven women recruited from a follow-up study of breast cancer patients participated in qualitative interviews about their everyday occupations seven years after ending treatment. The inductive analysis revealed ten categories that were organized into five subthemes under the two main themes 'bodily and mental loneliness' and 'new center of gravity in everyday life'. Findings showed how relevant information and guidance; active support to the client and their relatives; and a balance between occupations at home and at work were important matters to handle their everyday life challenges. By assisting these women in finding new patterns of meaningful occupations that positively affect their everyday life, the study suggests some central elements to be included in future follow-up practice for breast cancer survivors. Approaching this goal, occupational therapists should contribute to more involvement assisting cancer survivors and their partners in finding new patterns of meaningful occupations that positively affect their everyday life.

  14. Cervical cancer: a qualitative study on subjectivity, family, gender and health services.

    Villafuerte, Blanca E Pelcastre; Gómez, Laura L Tirado; Betancourt, Alejandro Mohar; Cervantes, Malaquías López

    2007-03-01

    In 2002, cervical cancer was one of the leading causes of death in Mexico. Quantitative techniques allowed for the identification of socioeconomic, behavioral and biological characteristics that are part of its etiology. However such characteristics, are inadequate to explain sufficiently the role that emotions, family networks and socially-constructed categories such as gender play in the demand and utilization of health services for cervical cancer diagnosis and treatment and neither the timely undertaking of preventive actions, such as getting a PAP smear or seeking adequate and continuous treatment. A qualitative study was carried out to analyze the role of different social and cultural factors in the timely detection of cervical cancer. As part of a multi-level, multi-method research effort, this particular study was based on individual interviews with women diagnosed with cervical cancer (identified as the "cases"), their female friends and relatives (identified as the "controls") and the cases' husbands. The results showed that both: denial and fear are two important components that regulate the behavior of both the women and their partners. Women with a small support network may have limited opportunities for taking action in favor of their own health and wellbeing. Women tend not to worry about their health, in general and neither about cervical cancer in particular, as a consequence of their conceptualizations regarding their body and feminine identify - both of which are socially determined. Furthermore, it is necessary to improve the quality of information provided in health services.

  15. Physician cooperation in outpatient cancer care. An amplified secondary analysis of qualitative interview data.

    Engler, J; Güthlin, C; Dahlhaus, A; Kojima, E; Müller-Nordhorn, J; Weißbach, L; Holmberg, C

    2017-11-01

    The importance of outpatient cancer care services is increasing due to the growing number of patients having or having had cancer. However, little is known about cooperation among physicians in outpatient settings. To understand what inter- and multidisciplinary care means in community settings, we conducted an amplified secondary analysis that combined qualitative interview data with 42 general practitioners (GPs), 21 oncologists and 21 urologists that mainly worked in medical practices in Germany. We compared their perspectives on cooperation relationships in cancer care. Our results indicate that all participants regarded cooperation as a prerequisite for good cancer care. Oncologists and urologists mainly reported cooperating for tumour-specific treatment tasks, while GPs' reasoning for cooperation was more patient-centred. While oncologists and urologists reported experiencing reciprocal communication with other physicians, GPs had to gather the information they needed. GPs seldom reported engaging in formal cooperation structures, while for specialists, participation in formal spaces of cooperation, such as tumour boards, facilitated a more frequent and informal discussion of patients, for instance on the phone. Further research should focus on ways to foster GPs' integration in cancer care and evaluate if this can be reached by incorporating GPs in formal cooperation structures such as tumour boards. © 2017 John Wiley & Sons Ltd.

  16. Psychosocial aspects of head and neck cancer--a review of the literature.

    Pruyn, J F; de Jong, P C; Bosman, L J; van Poppel, J W; van Den Borne, H W; Ryckman, R M; de Meij, K

    1986-12-01

    This study is a systematic analysis of the literature on psychosocial aspects in head and neck cancer patients. Patients with head and neck cancer experience a variety of physical as well as psychosocial problems. Physical problems include swallowing or chewing, speech and physical appearance. Psychosocial problems include anxiety, depression, loss of self-esteem and uncertainty about the future. Because of these problems, isolation from friends typically occurs, re-employment is difficult, and there are social and sexual tensions within families. Information and support by professionals, partners and/or fellow patients are related to positive rehabilitation outcomes such as the acquisition of speech, increases in constructive social functioning and decreases in depression.

  17. Role of the Technical Aspects of Hypofractionated Radiation Therapy Treatment of Prostate Cancer: A Review

    Clemente, Stefania, E-mail: clemente_stefania@libero.it [Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata Rionero in Vulture, Potenza (Italy); Nigro, Roberta [Azienda Sanitaria Locale Rieti, Roma (Italy); Oliviero, Caterina [Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata Rionero in Vulture, Potenza (Italy); Marchioni, Chiara [Azienda Sanitaria Locale Rieti, Roma (Italy); Esposito, Marco [Azienda Sanitaria, Firenze (Italy); Giglioli, Francesca Romana [Azienda Ospedaliera Città della Salute e della Scienza di Torino, Torino (Italy); Mancosu, Pietro [Humanitas Clinical and Research Hospital, Rozzano, Milano (Italy); Marino, Carmelo [Humanitas Centro Catanese di Oncologia, Catania (Italy); Russo, Serenella [Azienda Sanitaria, Firenze (Italy); Stasi, Michele [Azienda Ospedaliera Ordine Mauriziano di Torino, Torino (Italy); Strigari, Lidia [Istituto Nazionale Tumori Regina Elena, Roma (Italy); Veronese, Ivan [Universita' degli Studi di Milano, Milano (Italy); Landoni, Valeria [Istituto Nazionale Tumori Regina Elena, Roma (Italy)

    2015-01-01

    The increasing use of moderate (<35 fractions) and extreme (<5 fractions) hypofractionated radiation therapy in prostate cancer is yielding favorable results, both in terms of maintained biochemical response and toxicity. Several hypofractionation (HF) schemes for the treatment of prostate cancer are available, although there is considerable variability in the techniques used to manage intra-/interfraction motion and deliver radiation doses. We performed a review of the published studies on HF regimens as a topic of interest for the Stereotactic Ablative Radiotherapy working group, which is part of the Italian Association of Medical Physics. Aspects of organ motion management (imaging for contouring, target volume definition, and rectum/bladder preparation) and treatment delivery (prostate localization, image guided radiation therapy strategy and frequency) were evaluated and categorized to assess outcome relative to disease control and toxicity. Despite the heterogeneity of the data, some interesting trends that emerged from the review might be useful in identifying an optimum HF strategy.

  18. What Aspects of Personal Care Are Most Important to Patients Undergoing Radiation Therapy for Prostate Cancer?

    Foley, Kimberley A.; Feldman-Stewart, Deb; Groome, Patti A.; Brundage, Michael D.; McArdle, Siobhan; Wallace, David; Peng, Yingwei; Mackillop, William J.

    2016-01-01

    Purpose/Objective: The overall quality of patient care is a function of the quality of both its technical and its nontechnical components. The purpose of this study was to identify the elements of nontechnical (personal) care that are most important to patients undergoing radiation therapy for prostate cancer. Methods and Materials: We reviewed the literature and interviewed patients and health professionals to identify elements of personal care pertinent to patients undergoing radiation therapy for prostate cancer. We identified 143 individual elements relating to 10 aspects of personal care. Patients undergoing radical radiation therapy for prostate cancer completed a self-administered questionnaire in which they rated the importance of each element. The overall importance of each element was measured by the percentage of respondents who rated it as “very important.” The importance of each aspect of personal care was measured by the mean importance of its elements. Results: One hundred eight patients completed the questionnaire. The percentage of patients who rated each element “very important” ranged from 7% to 95% (mean 61%). The mean importance rating of the elements of each aspect of care varied significantly: “perceived competence of caregivers,” 80%; “empathy and respectfulness of caregivers,” 67%; “adequacy of information sharing,” 67%; “patient centeredness,” 59%; “accessibility of caregivers,” 57%; “continuity of care,” 51%; “privacy,” 51%; “convenience,” 45%; “comprehensiveness of services,” 44%; and “treatment environment,” 30% (P<.0001). Neither age nor education was associated with importance ratings, but the patient's health status was associated with the rating of some elements of care. Conclusions: Many different elements of personal care are important to patients undergoing radiation therapy for prostate cancer, but the 3 aspects of care that most believe are most important are these: the perceived

  19. What Aspects of Personal Care Are Most Important to Patients Undergoing Radiation Therapy for Prostate Cancer?

    Foley, Kimberley A. [Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Kingston, Ontario (Canada); Department of Public Health Sciences, Queen' s University, Kingston, Ontario (Canada); Feldman-Stewart, Deb [Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Kingston, Ontario (Canada); Department of Oncology, Queen' s University, Kingston, Ontario (Canada); Groome, Patti A. [Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Kingston, Ontario (Canada); Department of Public Health Sciences, Queen' s University, Kingston, Ontario (Canada); Brundage, Michael D. [Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Kingston, Ontario (Canada); Department of Public Health Sciences, Queen' s University, Kingston, Ontario (Canada); Department of Oncology, Queen' s University, Kingston, Ontario (Canada); Cancer Centre of Southeastern Ontario, Kingston, Ontario (Canada); McArdle, Siobhan [Cancer Centre of Southeastern Ontario, Kingston, Ontario (Canada); Wallace, David [Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Kingston, Ontario (Canada); Department of Public Health Sciences, Queen' s University, Kingston, Ontario (Canada); Peng, Yingwei [Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Kingston, Ontario (Canada); Department of Public Health Sciences, Queen' s University, Kingston, Ontario (Canada); Department of Mathematics and Statistics, Queen' s University, Kingston, Ontario (Canada); Mackillop, William J., E-mail: William.mackillop@krcc.on.ca [Cancer Care and Epidemiology, Queen' s Cancer Research Institute, Kingston, Ontario (Canada); Department of Public Health Sciences, Queen' s University, Kingston, Ontario (Canada); Department of Oncology, Queen' s University, Kingston, Ontario (Canada); Cancer Centre of Southeastern Ontario, Kingston, Ontario (Canada)

    2016-02-01

    Purpose/Objective: The overall quality of patient care is a function of the quality of both its technical and its nontechnical components. The purpose of this study was to identify the elements of nontechnical (personal) care that are most important to patients undergoing radiation therapy for prostate cancer. Methods and Materials: We reviewed the literature and interviewed patients and health professionals to identify elements of personal care pertinent to patients undergoing radiation therapy for prostate cancer. We identified 143 individual elements relating to 10 aspects of personal care. Patients undergoing radical radiation therapy for prostate cancer completed a self-administered questionnaire in which they rated the importance of each element. The overall importance of each element was measured by the percentage of respondents who rated it as “very important.” The importance of each aspect of personal care was measured by the mean importance of its elements. Results: One hundred eight patients completed the questionnaire. The percentage of patients who rated each element “very important” ranged from 7% to 95% (mean 61%). The mean importance rating of the elements of each aspect of care varied significantly: “perceived competence of caregivers,” 80%; “empathy and respectfulness of caregivers,” 67%; “adequacy of information sharing,” 67%; “patient centeredness,” 59%; “accessibility of caregivers,” 57%; “continuity of care,” 51%; “privacy,” 51%; “convenience,” 45%; “comprehensiveness of services,” 44%; and “treatment environment,” 30% (P<.0001). Neither age nor education was associated with importance ratings, but the patient's health status was associated with the rating of some elements of care. Conclusions: Many different elements of personal care are important to patients undergoing radiation therapy for prostate cancer, but the 3 aspects of care that most believe are most important are these: the

  20. Coping, social relations, and communication: A qualitative exploratory study of children of parents with cancer

    Thastum, Mikael; Johansen, Mikael Birkelund; Gubba, Lotte

    2008-01-01

    The purpose of this qualitative study of families where a parent has cancer was to explore ways of informing the child of the parent's illness, how the child perceives the parent's emotional state, how the child copes with the parent's illness, and how this coping relates to the parent's coping...... and concerns for the child. Twenty-one children from 15 families and their parents were interviewed. In 13 families the mother was ill, in two the father. Children were aware of the facts of the illness, but there was limited emotional communication between the generations. The children were very observant...

  1. Social disclosure about lymphoedema symptoms: A qualitative study among Japanese breast cancer survivors.

    Tsuchiya, Miyako; Horn, Sandra; Ingham, Roger

    2015-01-01

    Disclosing illness-related problems is the first step in help-seeking. The aim of this qualitative study was to explore Japanese breast cancer (BC) survivors' decision-making about disclosure of lymphoedema symptoms to people in their social networks. A total of ten women participated in group discussions in Japan. A dual analytic approach, thematic analysis and conceptual analysis, was applied to the transcripts. Two themes (perceived responsibility of social roles within the family and unsupportive reactions to BC from others) affected participants' decision-making. Support programs for Japanese BC survivors who feel unable to disclose lymphoedema symptoms to family members are suggested.

  2. Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer.

    Coolbrandt, A; Dierckx de Casterlé, B; Wildiers, H; Aertgeerts, B; Van der Elst, E; van Achterberg, T; Milisen, K

    2016-01-01

    Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with chemotherapy-related symptoms in their home, which factors and ideas influence their self-management and what role professional caregivers play. One-off, semi-structured interviews were held with 28 adult patients with cancer being treated with chemotherapy. Using a Grounded Theory approach, we cyclically collected and analysed data to come to a thorough understanding of the major conceptual themes and their interconnections. Dealing with chemotherapy-related symptoms involves a process of experiencing and learning how side effects unfold over time and how to deal with them. Patients express very personal symptom experiences and symptom-management styles, which are shaped by personal factors (e.g. coping with cancer and cancer treatment, perceived level of control) and environmental factors (e.g. professionals' attitude, information resources). Improving symptom self-management support requires active exploration of the personal symptom experience and symptom-management style. Professional care should be tailored to the patient's perspective and should address personal and environmental determinants of their behaviour. © 2015 John Wiley & Sons Ltd.

  3. Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study.

    Reese, Jennifer Barsky; Beach, Mary Catherine; Smith, Katherine Clegg; Bantug, Elissa T; Casale, Kristen E; Porter, Laura S; Bober, Sharon L; Tulsky, James A; Daly, Mary B; Lepore, Stephen J

    2017-10-01

    Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.

  4. Managing One's Symptoms: A Qualitative Study of Low-Income African Americans With Advanced Cancer.

    Yeager, Katherine A; Sterk, Claire E; Quest, Tammie E; DiIorio, Colleen; Vena, Catherine; Bauer-Wu, Susan

    2016-01-01

    African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life. The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do. A purposive sample of 27 individuals participated in semistructured interviews conducted by 2 research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management. Participants described 2 approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience. This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms. As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.

  5. Men's sexual issues after breast cancer in their wives: a qualitative study.

    Nasiri, Ahmad; Taleghani, Fariba; Irajpour, Alireza

    2012-01-01

    Husbands of women with breast cancer may experience problems in their sexual relationships with their wives. Adjustment to sexual issues can be affected by cultural norms and beliefs. Understanding men's perceptions and responses to their new sexual status after diagnosis of their wife's disease and during its treatment may help clinicians to better support the couple. The objective of this study was to explore the sexual issues of Iranian men after breast cancer in their wives. A qualitative research method based on the grounded theory approach was used. In-depth interviews were conducted with a purposive sampling of Iranian men experiencing breast cancer in their wives. Data analysis was based on the constant comparative method. Eighteen men were interviewed. Five main themes emerged: sexual relationship changes, sexual avoidance, sexual abstinence, sexual restraint, and efforts to normalize the relationship. The participants experienced problems in their sex lives. Because cultural and religious beliefs were important factors affecting the men's sexual adjustment, health system providers should encourage husbands to tolerate and adjust to their sexual issues in the context of their culture and religion. The findings of this study could help nurses and other healthcare professionals recognize sexual issues in the husbands of women with breast cancer and promote the couples' healthy sexual life.

  6. A qualitative cancer screening study with childhood sexual abuse survivors: experiences, perspectives and compassionate care.

    Gesink, Dionne; Nattel, Lilian

    2015-08-05

    The childhood sexual abuse (CSA) survivor population is substantial and survivors have been identified as part of the population who were under-screened or never-screened for breast, cervical and colon cancer. Our objective was to learn CSA survivor perspectives on, and experiences with, breast, cervical and colon cancer screening with the intention of generating recommendations to help healthcare providers improve cancer screening participation. A pragmatic constructivist qualitative study involving individual, semistructured, in-depth interviews was conducted in January 2014. Thematic analysis was used to describe CSA survivor perspectives on cancer screening and identify potential facilitators for screening. A diverse purposive sample of adult female CSA survivors was recruited. The inclusion criteria were: being a CSA survivor, being in a stable living situation, where stable meant able to meet one's financial needs independently, able to maintain supportive relationships, having participated in therapy to recover from past abuse, and living in a safe environment. 12 survivors were interviewed whose ages ranged from the early 40s to mid-70s. Descriptive saturation was reached after 10 interviews. Interviews were conducted over the phone or Internet. CSA survivors were primarily from urban and rural Ontario, but some resided elsewhere in Canada and the USA. The core concept that emerged was that compassionate care at every level of the healthcare experience could improve cancer screening participation. Main themes included: desire for holistic care; unique needs of patients with dissociative identity disorder; the patient-healthcare provider relationship; appointment interactions; the cancer screening environment; and provider assumptions about patients. Compassionate care can be delivered by: building a relationship; practising respect; focusing attention on the patient; not rushing the appointment; keeping the environment positive and comfortable; maintaining

  7. Women's interpretation of and responses to potential gynaecological cancer symptoms: a qualitative interview study.

    Low, E L; Whitaker, K L; Simon, A E; Sekhon, M; Waller, J

    2015-07-06

    To explore women's experiences of symptoms potentially indicative of gynaecological cancer in a community-based sample without imposing a cancer perspective. A qualitative interview study with thematic analysis of transcripts. 26 women aged ≥30 years, who had experienced a symptom that might indicate gynaecological cancer in the past 3 months, were recruited using a screening questionnaire distributed online and in community settings. London, UK. Women attributed gynaecological symptoms to existing illnesses/conditions or considered themselves to be predisposed to them, either through their 'genes' or previous personal experience. Normalising symptoms by attributing them to demographic characteristics (eg, age, sex) was common, as was considering them a side effect of hormonal contraception. When women raised cancer as a possible cause, they often dismissed it as unlikely. Responses to symptoms included self-management (eg, self-medicating, making lifestyle changes), adopting a 'lay system of care', or consulting a healthcare professional. Triggers to help-seeking included persistent, painful or debilitating symptoms, concern about symptom seriousness, and feeling that help-seeking was legitimised. Barriers to help-seeking included lack of concern, vague symptoms, unusual symptom location, competing time demands, previous negative experiences with the healthcare system, and not wanting to be perceived as a time-waster. Attributions of symptoms potentially indicative of a gynaecological cancer were varied, but most often involved women fitting symptoms into their expectations of what was 'normal'. Normalising acted as a barrier to seeking help from a healthcare professional, alongside competing time demands and negative attitudes towards help-seeking. These barriers may lead to later diagnosis and poorer cancer survival. Our findings could be used to inform the development of interventions to encourage appropriate help-seeking. Published by the BMJ Publishing

  8. Aspects of family caregiving as addressed in planned discussions between nurses, patients with chronic diseases and family caregivers: a qualitative content analysis.

    Hagedoorn, E I; Paans, W; Jaarsma, T; Keers, J C; van der Schans, C; Luttik, M Louise

    2017-01-01

    Caregiving by family members of elderly with chronic conditions is currently intensifying in the context of an aging population and health care reform in the Netherlands. It is essential that nurses have attention for supporting roles of family caregivers of older patients and address family caregiving aspects on behalf of the continuity of care. This study aims to explore what aspects of family caregiving were addressed during planned discussions between nurses, patients and family caregivers in the hospital. Qualitative descriptive research was conducted using non-participant observation and audio-recordings of planned discussions between nurses, older patients and their family caregivers as they took place in the hospital. Through purposive sampling eligible patients (≥ 65 years) with one or more chronic conditions were included. These patients were admitted to the hospital for diagnostics or due to consequences of their chronic illness. Retrospective chart review was done to obtain patient characteristics. Data were collected in November/December 2013 and April/May 2014 in four hospitals. Qualitative content analysis was performed using the inductive approach in order to gain insight into addressed aspects of family caregiving. A total of 62 patients (mean age (SD) 76 years (7.2), 52% male) were included in the study, resulting in 146 planned discussions (62 admission and discharge discussions and 22 family meetings). Three themes were identified regarding addressed aspects of family caregiving. Two themes referred to aspects addressing the patients' social network, and included 'social network structure' and 'social network support'. One theme referred to aspects addressing coordination of care issues involving family caregiving, referred to as 'coordination of care'. During discussions nurses mostly addressed practical information on the patients' social network structure. When specific family caregiving support was addressed, information was limited and

  9. Concern about aspects of body image and adjustment to early stage breast cancer.

    Carver, C S; Pozo-Kaderman, C; Price, A A; Noriega, V; Harris, S D; Derhagopian, R P; Robinson, D S; Moffat, F L

    1998-01-01

    Several authors have suggested that patients adjust more poorly to breast cancer if they are heavily invested in body image as a source of their sense of self-worth. This prospective study examined this possibility, looking at two aspects of concern about body image as predictors of several indices of adjustment over the first postoperative year. At diagnosis (and again a year later) 66 women with early stage breast cancer reported how much they valued a) a sense of body integrity (or intactness) and b) a good physical appearance. The day before surgery, a week afterward, and at 3-month, 6-month, and 12-month follow ups, they reported on their mood. At presurgery and at follow ups they also rated their attractiveness and sexual desirability and reported on frequency of sexual interaction. At follow-ups they also indicated how much their illness and treatment were interfering with social and recreational activities. Initial investment in appearance was related to distress across the postsurgical year. In contrast, investment in appearance made women more resilient against deterioration in their perceptions of attractiveness. Concern about body integrity did not strongly predict emotional distress, but it related to adverse impact on social and recreational activities in the follow-up period, to deterioration in feelings of sexual desirability, and to feelings of alienation from the self (feeling "not like yourself anymore"). Body image is often thought of in terms of physical appearance, but there is also a body image pertaining to integrity, wholeness, and normal functioning. People who are greatly concerned about either aspect of their body image are vulnerable to poorer psychosocial adjustment when confronting treatment for breast cancer. The poorer adjustment takes a different form, however, depending on the nature of the patient's body-image concern.

  10. Improving access to supportive cancer care through an eHealth application: a qualitative needs assessment among cancer survivors.

    Lubberding, Sanne; van Uden-Kraan, Cornelia F; Te Velde, Elisabeth A; Cuijpers, Pim; Leemans, C René; Verdonck-de Leeuw, Irma M

    2015-05-01

    To gain insight into cancer survivors' needs towards an eHealth application monitoring quality of life and targeting personalised access to supportive care. Supportive care in cancer addresses survivors' concerns and needs. However, many survivors are not taking advantage of supportive care provided. To enable cancer survivors to benefit, survivors' needs must be identified timely and effectively. An eHealth application could be a solution to meet patients' individual supportive care needs. A qualitative approach. Thirty cancer survivors (15 head and neck and 15 breast cancer survivors) participated. The majority were female (n = 20·67%). The mean age was 60 (SD 8·8) years. Mean time interval since treatment was 13·5 months (SD 10·5). All interviews were audio-recorded and transcribed verbatim. During the interviews, participants were asked about their unmet needs during follow-up care and a potential eHealth application. Data were analyzed independently by two coders and coded into key issues and themes. Cancer survivors commented that they felt unprepared for the post-treatment period and that their symptoms often remained unknown to care providers. Survivors also mentioned a suboptimal referral pattern to supportive care services. Mentioned advantages of an eHealth application were as follows: insight into the course of symptoms by monitoring, availability of information among follow-up appointments, receiving personalised advice and tailored supportive care. Cancer survivors identified several unmet needs during follow-up care. Most survivors were positive towards the proposed eHealth application and expressed that it could be a valuable addition to follow-up cancer care. Study results provide care providers with insight into barriers that impede survivors from obtaining optimal supportive care. This study also provides insight into the characteristics needed to design, build and implement an eHealth application targeting personalised access to supportive

  11. Impact of the Qualitative and Quantitative Aspects of Human Activity on the Ecosystem: Demonstration through the Use of Ecological Footprint Approach

    Makram GAALICHE

    2012-12-01

    Full Text Available This article aims to show that the impact of human activities on the ecosystem, measured by the Ecological Footprint, depends on the qualitative and quantitative aspects of the population. Indeed, we confirmed our hypothesis by an empirical analysis on Tunisia, where it was revealed that the increase in its Ecological Footprint, is attributed mainly to massive consumption of goods, bad land management by building horizontal, and to a lesser extent, to the presence of polluting employments. The results suggest the adoption of targeted policies, according to the specific characteristics of population.

  12. Qualitative and quantitative dermatoglyphic traits in patients with breast cancer: a prospective clinical study

    Tuteja Amita

    2007-03-01

    Full Text Available Abstract Background Breast cancer is one of the most extensively studied cancers and its genetic basis is well established. Dermatoglyphic traits are formed under genetic control early in development but may be affected by environmental factors during first trimester of pregnancy. They however do not change significantly thereafter, thus maintaining stability not greatly affected by age. These patterns may represent the genetic make up of an individual and therefore his/her predisposition to certain diseases. Patterns of dermatoglyphics have been studied in various congenital disorders like Down's syndrome and Kleinfelter syndrome. The prints can thus represent a non-invasive anatomical marker of breast cancer risk and thus facilitate early detection and treatment. Methods The study was conducted on 60 histo-pathologically confirmed breast cancer patients and their digital dermatoglyphic patterns were studied to assess their association with the type and onset of breast cancer. Simultaneously 60 age-matched controls were also selected that had no self or familial history of a diagnosed breast cancer and the observations were recorded. The differences of qualitative (dermatoglyphic patterns data were tested for their significance using the chi-square test, and for quantitative (ridge counts and pattern intensity index data using the t- test. Results It was observed that six or more whorls in the finger print pattern were statistically significant among the cancer patients as compared to controls. It was also seen that whorls in the right ring finger and right little finger were found increased among the cases as compared to controls. The differences between mean pattern intensity index of cases and controls were found to be statistically significant. Conclusion The dermatoglyphic patterns may be utilized effectively to study the genetic basis of breast cancer and may also serve as a screening tool in the high-risk population. In a developing

  13. Cervical cancer: a qualitative study on subjectivity, family, gender and health services

    López-Cervantes Malaquías

    2007-03-01

    Full Text Available Abstract Background In 2002, cervical cancer was one of the leading causes of death in Mexico. Quantitative techniques allowed for the identification of socioeconomic, behavioral and biological characteristics that are part of its etiology. However such characteristics, are inadequate to explain sufficiently the role that emotions, family networks and socially-constructed categories such as gender play in the demand and utilization of health services for cervical cancer diagnosis and treatment and neither the timely undertaking of preventive actions, such as getting a PAP smear or seeking adequate and continuons treatment. Methods A qualitative study was carried out to analyze the role of different social and cultural factors in the timely detection of cervical cancer. As part of a multi-level, multi-method research effort, this particular study was based on individual interviews with women diagnosed with cervical cancer (identified as the "cases", their female friends and relatives (identified as the "controls" and the cases' husbands. Results The results showed that both: denial and fear are two important components that regulate the behavior of both the women and their partners. Women with a small support network may have limited opportunities for taking action in favor of their own health and wellbeing. Conclusion Women tend not to worry about their health, in general and neither about cervical cancer in particular, as a consequence of their conceptualizations regarding their body and feminine identify – both of which are socially determined. Furthermore, it is necessary to improve the quality of information provided in health services.

  14. Lived experiences of breast cancer survivors after diagnosis, treatment and beyond: qualitative study.

    Williams, Faustine; Jeanetta, Stephen C

    2016-06-01

    The number of breast cancer survivors has increased since 1990 due to advances in biomedical technology that lead to an increase in early diagnosis and treatment. Research on survivorship has focused on the psychological and treatment aspects of the disease. The goal of this study was focused on exploring the lived experiences of breast cancer survivors from diagnosis, treatment and beyond. To understand the lived experiences of women who are breast cancer survivors. A purposive sampling strategy was used to recruit participants from two Missouri cancer centres. A total of 15 women breast cancer survivors were interviewed. Three major themes emerged that described the lived experiences of the women. These were factors from the diagnosis and treatment management impacting survivorship, relationship and support system and implication of survivorship. Participants noted that coping with the diagnosis and treatment was a stressful journey and required lots of adjustment and changes. Some developed various techniques such as journaling their activities which provided comfort. In addition, support from family was shared as the key which gave them strength and courage through the different stages of treatment. However, they found it difficult to articulate what survivorship meant. Using in-depth interview techniques, this study shed light on the experiences of women who were diagnosed with breast cancer and have completed treatment. They acknowledged frustration with their diagnosis and body changes. Support received from family and friends helped them cope through their treatment. However, they felt abandoned once the treatment phase was over and were uncertain what survivorhood meant to them. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  15. The role of occupational participation and environment among Icelandic women with breast cancer: a qualitative study.

    Palmadottir, Gudrun

    2010-12-01

    Breast cancer diagnosis generally causes a disruption of occupational life. The purpose of this study was to explore the role of occupational participation and environment in the perception of health and well-being of Icelandic women with breast cancer. Eighteen women were interviewed using the main areas from the Occupational Performance History Interview as a guideline. An inductive analysis revealed seven categories that were organized under two main headings: occupational participation and environment. The categories were labelled "maintaining control and stability", "experiencing sense of self-worth", "enhancing self development", "access to information", "support and care", "refuge in community", and "rehabilitative opportunities". Through occupational participation the women were able to regain control of life and a sense of competence and development. Information, emotional support, safety, and stimulating environments were crucial in alleviating distress and facilitate satisfactory coping with the cancer experience. The results support that occupational participation in a safe and supportive environment has powerful restorative properties. Rehabilitative and supportive services should be based on a holistic perspective and emphasize the healthy aspects of a women's life. Furthermore, occupational therapists need to widen their approach when working with women with breast cancer and focus on their needs as occupational beings.

  16. Suffering and euthanasia: a qualitative study of dying cancer patients' perspectives.

    Karlsson, Marit; Milberg, Anna; Strang, Peter

    2012-05-01

    Although intolerable suffering is a core concept used to justify euthanasia, little is known about dying cancer patients' own interpretations and conclusions of suffering in relation to euthanasia. Sixty-six patients with cancer in a palliative phase were selected through maximum-variation sampling, and in-depth interviews were conducted on suffering and euthanasia. The interviews were analyzed using qualitative content analysis with no predetermined categories. The analysis demonstrated patients' different perspectives on suffering in connection to their attitude to euthanasia. Those advocating euthanasia, though not for themselves at the time of the study, did so due to (1) perceptions of suffering as meaningless, (2) anticipatory fears of losses and multi-dimensional suffering, or (3) doubts over the possibility of receiving help to alleviate suffering. Those opposing euthanasia did so due to (1) perceptions of life, despite suffering, as being meaningful, (2) trust in bodily or psychological adaptation to reduce suffering, a phenomenon personally experienced by informants, and (3) by placing trust in the provision of help and support by healthcare services to reduce future suffering. Dying cancer patients draw varying conclusions from suffering: suffering can, but does not necessarily, lead to advocations of euthanasia. Patients experiencing meaning and trust, and who find strategies to handle suffering, oppose euthanasia. In contrast, patients with anticipatory fears of multi-dimensional meaningless suffering and with lack of belief in the continuing availability of help, advocate euthanasia. This indicates a need for healthcare staff to address issues of trust, meaning, and anticipatory fears.

  17. Perceptions of family caregivers of cancer patients about the challenges of caregiving: a qualitative study.

    Nemati, Shahnaz; Rassouli, Maryam; Ilkhani, Mahnaz; Baghestani, Ahmad Reza

    2018-03-01

    The experience of caring for a family member with cancer is associated with several care-related problems and challenges for the caregiver. The comprehensive and in-depth understanding of the trials and tribulations of caregiving can be a step towards resolving the problems faced by family caregivers of these patients. The present study aimed to explore challenges faced by Iranian family caregivers of cancer patients. The present qualitative study was conducted through in-depth semi-structured interviews held with 21 family caregivers of cancer patients selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analysed through conventional content analysis. The codes extracted from interviews produced four main themes, including 'confusion', 'uncertainty', 'disintegration' and 'setback', which collectively caused suffering for family caregivers. Care provided in an atmosphere of suffering and discontent diminishes caregiver's quality of life and quality of patient care. Health planners should therefore consider the challenges and sufferings faced by family caregivers and should seek to obviate them through appropriate plans. © 2017 Nordic College of Caring Science.

  18. Religious Coping in Iranian Mothers of Children With Cancer: A Qualitative Content Analysis.

    Nikfarid, Lida; Rassouli, Maryam; Borimnejad, Leili; Alavimajd, Hamid

    2018-05-01

    Religious coping is one of the most frequently used coping methods in parents of children with cancer. This study aims to explain dimensions of religious coping in mothers of children with cancer in Iran. In this qualitative content analysis, using purposeful sampling, 8 mothers of children with cancer were selected and interviewed. When saturation was achieved, data were analyzed through directed content analysis. Primary and secondary codes were placed in prelabeled categories and subcategories based on Pargament's religious coping theory. The participants of the study used coping methods in 4 of the 5 objectives of religious coping, that are meaning, control, comfort, and intimacy with others and closeness to God. Three of the most frequent used coping methods by the participants were "Punishing God Reappraisal," "Pleading for Direct Intercession," and "Benevolent Religious Reappraisal," respectively. None of the participants used religious coping methods for its function of "life transformation." As suggested by Pargament's theory of religious coping, the dynamic, multidimensional process of religious coping has a culture-based pattern with unpredictable outcomes. Despite many similarities between religious coping in a Shia Muslim society and other studied ones, some differences are observed. Further studies are needed to show the potential evidence of the concept in relation to cultural diversity and religious differences.

  19. Renegotiating hope while living with lymphoedema after cancer: a qualitative study.

    Hamilton, R; Thomas, R

    2016-09-01

    Hope is defined as a multi-dimensional life force, a coping resource and a necessity for coping with illness. Concepts of normalcy, hope and loss are explored in this qualitative study and positioned within recent scholarship on hope in cancer survivors. The experiences of 13 participants (11 women, 2 men) in two Canadian provinces who were living with lymphoedema secondary to cancer were analysed. For these participants, hope assumed various meanings. For some, hope was seen as passive inaction, whereas hope for others was positive and action-oriented, even when faced with the uncertainty of chronic illness. Hope for the individual with lymphoedema is also juxtaposed with hope associated with cancer treatment where a desired return to normal is the object of hope and paramount to coping. However, when met with the chronic nature of lymphoedema, the hope of a return to normalcy is lost and the meaning, direction and actions of hope must be renegotiated. © 2015 John Wiley & Sons Ltd.

  20. Acceptability of Bibliotherapy for Patients With Cancer: A Qualitative, Descriptive Study.

    Roberts, Nicole; Lee, Virginia; Ananng, Bethsheba; Körner, Annett

    2016-09-01

    To determine the acceptability of a self-help workbook, Mastering the Art of Coping in Good Times and Bad, for patients with cancer.
. Descriptive, qualitative.
. Participants were recruited from the psychosocial support cancer centers of two tertiary care teaching hospitals in Montreal, Quebec, Canada.
. 18 individuals diagnosed with cancer.
. A semistructured interview guide with open-ended questions was used to gather feedback from participants about the workbook. 
. 18 participants completed the interviews from which the data emerged. Two main categories were identified from the respondents' interviews regarding the acceptability of the workbook. The first category focuses on content, whereas the other focuses on recommendations. Interviewees specified the following content as most helpful. Bibliotherapy gives patients access to knowledge to help them cope and engage in their own self-management. The workbook Mastering the Art of Coping in Good Times and Bad may be an acceptable means of helping them manage their stress. 
. Bibliotherapy is not only cost-effective and easy to administer but also an acceptable minimal intervention.

  1. Factors affecting presentation and delay in patients with testicular cancer: results of a qualitative study.

    Gascoigne, P; Mason, M D; Roberts, E

    1999-01-01

    A qualitative study was undertaken with men treated for testicular tumours, to ascertain how they interpreted their symptoms and the factors which influenced a decision to consult a physician. The research was undertaken with six men who had been diagnosed as having testicular tumours. Interviews were also conducted with four wives and one mother. The findings showed that giving men information on testicular cancer may not guarantee early presentation. Symptoms were not generally attributed to cancer and the one patient who practised self-examination had delayed seeking help for 6 months. The extent to which symptoms affected the patient's lifestyle was also a factor in the decision-making process, as was the checking of symptoms with other family members. Wives were often pivotal in persuading men to seek help. The discovery of testicular symptoms produced emotional responses which included embarrassment and fear of both cancer and castration. There was evidence of strong feelings of masculine identity bound up with the appearance of 'normal' genitals. Provider-delay was identified in four cases and was associated with misattribution of symptoms by physicians and the failure to initiate specialist referral. Delay was under-recorded in the hospital notes in all cases where presentation was not immediate.

  2. Post-traumatic Growth in Breast Cancer Patients: A Qualitative Phenomenological Study

    Rahele Fallah

    2012-04-01

    Full Text Available Background: Studies about cancer-related trauma have shown that psychological reactions to the disease are not exclusively negative but most patients also report positive experiences. These positive perceptions are also called post-traumatic growth and benefit patients psychologically, spiritually, and physically. Therefore,we have conducted a study about how women with breast cancer perceive posttraumatic growth and the recognition of its dimensions in Iran.Methods: This qualitative study was conducted by using Interpretative Phenomenological Analysis. A total of 23 women with breast cancer who met the inclusion criteria were selected after which patients completed a researcher-generated open-ended questionnaire. Data were analyzed according to the guidelines for the Interpretative Phenomenological Analysis and Smith method.Results: Participants’ perceptions in this study about post-traumatic growth included three themes: spiritual growth, appreciation of life, and increased personal strengths.Conclusion: Themes found in this study conformed to dimensions according to the Tedeschi and Calhoun theory of post-traumatic growth. However, relations with others were not found in the present study. We propose that interventions should be designed and implemented in order to facilitate and enhance post-traumatic growth.

  3. Clinicodemographic aspect of resectable pancreatic cancer and prognostic factors for resectable cancer

    Chiang Kun-Chun

    2012-05-01

    Full Text Available Abstract Background Pancreatic adenocarcinoma (PCA is one of the most lethal human malignancies, and radical surgery remains the cornerstone of treatment. After resection, the overall 5-year survival rate is only 10% to 29%. At the time of presentation, however, about 40% of patients generally have distant metastases and another 40% are usually diagnosed with locally advanced cancers. The remaining 20% of patients are indicated for surgery on the basis of the results of preoperative imaging studies; however, about half of these patients are found to be unsuitable for resection during surgical exploration. In the current study, we aimed to determine the clinicopathological characteristics that predict the resectability of PCA and to conduct a prognostic analysis of PCA after resection to identify favorable survival factors. Methods We retrospectively reviewed the medical files of 688 patients (422 men and 266 women who had undergone surgery for histopathologically proven PCA in the Department of Surgery at Chang Gung Memorial Hospital in Taiwan from 1981 to 2006. We compared the clinical characteristics of patients who underwent resection and patients who did not undergo resection in order to identify the predictive factors for successful resectability of PCA, and we conducted prognostic analysis for PCA after resection. Results A carbohydrate antigen 19–9 (CA 19–9 level of 37 U/ml or greater and a tumor size of 3 cm or more independently predicted resectability of PCA. In terms of survival after resection, PCA patients with better nutritional status (measured as having an albumin level greater than 3.5 g/dl, radical resection, early tumor stage and better-differentiated tumors were associated with favorable survival. Conclusions Besides traditional imaging studies, preoperative CA 19–9 levels and tumor size can also be used to determine the resectability of PCA. Better nutritional status, curative resection, early tumor stage and well

  4. Qualitative aspects in the projects that are developed in the Instituto de Investigaciones Electricas; Aspectos cualitativos en los proyectos que se desarrollan en el Instituto de Investigaciones Electricas

    Ruiz Neblina, Joaquin [Instituto de Investigaciones Electricas, Temixco, Morelos (Mexico)

    1999-07-01

    The globalization of markets has generated more options of purchase of all type of goods and services, these options have generated opportunities and threats for all the companies and have looked for the satisfaction of the client as a strategy to remain or incursion into the global market. The Instituto de Investigaciones Electricas (IIE) is not the exception and therefore it looks for the identification of the qualitative aspects and to systematize its application in the projects that executes by means of the implantation of a system of quality assurance based on the series of ISO 9000 Standards. Some examples are described to identify the qualitative aspects of the projects that are developed in the Institute. [Spanish] La globalizacion de los mercados ha generado mas opciones de compra de todo tipo de bienes y servicios, dichas opciones han generado oportunidades y amenazas para todas las empresas y se ha buscado satisfacer al cliente como estrategia para permanecer o incursionar en el mercado global. El Instituto de Investigaciones Electricas (IIE) no es la excepcion y por lo tanto busca identificar los aspectos cualitativos y sistematizar su aplicacion en los proyectos que realiza mediante la implantacion de un sistema de aseguramiento de la calidad basado en la serie de normas ISO 9000. Se describen algunos ejemplos para identificar los aspectos cualitativos de los proyectos que se desarrollan en el instituto.

  5. Experiences of cancer patients in a patient navigation program: a qualitative systematic review.

    Tan, Clarice Hwee Hoon; Wilson, Sally; McConigley, Ruth

    2015-03-12

    A patient navigation program is a model of care which entails trained personnel providing individualized and assistive care to adult oncology patients to help the patients overcome barriers. A further aim of the program is to achieve continuity of care as patients experience the complex healthcare system. Patient navigation is a new model of care in many institutions, and as such the experiences of patients in the patient navigation program remains inconclusive. The review seeks to understand the experiences of adult patients in patient navigation programs and how patient navigators impact the challenges patients encounter in the cancer care continuum. Participants of interest were adult cancer patients more than 18 years of age who are receiving or have received cancer care and are in a patient navigation program or had been in a hospital patient navigation program. Types of intervention(s)/phenomena of interest: The phenomenon of interest was the experiences of adult cancer patients who used patient navigation programs in hospital including how patient navigators impact on the challenges patients encounter in the cancer care continuum. Types of studies: This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, action research and exploratory studies. The review includes patient navigation programs within a hospital setting. Types of outcome: The review sought to understand the experiences of patients with cancer in patient navigation programs in the hospital. A three-step search strategy was used. An initial search to identify keywords was undertaken in PubMed and Science Direct followed by an expanded search using all identified keywords and index terms specific to each included database. The reference lists of included papers were then searched for any other relevant studies. Each paper was assessed independently by two reviewers for methodological quality using the Joanna

  6. Radiosensitivity of cancer cells against carbon-ion beams in an aspect of the p53 gene status

    Takahashi, Akihisa; Ohnishi, Takeo; Matsumoto, Hideki

    2004-01-01

    We can easily understand that radiation sensitivities of cancer cells are dependent on the status of cancer-related genes. It is important to clarify which genes affect radiation sensitivity and reflect the effectiveness of radiation therapy for cancer cells. We have studied about the function of a tumor suppressor gene of p53, because p53 controls apoptosis, cell cycle and DNA repair from an aspect of important roles in cell fate. By analysis of function of p53 gene, therefore, we aim to predict the therapeutic effectiveness and to select the modalities of cancer therapies such as radiotherapy, chemotherapy and hyperthermia. As a final goal, we want to accept the most effective therapy, namely tailor-made cancer therapy, for each patient. Here, we introduce that carbon-beam therapy induced the expression of p53-independent apoptosis-related genes and NO radicals in mutated p53 cancer cells. (author)

  7. The views of patients with brain cancer about palliative care: a qualitative study.

    Vierhout, M; Daniels, M; Mazzotta, P; Vlahos, J; Mason, W P; Bernstein, M

    2017-12-01

    Palliative care, a specialty aimed at providing optimal care to patients with life-limiting and chronic conditions, has several benefits. Although palliative care is appropriate for neurosurgical conditions, including brain cancer, few studies have examined the views of brain cancer patients about palliative care. We aimed to explore the thoughts of brain cancer patients about palliative care, their opinions about early palliative care, and their preferred care setting. Semi-structured interviews and the qualitative research methodologies of grounded theory were used to explore perceptions of palliative care on the part of 39 brain cancer outpatients. Seven overarching actions emerged: ■Patients would prefer to receive palliative care in the home.■Increased time with caregivers and family are the main appeals of home care.■Patients express dissatisfaction with brief and superficial interactions with health care providers.■Patients believe that palliative care can contribute to their emotional well-being.■Patients are open to palliative care if they believe that it will not diminish optimism.■There is a preconceived idea that palliative care is directly linked to active dying, and that supposed link generates fear in some patients.■Patients prefer to be educated about palliative care as an option early in their illness, even if they are fearful of it. Overall, when educated about the true meaning of palliative care, most patients express interest in accessing palliative care services. Although the level of fear concerning palliative care varies in patients, most recognize the associated benefits.

  8. Barriers to cervical cancer screening among ethnic minority women: a qualitative study.

    Marlow, Laura A V; Waller, Jo; Wardle, Jane

    2015-10-01

    Ethnic minority women are less likely to attend cervical screening. To explore self-perceived barriers to cervical screening attendance among ethnic minority women compared to white British women. Qualitative interview study. Community groups in ethnically diverse London boroughs. Interviews were carried out with 43 women from a range of ethnic minority backgrounds (Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, White other) and 11 White British women. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. Fifteen women had delayed screening/had never been screened. Ethnic minority women felt that there was a lack of awareness about cervical cancer in their community, and several did not recognise the terms 'cervical screening' or 'smear test'. Barriers to cervical screening raised by all women were emotional (fear, embarrassment, shame), practical (lack of time) and cognitive (low perceived risk, absence of symptoms). Emotional barriers seemed to be more prominent among Asian women. Low perceived risk of cervical cancer was influenced by beliefs about having sex outside of marriage and some women felt a diagnosis of cervical cancer might be considered shameful. Negative experiences were well remembered by all women and could be a barrier to repeat attendance. Emotional barriers (fear, embarrassment and anticipated shame) and low perceived risk might contribute to explaining lower cervical screening coverage for some ethnic groups. Interventions to improve knowledge and understanding of cervical cancer are needed in ethnic minority communities, and investment in training for health professionals may improve experiences and encourage repeat attendance for all women. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Content of Spiritual Counselling for Cancer Patients Undergoing Chemotherapy in Iran: A Qualitative Content Analysis

    Memaryan, Nadereh; Ghaempanah, Zeinab; Saeedi, Mir Majid; Aryankhesal, Aidin; Ansarinejad, Nafiseh; Seddigh, Ruohollah

    2017-07-27

    Background: Cancer is one of the leading causes of human death. Besides clinical treatment, cancer patients may need emotional and spiritual counselling to overcome their mental and morale problems. Such counselling sessions have been reported influential by many patients. We aimed to explore the structure of spiritual counselling sessions and their content as one of services provided to patients who experience chemotherapy in Iranian hospitals. Methods: Through a qualitative content analysis study, we recorded the discussions between a counsellor, who was a cleric as well, and cancer cases who were undergoing chemotherapy in a hospital in Tehran. The sessions were only recorded if the patient consented to attend at the study. All consideration were taken to avoid release of patients’ identity. The recorded discussions were transcribed verbatim and analyzed thematically after each session, until no new theme was emerged. Result: Twenty two sessions were held. The patients aged 53 years old on average. The content of discussions were analyzed along which 165 codes emerged. Four general themes or phases were recognized through counseling as (i) history-Taking (including demographic, disease-related and spiritual history and characteristics), (ii) general advice, (iii) spiritual-religious advice, and (iv) dealing with patients’ spiritual or religious ambiguities and paradoxes. Conclusion: Counselling of cancer patients needs special and in depth knowledge on spiritual and religious issues. The counsellor should be able to motivate patients, among whom many are disappointed, to follow the curative instructions well and stay hopeful about their treatment and life. Exploring and understanding what happens during a spiritual counselling session can counselling to the conformity and standardization of such interventions. Creative Commons Attribution License

  10. Online information and support needs of women with advanced breast cancer: a qualitative analysis.

    Kemp, Emma; Koczwara, Bogda; Butow, Phyllis; Turner, Jane; Girgis, Afaf; Schofield, Penelope; Hulbert-Williams, Nicholas; Levesque, Janelle; Spence, Danielle; Vatandoust, Sina; Kichenadasse, Ganessan; Roy, Amitesh; Sukumaran, Shawgi; Karapetis, Christos S; Richards, Caroline; Fitzgerald, Michael; Beatty, Lisa

    2018-04-24

    Women with advanced breast cancer (ABC) face significant adjustment challenges, yet few resources provide them with information and support, and attendance barriers can preclude access to face-to-face psychosocial support. This paper reports on two qualitative studies examining (i) whether information and support-seeking preferences of women with ABC could be addressed in an online intervention, and (ii) how an existing intervention for patients with early stage cancer could be adapted for women with ABC. Women with ABC participated in telephone interviews about their information and support-seeking preferences (N = 21) and evaluated an online intervention focused on early-stage cancer (N = 15). Interviews were transcribed and underwent thematic analysis using the framework method to identify salient themes. Participants most commonly sought medical, lifestyle-related, and practical information/support; however, when presented with an online intervention, participants most commonly gave positive feedback on content on coping with emotional distress. Difficulty finding information and barriers to using common sources of information/support including health professionals, family and friends, and peers were reported; however, some women also reported not wanting information or support. All participants evaluating the existing intervention gave positive feedback on various components, with results suggesting an online intervention could be an effective means of providing information/support to women with ABC, given improved specificity/relevance to ABC and increased tailoring to individual circumstances and preferences. Adaptation of an existing online intervention for early stage cancer appears to be a promising avenue to address the information and support needs of women with ABC.

  11. [Management of penile cancer patients: new aspects of a rare tumour entity].

    Roiner, M; Maurer, O; Lebentrau, S; Gilfrich, C; Schäfer, C; Haberl, C; Brookman-May, S D; Burger, M; May, M; Hakenberg, O W

    2018-06-01

    Over the past few decades, some principles in the treatment of penile cancer have changed fundamentally. While 15 years ago a negative surgical margin of at least 2 cm was considered mandatory, organ-sparing surgery permitting minimal negative surgical margins has a high priority nowadays. The current treatment principle requires as much organ preservation as possible and as much radicality as necessary. The implementation of organ-sparing and reconstructive surgical techniques has improved the quality of life of surviving patients. However, oncological and functional outcomes are still unsatisfactory. Alongside with adequate local treatment of the primary tumour, a consistent management of inguinal lymph nodes is of fundamental prognostic significance. In particular, clinically inconspicuous inguinal lymph nodes staged T1b and upwards need a surgical approach. Sentinel node biopsy, minimally-invasive surgical techniques and modified inguinal lymphadenectomy have reduced morbidity compared to conventional inguinal lymph node dissection. Multimodal treatment with surgery and chemotherapy is required in all patients with lymph node-positive disease; neoadjuvant chemotherapy has been established for patients with locally advanced lymph node disease, and adjuvant treatment after radical inguinal lymphadenectomy for lymph node-positive disease. An increasing understanding of the underlying tumour biology, in particular the role of the human papilloma virus (HPV) and epidermal growth factor receptor (EGFR) status, has led to a new pathological classification and may further enhance treatment options. This review summarises current aspects in the therapeutic management of penile cancer. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Developing an Integrative Treatment Program for Cancer-Related Fatigue Using Stakeholder Engagement - A Qualitative Study.

    Canella, Claudia; Mikolasek, Michael; Rostock, Matthias; Beyer, Jörg; Guckenberger, Matthias; Jenewein, Josef; Linka, Esther; Six, Claudia; Stoll, Sarah; Stupp, Roger; Witt, Claudia M

    2017-11-01

    Although cancer-related fatigue (CRF) has gained increased attention in the past decade, it remains difficult to treat. An integrative approach combining conventional and complementary medicine interventions seems highly promising. Treatment programs are more likely to be effective if the needs and interests of the people involved are well represented. This can be achieved through stakeholder engagement. The aim of the study was to develop an integrative CRF treatment program using stakeholder engagement and to compare it to an expert version. In a qualitative study, a total of 22 stakeholders (4 oncologists, 1 radiation-oncologist, 1 psycho-oncologist, 5 nurses/nurse experts, 9 patients, 1 patient family member, 1 representative of a local Swiss Cancer League) were interviewed either face-to-face or in a focus group setting. For data analysis, qualitative content analysis was used. With stakeholder engagement, the integrative CRF treatment program was adapted to usual care using a prioritizing approach and allowing more patient choice. Unlike the expert version, in which all intervention options were on the same level, the stakeholder engagement process resulted in a program with 3 different levels. The first level includes mandatory nonpharmacological interventions, the second includes nonpharmacological choice-based interventions, and the third includes pharmacological interventions for severe CRF. The resulting stakeholder based integrative CRF treatment program was implemented as clinical practice guideline at our clinic (Institute for Complementary and Integrative Medicine, University Hospital Zurich). Through the stakeholder engagement approach, we integrated the needs and preferences of people who are directly affected by CRF. This resulted in an integrative CRF treatment program with graded recommendations for interventions and therefore potentially greater sustainability in a usual care setting.

  13. Carers' experiences of dysphagia in people treated for head and neck cancer: a qualitative study.

    Nund, Rebecca L; Ward, Elizabeth C; Scarinci, Nerina A; Cartmill, Bena; Kuipers, Pim; Porceddu, Sandro V

    2014-08-01

    The implication of dysphagia for people treated nonsurgically for head and neck cancer (HNC) and its detrimental effects on functioning and quality of life has been well documented. To date, however, there has been a paucity of research on the effects of dysphagia following HNC on carers, independent of the consequences of a gastrostomy. The objective of this qualitative study was to report on the experiences of carers of people with dysphagia (non-gastrostomy dependent) following nonsurgical treatment for HNC and to identify the support needs of this group. A purposive, maximum-variation sampling technique was adopted to recruit 12 carers of people treated curatively for HNC since 2007. Each participated in an in-depth interview, detailing their experience of caring for someone with dysphagia and the associated impact on their life. Thematic analysis was adopted to search the transcripts for key phases and themes that emerged from the discussions. Analysis of the transcripts revealed four themes: (1) dysphagia disrupts daily life, (2) carers make adjustments to adapt to their partner's dysphagia, (3) the disconnect between carers' expectations and the reality of dysphagia, and (4) experiences of dysphagia-related services and informal supports. Carers generally felt ill-prepared for their role in dysphagia management. The qualitative methodology successfully described the impact of dysphagia on the everyday lives of carers, particularly in regard to meal preparation, social events, and family lifestyle. Clinicians should provide adequate and timely training and support to carers and view carers as copartners in dysphagia management.

  14. Experiences of aromatherapy massage among adult female cancer patients: A qualitative study.

    Ho, Simone S M; Kwong, Alice N L; Wan, Karen W S; Ho, Rosita M L; Chow, Ka Ming

    2017-12-01

    To explore the experiences towards aromatherapy massage use, and to examine the perceived benefits and adverse effects of aromatherapy massage among adult female cancer patients. A qualitative research design was used. Fifteen women with cancer were recruited for semi-structured interviews. Sample recruitment was undertaken through cancer self-help groups and referrals of a private aromatherapy clinic by convenience sampling. The interview data were analysed by thematic analysis. All participants had a positive experience towards aromatherapy massage. The perceived benefits of aromatherapy massage included physical and psychological dimensions: overall comfort, relaxation, reduced pain, muscular tension, lymphoedema and numbness, improved sleep, energy level, appetite and mood. Interestingly, a few participants reported that aromatherapy massage helped to enhance self-acceptance and coping with their altered torso. No adverse effects were reported. The findings focused on four main themes that emerged: (i) an immediate effect that brings all-round comfort and reconnection to daily life; (ii) a pleasurable moment to forget the disease with aroma as a booster; (iii) a pampering experience of being cared for with a sense of dignity preserved; and (iv) communicating with the failing body. This study contributed by providing a better understanding in aromatherapy massage from female cancer patients' perspective which adds to the existing body of knowledge. The implications for nursing practice, education and future research were suggested. Aromatherapy massage seems to have both physical and psychological benefits for women with cancer. The findings elucidated a wide range of benefits that are perceived in such complex intervention, and the contextual factors that may influence these perceived benefits. This will inform future nurse-led quantitative research in the clinical setting. The study highlights the importance of touch towards a caring relationship and the

  15. Exploring family experiences of nursing aspects of end-of-life care in the ICU: A qualitative study.

    Noome, Marijke; Dijkstra, Boukje M; van Leeuwen, Evert; Vloet, Lilian C M

    2016-04-01

    The aim of this study was to examine the experience(s) of family with the nursing aspects of End-of-life care in the intensive care unit after a decision to end life-sustaining treatment, and to describe what nursing care was most appreciated and what was lacking. A phenomenological approach including inductive thematic analysis was used. Twenty-six family members of deceased critically ill-patients were interviewed within two months after the patient's death about their experiences with nursing aspects of end-of-life care in the intensive care unit. Most family members experienced nursing contribution to end-of-life care of the patient and themselves, especially supportive care. Families mentioned the following topics: Communication between intensive care nurses, critically ill patients and family; Nursing care for critically ill patients; Nursing care for families of critically ill patients; Pre-conditions. Families appreciated that intensive care nurses were available at any time and willing to answer questions. But care was lacking because families had for example, a sense of responsibility for obtaining information, they had problems to understand their role in the decision-making process, and were not invited by nurses to participate in the care. Most family appreciated the nursing EOLC they received, specifically the nursing care given to the patient and themselves. Some topics needed more attention, like information and support for the family. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Identification of aspects of functioning, disability and health relevant to patients experiencing vertigo: a qualitative study using the international classification of functioning, disability and health

    2012-01-01

    Purpose Aims of this study were to identify aspects of functioning and health relevant to patients with vertigo expressed by ICF categories and to explore the potential of the ICF to describe the patient perspective in vertigo. Methods We conducted a series of qualitative semi-structured face-to-face interviews using a descriptive approach. Data was analyzed using the meaning condensation procedure and then linked to categories of the International Classification of Functioning, Disability and Health (ICF). Results From May to July 2010 12 interviews were carried out until saturation was reached. Four hundred and seventy-one single concepts were extracted which were linked to 142 different ICF categories. 40 of those belonged to the component body functions, 62 to the component activity and participation, and 40 to the component environmental factors. Besides the most prominent aspect “dizziness” most participants reported problems within “Emotional functions (b152), problems related to mobility and carrying out the daily routine. Almost all participants reported “Immediate family (e310)” as a relevant modifying environmental factor. Conclusions From the patients’ perspective, vertigo has impact on multifaceted aspects of functioning and disability, mainly body functions and activities and participation. Modifying contextual factors have to be taken into account to cover the complex interaction between the health condition of vertigo on the individuals’ daily life. The results of this study will contribute to developing standards for the measurement of functioning, disability and health relevant for patients suffering from vertigo. PMID:22738067

  17. A qualitative study on mindfulness-based stress reduction for breast cancer patients: how women experience participating with fellow patients

    Schellekens, Melanie P. J.; Jansen, Ellen T. M.; Willemse, Heidi H. M. A.; van Laarhoven, Hanneke W. M.; Prins, Judith B.; Speckens, Anne E. M.

    2016-01-01

    Peer support groups for cancer patients show mixed findings regarding effectiveness on psychological wellbeing. When embedded in a psychosocial intervention, such as mindfulness-based stress reduction (MBSR), peer support might be of more benefit to participants. This study is a qualitative

  18. Mammographic features and subsequent risk of breast cancer: a comparison of qualitative and quantitative evaluations in the Guernsey prospective studies.

    Torres-Mejía, Gabriela; De Stavola, Bianca; Allen, Diane S; Pérez-Gavilán, Juan J; Ferreira, Jorge M; Fentiman, Ian S; Dos Santos Silva, Isabel

    2005-05-01

    Mammographic features are known to be associated with breast cancer but the magnitude of the effect differs markedly from study to study. Methods to assess mammographic features range from subjective qualitative classifications to computer-automated quantitative measures. We used data from the UK Guernsey prospective studies to examine the relative value of these methods in predicting breast cancer risk. In all, 3,211 women ages > or =35 years who had a mammogram taken in 1986 to 1989 were followed-up to the end of October 2003, with 111 developing breast cancer during this period. Mammograms were classified using the subjective qualitative Wolfe classification and several quantitative mammographic features measured using computer-based techniques. Breast cancer risk was positively associated with high-grade Wolfe classification, percent breast density and area of dense tissue, and negatively associated with area of lucent tissue, fractal dimension, and lacunarity. Inclusion of the quantitative measures in the same model identified area of dense tissue and lacunarity as the best predictors of breast cancer, with risk increasing by 59% [95% confidence interval (95% CI), 29-94%] per SD increase in total area of dense tissue but declining by 39% (95% CI, 53-22%) per SD increase in lacunarity, after adjusting for each other and for other confounders. Comparison of models that included both the qualitative Wolfe classification and these two quantitative measures to models that included either the qualitative or the two quantitative variables showed that they all made significant contributions to prediction of breast cancer risk. These findings indicate that breast cancer risk is affected not only by the amount of mammographic density but also by the degree of heterogeneity of the parenchymal pattern and, presumably, by other features captured by the Wolfe classification.

  19. The facilitating role of chemotherapy in the palliative phase of cancer: qualitative interviews with advanced cancer patients.

    Hilde M Buiting

    Full Text Available OBJECTIVE: To explore the extent to which patients have a directing role in decisions about chemotherapy in the palliative phase of cancer and (want to anticipate on the last stage of life. DESIGN: Qualitative interview study. METHODS: In depth-interviews with 15 patients with advanced colorectal or breast cancer at the medical oncology department in a Dutch teaching hospital; interviews were analysed following the principles of thematic content-analysis. RESULTS: All patients reported to know that the chemotherapy they received was with palliative intent. Most of them did not express the wish for information about (other treatment options and put great trust in their physicians' treatment advice. The more patients were aware of the severity of their disease, the more they seemed to 'live their life' in the present and enjoy things besides having cancer. Such living in the present seemed to be facilitated by the use of chemotherapy. Patients often considered the 'chemotherapy-free period' more stressful than periods when receiving chemotherapy despite their generally improved physical condition. Chemotherapy (regardless of side-effects seemed to shift patients' attention away from the approaching last stage of life. Interestingly, although patients often discussed advance care planning, they were reluctant to bring on end-of-life issues that bothered them at that specific moment. Expressing real interest in people 'as a person' was considered an important element of appropriate care. CONCLUSIONS: Fearing their approaching death, patients deliberately focus on living in the present. Active (chemotherapy treatment facilitates this focus, regardless of the perceived side-effects. However, if anxiety for what lies ahead is the underlying reason for treatment, efforts should be made in assisting patients to find other ways to cope with this fear. Simultaneously, such an approach may reduce the use of burdensome and sometimes costly treatment in the

  20. Controversies about cervical cancer screening: A qualitative study of Roma women's (non)participation in cervical cancer screening in Romania.

    Andreassen, Trude; Weiderpass, Elisabete; Nicula, Florian; Suteu, Ofelia; Itu, Andreea; Bumbu, Minodora; Tincu, Aida; Ursin, Giske; Moen, Kåre

    2017-06-01

    Romania has Europe's highest incidence and mortality of cervical cancer. While a free national cervical cancer-screening programme has been in operation since 2012, participation in the programme is low, particularly in minority populations. The aim of this study was to explore Roma women's (non)participation in the programme from women's own perspectives and those of healthcare providers and policy makers. We carried out fieldwork for a period of 125 days in 2015/16 involving 144 study participants in Cluj and Bucharest counties. Fieldwork entailed participant observation, qualitative interviewing and focus group discussions. A striking finding was that screening providers and Roma women had highly different takes on the national screening programme. We identified four fundamental questions about which there was considerable disagreement between them: whether a free national screening programme existed in the first place, whether Roma women were meant to be included in the programme if it did, whether Roma women wanted to take part in screening, and to what degree screening participation would really benefit women's health. On the background of insights from actor-network theory, the article discusses to what degree the programme could be said to speak to the interest of its intended Roma public, and considers the controversies in light of the literature on patient centred care and user involvement in health care. The paper contributes to the understanding of the health and health-related circumstances of the largest minority in Europe. It also problematizes the use of the concept of "barriers" in research into participation in cancer screening, and exemplifies how user involvement can potentially help transform and improve screening programmes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Sexual life after mastectomy in breast cancer survivors: A qualitative study.

    Fouladi, Nasrin; Pourfarzi, Farhad; Dolattorkpour, Negin; Alimohammadi, Sara; Mehrara, Elham

    2018-02-01

    Mastectomy is a highly frequent form of breast cancer treatment in Iran, and sexual dysfunction after mastectomy has been reported in the majority of breast cancer survivors in Iran. In this qualitative study, an attempt was made to examine the stages that patients go through in their sexual lives after mastectomy. Using purposeful sampling, 30 married women, who had undergone surgery and had completed an adjuvant treatment period, participated in the study. Data collection was done using in-depth, open, and semistructured interviews. Content analysis was used. Two main categories were identified in the stages the patients go through following mastectomy: sexual function breakdown and restoration of sexual function, each of which involved 3 subcategories, in turn. Subcategories of the first category were perceived physical changes by the survivor and altered sexual behaviors. These 2 factors lead to sexual function breakdown. The third subcategory includes the factors exacerbating the sexual function breakdown. The subcategories of the second category were modification in sexual behaviors, effort for physical restoration, and striving to gain support. It was found that in Iranian society, due to cultural context, some taboos, and patriarchal structure, the patients are placed under added pressure following mastectomy. As a consequence, they suffer emotional problems, in addition to physical complications of the disease and its treatments. Copyright © 2017 John Wiley & Sons, Ltd.

  2. Dying cancer patients' own opinions on euthanasia: an expression of autonomy? A qualitative study.

    Karlsson, Marit; Milberg, Anna; Strang, Peter

    2012-01-01

    Deliberations on euthanasia are mostly theoretical, and often lack first-hand perspectives of the affected persons. Sixty-six patients suffering from cancer in a palliative phase were interviewed about their perspectives of euthanasia in relation to autonomy. The interviews were transcribed verbatim and analysed using qualitative content analysis with no predetermined categories. The informants expressed different positions on euthanasia, ranging from support to opposition, but the majority were undecided due to the complexity of the problem. The informants' perspectives on euthanasia in relation to autonomy focused on decision making, being affected by (1) power and (2) trust. Legalization of euthanasia was perceived as either (a) increasing patient autonomy by patient empowerment, or (b) decreasing patient autonomy by increasing the medical power of the health care staff, which could be frightening. The informants experienced dependence on others, and expressed various levels of trust in others' intentions, ranging from full trust to complete mistrust. Dying cancer patients perceive that they cannot feel completely independent, which affects true autonomous decision making. Further, when considering legalization of euthanasia, the perspectives of patients fearing the effects of legalization should also be taken into account, not only those of patients opting for it.

  3. Decision-making in rectal and colorectal cancer: systematic review and qualitative analysis of surgeons' preferences.

    Broc, Guillaume; Gana, Kamel; Denost, Quentin; Quintard, Bruno

    2017-04-01

    Surgeons are experiencing difficulties implementing recommendations not only owing to incomplete, confusing or conflicting information but also to the increasing involvement of patients in decisions relating to their health. This study sought to establish which common factors including heuristic factors guide surgeons' decision-making in colon and rectal cancers. We conducted a systematic literature review of surgeons' decision-making factors related to colon and rectal cancer treatment. Eleven of 349 identified publications were eligible for data analyses. Using the IRaMuTeQ (Interface of R for the Multidimensional Analyses of Texts and Questionnaire), we carried out a qualitative analysis of the significant factors collected in the studies reviewed. Several validation procedures were applied to control the robustness of the findings. Five categories of factors (i.e. patient, surgeon, treatment, tumor and organizational cues) were found to influence surgeons' decision-making. Specifically, all decision criteria including biomedical (e.g. tumor information) and heuristic (e.g. surgeons' dispositional factors) criteria converged towards the factor 'age of patient' in the similarity analysis. In the light of the results, we propose an explanatory model showing the impact of heuristic criteria on medical issues (i.e. diagnosis, prognosis, treatment features, etc.) and thus on decision-making. Finally, the psychosocial complexity involved in decision-making is discussed and a medico-psycho-social grid for use in multidisciplinary meetings is proposed.

  4. The attitudes of brain cancer patients and their caregivers towards death and dying: a qualitative study

    Kimmelman Jonathan

    2007-11-01

    Full Text Available Abstract Background Much money and energy has been spent on the study of the molecular biology of malignant brain tumours. However, little attention has been paid to the wishes of patients afflicted with these incurable tumours, and how this might influence treatment considerations. Methods We interviewed 29 individuals – 7 patients dying of a malignant brain tumor and 22 loved ones. One-on-one interviews were conducted according to a pre-designed interview guide. A combination of open-ended questions, as well as clinical scenarios was presented to participants in order to understand what is meaningful and valuable to them when determining treatment options and management approaches. The results were analyzed, coded, and interpreted using qualitative analytic techniques in order to arrive at several common overarching themes. Results Seven major themes were identified. In general, respondents were united in viewing brain cancer as unique amongst malignancies, due in large part to the premium placed on mental competence and cognitive functioning. Importantly, participants found their experiences, however difficult, led to the discovery of inner strength and resilience. Responses were usually framed within an interpersonal context, and participants were generally grateful for the opportunity to speak about their experiences. Attitudes towards religion, spirituality, and euthanasia were also probed. Conclusion Several important themes underlie the experiences of brain cancer patients and their caregivers. It is important to consider these when managing these patients and to respect not only their autonomy but also the complex interpersonal toll that a malignant diagnosis can have.

  5. We as Spouses Have Experienced a Real Disaster!: A Qualitative Study of Women With Breast Cancer and Their Spouses.

    Çömez, Saadet; Karayurt, Özgül

    2016-01-01

    Breast cancer is the most common cancer in women in Turkey. The emotional effects of this condition are experienced by the women and their families. The aim of the study was to describe the experiences of women with breast cancer and their spouses from diagnosis to treatment completion. This qualitative study with a descriptive qualitative design was conducted at participants' homes. Fourteen women and their spouses were enrolled in the study (n = 28). Data were collected during in-depth interviews and analyzed with inductive content analysis. The women with breast cancer and their spouses' experiences were categorized into 4 main themes: "facing breast cancer," "treatment process," "coping with disease and treatment," and "life after treatment." Subthemes were also identified and described. The women with breast cancer and their spouses reported that they had positive and negative experiences in terms of their physical, psychological, and social status from diagnosis to completion of treatment, indicating that breast cancer is a disease of women and a condition of families. Knowledge of these experiences can help nurses plan care that is designed to improve the quality of life of women and their husbands.

  6. A Qualitative Analysis of Acute Skin Toxicity among Breast Cancer Radiotherapy Patients

    Schnur, Julie B.; Ouellette, Suzanne C.; DiLorenzo, Terry A.; Green, Sheryl; Montgomery, Guy H.

    2013-01-01

    Objectives One of the most common acute side effects of breast cancer radiotherapy is treatment induced skin changes, referred to as skin toxicity. Yet no research to date has focused expressly on skin toxicity-related quality of life in breast cancer radiotherapy patients. Therefore, our aim was to use qualitative approaches to better understand the impact of skin toxicity on quality of life. Methods Semi-structured interviews were conducted with 20 women (Stage 0-III breast cancer), during their last week of external beam radiotherapy. Each interview was transcribed verbatim, and thematic analysis was performed. Results Three themes were identified based on the interview responses: First, skin changes affect multiple dimensions of quality of life. They cause physical discomfort, body image disturbance, emotional distress, and impair both day-to-day functioning and satisfaction with radiation treatment. Second, individual differences affect women’s experiences. Generally African-American women, younger women, women who are not currently in a relationship, women who are being treated during the summer, and women who are more invested in their appearance are more distressed by skin toxicity. Third, women use a variety of symptom management strategies including self-medication, complementary/alternative medicine approaches, and psychological strategies. Conclusions Implications of results are: 1) Skin toxicity affects numerous dimensions of quality of life, and assessment approaches and psychosocial interventions should address this; 2) individual differences may affect the experience of skin toxicity, and should be considered in treatment and education approaches; and 3) participants’ own creativity and problem-solving should be used to improve the treatment experience. PMID:20238306

  7. Bereaved relatives' experiences during the incurable phase of cancer: a qualitative interview study.

    Wijnhoven, Marleen N; Terpstra, Wim E; van Rossem, Ronald; Haazer, Carolien; Gunnink-Boonstra, Nicolette; Sonke, Gabe S; Buiting, Hilde M

    2015-11-25

    To examine bereaved relatives' experiences from time of diagnosis of incurable cancer until death with specific emphasis on their role in the (end-of-life) decision-making concerning chemotherapy. Qualitative interview study. Hospital-based. In-depth interviews with 15 close relatives of patients who died from non-small cell lung cancer or pancreatic cancer, using a thematic content analysis. All relatives reported that patients' main reason to request chemotherapy was the possibility to prolong life. Relatives reported that patients receiving chemotherapy had more difficulty to accept the incurable nature of their disease than patients who did not. They mostly followed the patients' treatment wish and only infrequently suggested ceasing chemotherapy (because of side effects) despite sometimes believing that this would be a better option. Relatives continuously tried to support the patient in either approaching the death or in attaining hope to continue life satisfactorily. Most relatives considered the chemotherapy period meaningful, since it sparked patients' hope and was what patients wanted. Cessation of chemotherapy caused a relief but coincided with physical deterioration and an increased caregivers' role; many relatives recalled this latter period as more burdensome. Relatives tend to follow patients' wish to continue or cease chemotherapy, without expressing their own feelings, although they were more inclined to opt cessation. They experience a greater caregiver role after cessation and their feelings of responsibility associated with the disease can be exhausting. More attention is needed to reduce relatives' distress at the end of life, also to fully profit from this crucial form of (informal) healthcare. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Resistance to discontinuing breast cancer screening in older women: A qualitative study.

    Housten, Ashley J; Pappadis, Monique R; Krishnan, Shilpa; Weller, Susan C; Giordano, Sharon H; Bevers, Therese B; Volk, Robert J; Hoover, Diana S

    2018-06-01

    Screening mammography is associated with reduced breast cancer-specific mortality; however, among older women, evidence suggests that the potential harms of screening may outweigh the benefits. We used a qualitative approach to examine the willingness of older women from different racial/ethnic groups to discontinue breast cancer screening. Women ≥70 years of age who reported having a screening mammogram in the past 3 years and/or reported that they intended to continue screening in the future were recruited for in-depth interviews. Participants who intended to continue screening were asked to describe how the following hypothetical scenarios would impact a decision to discontinue screening: health concerns or limited life expectancy, a physician's recommendation to discontinue, reluctance to undergo treatment, and recommendations from experts or governmental panels to stop screening. Semi-structured, face-to-face interviews were audio-recorded. Data coding and analysis followed inductive and deductive approaches. Regardless of the scenario, participants (n = 29) expressed a strong intention to continue screening. Based on the hypothetical physician recommendations, intentions to continue screening appeared to remain strong. They did not envision a change in their health status that would lead them to discontinue screening and were skeptical of expert/government recommendations. There were no differences observed according to age, race/ethnicity, or education. Among older women who planned to continue screening, intentions to continue breast cancer screening appear to be highly resilient and resistant to recommendations from physicians or expert/government panels. Copyright © 2018 John Wiley & Sons, Ltd.

  9. "A stressful and frightening experience"? Children's nurses' perceived readiness to care for children with cancer following pre-registration nurse education: A qualitative study.

    Jestico, Elizabeth; Finlay, Teresa

    2017-01-01

    In the UK children with cancer are cared for by children's nurses in a variety of settings, specialist and non-specialist. Whilst post-registration specialist education is available to some nurses, many nurses rely solely on pre-registration education to competently care for these children. This study explores whether nurses perceive that this adequately prepares them. To explore the extent to which qualified nurses perceive that pre-registration nurse education prepares them to care for children with cancer; to consider the implications for children's nursing pre-registration curricula. A small-scale qualitative study was undertaken using an interpretivist approach. Semi-structured interviews were conducted with six qualified children's nurses in two clinical areas - a specialist children's cancer inpatient ward, and a general children's ward where inpatients included children with cancer. Findings are discussed in relation to three emergent themes: Learning in Theory and Practice, Care of the Child and Family, and Resilience. Participants attached significance to the quantity and quality of practice experience. They reflected on barriers to specific and transferable theoretical learning and stressed the importance of integrating theory and practice. Understanding of family-centred care formed a significant part of their preparation. Preconceptions, communication with families and the emotional impact of this speciality were stressful. Improved pre-registration preparation may have developed participants' resilience. The complexities of caring for children with cancer and their families require well-prepared nurses. Participants' perceptions of preparedness were influenced by aspects of pre-registration education. Their experiences suggest that curricula should be practice-focused and include a range of placements. Specialist theoretical content must be integrated with practice and transferability of knowledge and skills made explicit. Reflection and problem

  10. Cancer survivors' perspectives and experience on western medicine and traditional Chinese medicine treatment and rehabilitation: a qualitative study.

    Wang, Ji-Wei; Yang, Zhi-Qi; Liu, Cong; Chen, Si-Jia; Shen, Qian; Zhang, Tian-Rui; Partike, Nancy S; Yuan, Zheng-Ping; Yu, Jin-Ming

    2015-01-01

    In the People's Republic of China, both western medicine (WM) and traditional Chinese medicine (TCM) are the main treatment and rehabilitation options for cancer patients. This study aimed to explore cancer survivors' perspectives and experience of treatment and rehabilitation, in order to promote patient-centered activities of treatment and rehabilitation. Using a qualitative research approach, 68 cancer survivors were recruited from eight community cancer rehabilitation organizations in Shanghai, People's Republic of China. Eight focus group interviews were conducted. All these interviews were transcribed verbatim, and the data were analyzed by theme analysis. WM was the main choice in treatment phase though study participants noted more side effects. TCM was primarily used in the recovery phase. The lack of communication between doctors and cancer patients appears to affect treatment adherence and impair the doctor-patient relationship. WM was expensive for diagnostic procedures and treatment, while the cumulative costs of frequent use of TCM in the long rehabilitation period were also high. Both treatment options created significant perceived economic burden on patients. Conflicting information about dietary supplements tended to make cancer survivors confused. Improving the communication between doctors and cancer patients helps to ameliorate cancer patient adherence and the effect of treatments. It is essential to educate cancer patients about the effect and cost of both WM and traditional TCM. Meanwhile, marketing management and guidance to consumers regarding use of dietary supplements in the cancer rehabilitation field are also necessary.

  11. Culture, attitude and knowledge about breast cancer and preventive measures: a qualitative study of South Asian breast cancer patients in the UK.

    Karbani, Gulshan; Lim, Jennifer N W; Hewison, Jenny; Atkin, Karl; Horgan, Kieran; Lansdown, Mark; Chu, Carol E

    2011-01-01

    Little is known about the influence of culture and beliefs about breast cancer, and its implications on preventive health behaviour among South Asian people in the UK. Using a qualitative approach, 24 South Asian breast cancer patients and their significant others were interviewed. Most patients were unfamiliar with the subject of cancer; they expressed lack of knowledge of cancer as a disease and its symptoms. They identified a painless lump in the breast as sign of abnormality, but not cancer. They also did not know any non-lump breast symptoms. Over half participated in breast screening after encouragement from daughters or relatives. Most did not practise breast self-examination. Perceptions of cancer and health behaviour were influenced by cultural beliefs. Common themes were cancer is a taboo subject and cancer is a stigma. Patients also expressed misunderstandings about the cause of cancer. Cancer in the family had ramifications on children' s marriage prospects and may cause marital breakdown. Terminology used also caused communication problems with healthcare professionals and within the family: the use of ' chest' to substitute ' breast' changed the meaning of the message conveyed. Cultural beliefs and practices accentuate difficulties in understanding breast cancer, breast screening and breast self-examination, and can prevent South Asian women from adopting preventive health practices.

  12. Social aspects of living with rheumatoid arthritis: a qualitative descriptive study in Soweto, South Africa – a low resource context

    Manabile Esther

    2008-07-01

    Full Text Available Abstract Background Rheumatoid Arthritis (RA is a chronic illness with important functional, social and employment consequences. We therefore undertook a cross-sectional study, using the International Classification of Functioning, Disability and Health framework, to investigate the personal and social consequences of RA in women, living under largely impoverished conditions. Methods A qualitative case study design was used with a convenience sample of 60 women with RA living in Soweto, South Africa. Semi-structured in-depth interviews were conducted to cover a range of experiences including onset of disease, treatment, environmental barriers and facilitators, employment, and social inclusion in family and community life. The outcomes are described according the International Classification of Functioning, Health and Disability framework at the body, person and societal levels and looking at both personal and environmental factors. Results The main features of living with RA were pain, muscle stiffness at the body level, difficulties in doing various activities such as mobility, washing, dressing, domestic activities, using transport and obtaining and maintaining employment at the person level. At the societal level the participants described difficulties moving around, interacting socially and taking part in community activities, fulfilling social roles and earning a living. Environmental facilitators such as assistive devices and health care services improved functioning. Barriers such as physical environments, lack of transport and basic services, such as electricity, and attitudes of others lead to social exclusion, loss of a sense of self and independence. Low income, lack of sufficient public transport, and sparse basic services were poverty features that exacerbated negative experiences. Conclusion The experiences of living with RA in a low resource context are similar to those in mid- and high resource contexts, but are exacerbated by

  13. Primary social and emotional aspects of learning (SEAL small group interventions: a qualitative study of factors affecting implementation and the role of Local Authority support

    Neil Humphrey

    2009-11-01

    Full Text Available The aims of the current study were to examine the factors affecting implementation of social and emotional aspects of learning (SEAL small group interventions in primary schools and to explore the role of support from Local Authorities (LAs in the implementation process. Telephone interviews were conducted with lead SEAL staff in 12 LAs across England as part of a larger national evaluation of this educational initiative. Data were transcribed and subjected to qualitative content analysis. Subsequently, a tentative model was developed to document the relationship between the nature of support provided by LAs (e.g. training events, developing/providing additional materials, factors affecting implementation at school level (e.g. school readiness, the profile of SEAL and perceived barriers to success (e.g. misconceptions about the purpose of small group interventions. These findings are discussed in relation to the existing literature on the implementation of social-emotional initiatives and interventions in education.

  14. Field inoculation of arbuscular mycorrhiza on maize (Zea mays L. under low inputs: preliminary study on quantitative and qualitative aspects

    Emilio Sabia

    2015-03-01

    Full Text Available Arbuscular mycorrhizal symbiosis contributes to the sustainability of soil-plant system. A field experiment was conducted to examine the effect of arbuscular mycorrhiza (AM on quantitative and qualitative performance in forage maize (Zea mays L.. Within the project Sviluppo di modelli zootecnici ai fini della sostenibilità (SOS-ZOOT a trial was conducted at the experimental farm of the Agricultural Research Council in Bella (PZ, located in Basilicata region (Southern Italy at 360 m asl, characterised by an annual rainfall of approximately 650 mm. For spring sowing, two plots of 2500 m2 were used, one sown with seeds inoculated with AM (M, 1.0 kg/ha, and the other one with non-inoculated seeds (NM. After 120 days after sowing, when plants showed 30% dry matter, five replicates of 1 m2 per plot were used to estimate dry matter yield (DMY, while half plot was dedicated to the assessment of grain production. For each replicate, three representative plants were considered; each plant was measured for height and was divided into leaves, stem and ear. For each plot, the following constituents were determined: crude protein, ash, ether extract, crude fibre (CF, fractions of fibre [neutral detergent (NDF, acid detergent fibre (ADF and sulphuric acid lignin] and phosphorus (P. Throughout the period of plants’ growth, no herbicides, organic or inorganic fertilisation, and irrigation water were distributed. The preliminary results revealed a significant effect of AM inoculation on forage maize DMY, P content in the whole plant, into the leaves and on the quality of steam. The M thesis showed a significant increase in terms of DMY in comparison with the NM thesis: 21.2 vs 17.9 t/ha (P<0.05. The mycorrhized whole plants [0.22 vs 0.17% dry matter (DM, P<0.05] and leaves (0.14 vs 0.09% DM, P<0.05 showed an increased P content. The stems of M plants showed a content of CF, NDF, ADF and Ash significantly lower compared with NM plants. No significant

  15. A qualitative analysis of changes in relationship dynamics and roles between people with cancer and their primary informal carer.

    Ussher, Jane M; Tim Wong, W K; Perz, Janette

    2011-11-01

    It is widely accepted that cancer is an intersubjective experience that impacts upon the psychological well-being of people with cancer and informal carers, as well as on couple relationships. This qualitative study examined the nature and consequences of cancer on the relationship between informal carers and the person with cancer, from the perspective of Australian cancer carers. Sixty-two carers (42 women and 20 men), across a range of cancer types, stages and relationship dyads took part in semi-structured interviews. Participants reported that cancer had precipitated a change in roles and in the dynamics of the relationship, including having to take on quasi-medical tasks and decisions, neglecting self and other relationships, changes to the emotions or personality of the person with cancer, changed patterns of communication, and changes to sexuality and intimacy. The impact of the changed relationship included sadness, anger and frustration, as well as feelings of love and being closer together, resulting in relationship enhancement. Women were more likely to report changes in the person with cancer and to mourn the previous relationship, while more men reported relationship enhancement.

  16. The position of the cancer patient undergoing radiotherapy -psychological and physical aspects

    Frischenschlager, O.; Hohenberg, G.; Handl-Zeller, L.

    1991-01-01

    This study examines the psychological strains experienced by patients undergoing radiotherapy, as well as their somatic complaints and the possible connection between these two aspects. The sample consisted of 87 cancer patients, 64 female, 23 male. We used two standardized clinical instruments, one Zerssen's list of somatic complaints ('Beschwerdeliste' in German) and Zerssen's questionnaire of wellbeing ('Befindlichkeitsskala' in German). These two research instruments were implemented four times: at the beginning, in the middle and at the end of radiation, and three month afterwards. Results: Both the psychological state of well-being and somatic complaints remained at approximately the same level during the whole course of therapy. The state of well-being increased significantly after therapy, which is indicated by the decrease in the number of psychological impairments, whereas the score for somatic complaints remained the same. We observed a general tendency on the part of the patients to play down their situation. Sex differences were not observed. The discussion of the results includes their implication on the doctor-patient relationship. (Author)

  17. Pain in castration-resistant prostate cancer with bone metastases: a qualitative study

    Gater Adam

    2011-10-01

    Full Text Available Abstract Background Bone metastases are a common painful and debilitating consequence of castration-resistant prostate cancer (CPRC. Bone pain may predict patients' prognosis and there is a need to further explore CRPC patients' experiences of bone pain in the overall context of disease pathology. Due to the subjective nature of pain, assessments of pain severity, onset and progression are reliant on patient assessment. Patient reported outcome (PRO measures, therefore, are commonly used as key endpoints for evaluating the efficacy of CRPC treatments. Evidence of the content validity of leading PRO measures of pain severity used in CRPC clinical trials is, however, limited. Methods To document patients' experience of CRPC symptoms including pain, and their impact on health-related quality of life (HRQL, semi-structured in-depth qualitative interviews were conducted with 17 patients with CRPC and bone metastases. The content validity of the Present Pain Intensity (PPI scale from the McGill Pain Questionnaire (MPQ, and the 'Average Pain' and 'Worst Pain' items of the Brief Pain Inventory Short-Form (BPI-SF was also assessed. Results Patients with CRPC and bone metastases present with a constellation of symptoms that can have a profound effect on HRQL. For patients in this study, bone pain was the most prominent and debilitating symptom associated with their condition. Bone pain was chronic and, despite being generally well-managed by analgesic medication, instances of breakthrough cancer pain (BTcP were common. Cognitive debriefing of the selected PRO measures of pain severity highlighted difficulties among patients in understanding the verbal response scale (VRS of the MPQ PPI scale. There were also some inconsistencies in the way in which the BPI-SF 'Average Pain' item was interpreted by patients. In contrast, the BPI-SF 'Worst Pain' item was well understood and interpreted consistently among patients. Conclusions Study findings support the

  18. General Practitioners' Experiences of, and Responses to, Uncertainty in Prostate Cancer Screening: Insights from a Qualitative Study.

    Kristen Pickles

    Full Text Available Prostate-specific antigen (PSA testing for prostate cancer is controversial. There are unresolved tensions and disagreements amongst experts, and clinical guidelines conflict. This both reflects and generates significant uncertainty about the appropriateness of screening. Little is known about general practitioners' (GPs' perspectives and experiences in relation to PSA testing of asymptomatic men. In this paper we asked the following questions: (1 What are the primary sources of uncertainty as described by GPs in the context of PSA testing? (2 How do GPs experience and respond to different sources of uncertainty?This was a qualitative study that explored general practitioners' current approaches to, and reasoning about, PSA testing of asymptomatic men. We draw on accounts generated from interviews with 69 general practitioners located in Australia (n = 40 and the United Kingdom (n = 29. The interviews were conducted in 2013-2014. Data were analysed using grounded theory methods. Uncertainty in PSA testing was identified as a core issue.Australian GPs reported experiencing substantially more uncertainty than UK GPs. This seemed partly explainable by notable differences in conditions of practice between the two countries. Using Han et al's taxonomy of uncertainty as an initial framework, we first outline the different sources of uncertainty GPs (mostly Australian described encountering in relation to prostate cancer screening and what the uncertainty was about. We then suggest an extension to Han et al's taxonomy based on our analysis of data relating to the varied ways that GPs manage uncertainties in the context of PSA testing. We outline three broad strategies: (1 taking charge of uncertainty; (2 engaging others in managing uncertainty; and (3 transferring the responsibility for reducing or managing some uncertainties to other parties.Our analysis suggests some GPs experienced uncertainties associated with ambiguous guidance and the

  19. Doctors' experiences and their perception of the most stressful aspects of complaints processes in the UK: an analysis of qualitative survey data.

    Bourne, Tom; Vanderhaegen, Joke; Vranken, Renilt; Wynants, Laure; De Cock, Bavo; Peters, Mike; Timmerman, Dirk; Van Calster, Ben; Jalmbrant, Maria; Van Audenhove, Chantal

    2016-07-04

    To examine doctors' experiences of complaints, including which aspects are most stressful. We also investigated how doctors felt complaints processes could be improved. A qualitative study based on a cross-sectional survey of members of the British Medical Association (BMA). We asked the following: (1) Try to summarise as best as you can your experience of the complaints process and how it made you feel. (2) What were the most stressful aspects of the complaint? (3) What would you improve in the complaints system? We sent the survey to 95 636 doctors, and received 10 930 (11.4%) responses. Of these, 6146 had a previous, recent or current complaint and 3417 (31.3%) of these respondents answered questions 1 and 2. We randomly selected 1000 answers for analysis, and included 100 using the saturation principle. Of this cohort, 93 responses for question 3 were available. Doctors frequently reported feeling powerless, emotionally distressed, and experiencing negative feelings towards both those managing complaints and the complainants themselves. Many felt unsupported, fearful of the consequences and that the complaint was unfair. The most stressful aspects were the prolonged duration and unpredictability of procedures, managerial incompetence, poor communication and perceiving that processes are biased in favour of complainants. Many reported practising defensively or considering changing career after a complaint, and few found any positive outcomes from complaints investigations. Physicians suggested procedures should be more transparent, competently managed, time limited, and that there should be an open dialogue with complainants and policies for dealing with vexatious complaints. Some felt more support for doctors was needed. Complaints seriously impact on doctors' psychological wellbeing, and are associated with defensive practise. This is not beneficial to patient care. To improve procedures, doctors propose they are simplified, time limited and more

  20. Perspectives on cervical cancer screening among educated Muslim women in Dubai (the UAE): a qualitative study.

    Khan, Sarah; Woolhead, Gillian

    2015-10-24

    Cervical cancer (CC) is the seventh leading cause of death among women in the United Arab Emirates (UAE), with most deaths attributed to late detection of this cancer. The UAE lacks a national CC screening programme. Thus, cervical screening is only performed opportunistically during women's visits to health facilities. CC screening rates in the UAE are as low as 16.9 %, and little is known about the perspectives of the nation's educated Muslim women regarding screening. Consequently, the aim of this study is to explore Muslim women's perspectives towards cervical screening in Dubai to promote strategies for increasing its uptake, thereby leading to a decrease in morbidity and mortality associated with CC. Interpretivist and social constructivist epistemological approaches were applied for this qualitative study. Data were obtained through 13 in-depth interviews. Purposive and snowballing methods were used to recruit six South Asian women and seven Emirati women living in Dubai. Thematic content analysis was concurrently applied with comparative analysis to the data. Four themes regarding women's perceptions of CC emerged from the data. First, CC was considered a 'silent disease' that could be detected with early screening. However, it was also associated with extramarital sexual relations, which negatively influenced screening uptake. Second, women's fear, pain and embarrassment, along with cultural influences, deterred them from undergoing screening. Third, a growing mistrust of allopathic medicine and impersonal healthcare promoted a negative view of screening. Last, women became aware of screening mainly when they were pregnant or receiving fertility treatment. The study highlighted a number of important factors relating to cultural, religious and sexual behaviour that shaped educated Muslim women's perspectives on CC screening. Evidently, the current opportunistic approach to screening is flawed. A national awareness programme on CC screening should be

  1. Symptoms and Impacts in Non-Metastatic Castration-Resistant Prostate Cancer: Qualitative Study Findings.

    Tomaszewski, Erin L; Moise, Pierre; Krupnick, Robert N; Downing, Jared; Meyer, Margaret; Naidoo, Shevani; Holmstrom, Stefan

    2017-10-01

    We developed a conceptual model to define key concepts associated with patients' experiences with the signs, symptoms, and impacts of non-metastatic castration-resistant prostate cancer (M0-CRPC). A targeted review of peer-reviewed literature, and other publicly available information, identified and categorized symptoms and impacts related to early-stage prostate cancer. Semi-structured interviews with five clinical experts helped determine the most relevant and important concepts for patients with M0-CRPC. Qualitative interviews with 17 patients with M0-CRPC identified the most frequently experienced symptoms and impacts, and their degree of interference with patients' lives. The findings from these three lines of evidence were summarized in a conceptual model. Literature searches identified mainly urinary, intestinal, and sexual symptoms. Experts noted the symptoms most frequently mentioned by patients include erectile dysfunction, loss of sexual desire or interest, incontinence/leaking, urgency, and hot flashes. Patient interviews confirmed the high frequency of erectile dysfunction, loss of libido, urinary urgency, and incontinence. The most frequently mentioned impacts expressed by patients were the need to monitor/plan for urinary frequency, interference with/restriction of daily activities, and frustration or anxiety over diagnosis, symptoms, or treatment. Symptoms and impacts most frequently experienced by patients were typically not those with the greatest effects on their lives; rather, those with the greatest consequences were related to treatment. The leading concerns associated with M0-CRPC were related to voiding and sexual dysfunction. The most relevant symptoms and impacts expressed by patients may be a consequence of therapy rather than of the disease.

  2. How older people with incurable cancer experience daily living: A qualitative study from Norway.

    Haug, Sigrid Helene Kjørven; Danbolt, Lars J; Kvigne, Kari; Demarinis, Valerie

    2015-08-01

    An increasing number of older people are living with incurable cancer as a chronic disease, requiring palliative care from specialized healthcare for shorter or longer periods of time. The aim of our study was to describe how they experience daily living while receiving palliative care in specialized healthcare contexts. We conducted a qualitative research study with a phenomenological approach called "systematic text condensation." A total of 21 participants, 12 men and 9 women, aged 70-88, took part in semistructured interviews. They were recruited from two somatic hospitals in southeastern Norway. The participants experienced a strong link to life in terms of four subthemes: to acknowledge the need for close relationships; to maintain activities of normal daily life; to provide space for existential meaning-making and to name and handle decline and loss. In addition, they reported that specialized healthcare contexts strengthened the link to life by prioritizing and providing person-centered palliative care. Older people with incurable cancer are still strongly connected to life in their daily living. The knowledge that the potential for resilience remains despite aging and serious decline in health is considered a source of comfort for older people living with this disease. Insights into the processes of existential meaning-making and resilience are seen as useful in order to increase our understanding of how older people adapt to adversity, and how their responses may help to protect them from some of the difficulties inherent to aging. Healthcare professionals can make use of this information in treatment planning and for identification of psychosocial and sociocultural resources to support older people and to strengthen patients' life resources.

  3. Cervical cancer screening attitudes and beliefs of Malaysian women who have never had a pap smear: a qualitative study.

    Wong, L P; Wong, Y L; Low, W Y; Khoo, E M; Shuib, R

    2008-01-01

    Attitudes toward cervical cancer and participation in early detection and screening services are well known to be profoundly affected by cultural beliefs and norms. This study explored the attitudes and sociocultural beliefs on cervical cancer screening among Malaysian women. In this qualitative study, in-depth interviews were conducted with 20 Malaysian women, ages 21 to 56 years, who have never had a Papanicolaou (Pap) smear. Respondents generally showed a lack of knowledge about cervical cancer screening using Pap smear, and the need for early detection for cervical cancer. Many believed the Pap smear was a diagnostic test for cervical cancer, and since they had no symptoms, they did not go for Pap screening. Other main reasons for not doing the screening included lack of awareness of Pap smear indications and benefits, perceived low susceptibility to cervical cancer, and embarrassment. Other reasons for not being screened were related to fear of pain, misconceptions about cervical cancer, fatalistic attitude, and undervaluation of own health needs versus those of the family. Women need to be educated about the benefits of cervical cancer screening. Health education, counseling, outreach programs, and community-based interventions are needed to improve the uptake of Pap smear in Malaysia.

  4. Coping, social relations, and communication: a qualitative exploratory study of children of parents with cancer.

    Thastum, Mikael; Johansen, Mikael Birkelund; Gubba, Lotte; Olesen, Louise Berg; Romer, Georg

    2008-01-01

    The purpose of this qualitative study of families where a parent has cancer was to explore ways of informing the child of the parent's illness, how the child perceives the parent's emotional state, how the child copes with the parent's illness, and how this coping relates to the parent's coping and concerns for the child. Twenty-one children from 15 families and their parents were interviewed. In 13 families the mother was ill, in two the father. Children were aware of the facts of the illness, but there was limited emotional communication between the generations. The children were very observant of both the ill and the healthy parent's emotional condition. The children's observations and expressions led us to identify five coping strategies the younger generation used: Helping others, parentification, distraction, keeping it in the head, and wishful thinking. Both adaptive and destructive examples of parentification were found. Communication patterns and parental coping seemed to be highly related to the child's coping repertoire. Even though most children seemed to manage rather well, all children were strongly affected by the illness. The 'healthiest' adaptation related to factors within the family system, which has implications for the provision of help.

  5. Clinician-Reported Barriers to Implementing Breast Cancer Chemoprevention in the UK: A Qualitative Investigation.

    Smith, Samuel G; Side, Lucy; Meisel, Susanne F; Horne, Rob; Cuzick, Jack; Wardle, Jane

    2016-01-01

    The use of tamoxifen and raloxifene as preventive therapy for women at increased risk of breast cancer was approved by the National Institute for Health and Care Excellence (NICE) in 2013. We undertook a qualitative investigation to investigate the factors affecting the implementation of preventive therapy within the UK. We recruited general practitioners (GPs) (n = 10) and clinicians working in family history or clinical genetics settings (FHCG clinicians) (n = 15) to participate in semi-structured interviews. Data were coded thematically within the Consolidated Framework for Implementation Research. FHCG clinicians focussed on the perceived lack of benefit of preventive therapy and difficulties interpreting the NICE guidelines. FHCG clinicians felt poorly informed about preventive therapy, and this discouraged patient discussions on the topic. GPs were unfamiliar with the concept of preventive therapy, and were not aware that they may be asked to prescribe it for high-risk women. GPs were reluctant to initiate therapy because it is not licensed, but were willing to continue a prescription if it had been started in secondary or tertiary care. Barriers to implementing preventive therapy within routine clinical practice are common and could be addressed by engaging all stakeholders during the development of policy documents. © 2016 The Author(s) Published by S. Karger AG, Basel.

  6. Image of God, religion, spirituality, and life changes in breast cancer survivors: a qualitative approach.

    Schreiber, Judith A; Edward, Jean

    2015-04-01

    Religion and spirituality are much studied coping mechanisms; however, their relationship to changes in behaviors, relationships, and goals is unclear. This study explored the impact of a breast cancer diagnosis on religion/faith and changes in behaviors, relationship, or goals. In this qualitative study, women, who participated in a larger, quantitative study, completed written responses to questions regarding the role of religion/faith in their lives, the impact of their diagnosis on their image of God and on faith/religious beliefs, and any changes in behaviors, relationships, or life goals were examined. Based on previous findings noting differences in psychological outcomes based on a higher (HE) or lesser (LE) engaged view of God, 28 (14 HE; 14 LE) women were included in the analysis. Awareness of life and its fleeting nature was common to all. Ensuing behaviors varied from a need to focus on self-improvement-egocentrism (LE)-to a need to focus on using their experiences to help others-altruism (HE). Study results suggest that seemingly small, but highly meaningful, differences based on one's worldview result in considerably different attitudinal and behavioral outcomes.

  7. Social Representations of Gynecologic Cancer Screening Assessment a Qualitative research on Ecuadorian women.

    Godoy, Yolanda; Godoy, Clara; Reyes, Juan

    2016-06-01

    The purpose of this work was to explore: knowledge, attitudes, and beliefs regarding gynecologic cancer screening on Ecuadorian women users of primary care facilities, to identify the social representations that users of health services make about these programs and their influence on the decision to undergo a screening. An exploratory and qualitative research design was held using focus groups and in-depth interviews for data collection. A narrative content analysis of the results was conducted. Women's knowledge on gynecological cancer screening was confusing. Most frequent misconceptions related to the pap smear were: the belief that it could be useful for detecting pregnancy, ovarian cysts or infections. Most of the participants stated that the pap smear procedure is a traumatic and painful experience. Regarding to mammography women said it was used for sick woman and this procedure by itself may cause cancer. El propósito de esta investigación fue explorar los conocimientos, actitudes y creencias respecto a los programas de detección del cáncer ginecológico entre usuarias de centros de atención primaria de salud para identificar las representaciones sociales que las usuarias de los servicios de salud elaboran acerca de estos programas y de los diferentes procedimientos que comprenden. El diseño de la investigación fue exploratorio y cualitativo, mediante grupos focales y entrevistas a profundidad, con el respectivo análisis narrativo e interpretativo del contenido. Se encontró conocimiento confuso acerca de los programas de tamizaje de cáncer ginecológico y dificultades asociadas a la realización de los procedimientos. Los significados más frecuentes acerca de los programas fueron: el uso de la citología cérvico-vaginal para detectar embarazo, quistes ováricos o infecciones. La mayoría de los participantes asociaba este procedimiento con una experiencia dolorosa y traumática. Respecto al autoexamen de mamas, lo calificaron como un masaje

  8. Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study.

    Wiener, Renda Soylemez; Koppelman, Elisa; Bolton, Rendelle; Lasser, Karen E; Borrelli, Belinda; Au, David H; Slatore, Christopher G; Clark, Jack A; Kathuria, Hasmeena

    2018-02-21

    Guidelines recommend, and Medicare requires, shared decision-making between patients and clinicians before referring individuals at high risk of lung cancer for chest CT screening. However, little is known about the extent to which shared decision-making about lung cancer screening is achieved in real-world settings. To characterize patient and clinician impressions of early experiences with communication and decision-making about lung cancer screening and perceived barriers to achieving shared decision-making. Qualitative study entailing semi-structured interviews and focus groups. We enrolled 36 clinicians who refer patients for lung cancer screening and 49 patients who had undergone lung cancer screening in the prior year. Participants were recruited from lung cancer screening programs at four hospitals (three Veterans Health Administration, one urban safety net). Using content analysis, we analyzed transcripts to characterize communication and decision-making about lung cancer screening. Our analysis focused on the recommended components of shared decision-making (information sharing, deliberation, and decision aid use) and barriers to achieving shared decision-making. Clinicians varied in the information shared with patients, and did not consistently incorporate decision aids. Clinicians believed they explained the rationale and gave some (often purposely limited) information about the trade-offs of lung cancer screening. By contrast, some patients reported receiving little information about screening or its trade-offs and did not realize the CT was intended as a screening test for lung cancer. Clinicians and patients alike did not perceive that significant deliberation typically occurred. Clinicians perceived insufficient time, competing priorities, difficulty accessing decision aids, limited patient comprehension, and anticipated patient emotions as barriers to realizing shared decision-making. Due to multiple perceived barriers, patient

  9. Review of colorectal cancer and its metastases in rodent models: comparative aspects with those in humans

    Kobaek-Larsen, M; Thorup, I; Diederichsen, Axel Cosmus Pyndt

    2000-01-01

    BACKGROUND AND PURPOSE: Colorectal cancer (CRC) remains one of the most common cancer forms developing in industrialized countries, and its incidence appears to be rising. Studies of human population groups provide insufficient information about carcinogenesis, pathogenesis, and treatment of CRC...

  10. Awareness, perception and factors affecting utilization of cervical cancer screening services among women in Ibadan, Nigeria: a qualitative study

    Ndikom Chizoma

    2012-08-01

    Full Text Available Abstract Background Over the years awareness and uptake of cervical cancer screening services has remained poor in developing countries. Problems associated with cervical cancer incidence include late reporting, ignorance and cultural issues relating to cervical cancer screening. This study sought to explore the awareness, perception and utilization of cervical cancer screening among women in Ibadan as well as factors that influence utilization. Method This is a qualitative study that utilized Eight Focus Group Discussions to collect information from women in selected health facilities in Ibadan, South West, Nigeria. The 82 participants were purposely recruited from women attending Antenatal clinics in 4 secondary and 4 primary health care facilities after approval was received from the Institutional Review Board in charge of the facilities. The focus group discussions were tape recorded and transcribed verbatim. The transcripts were analyzed into themes. Findings The study provided qualitative information on the awareness, perception of the utilization of cervical cancer screening services among women in Ibadan. Participants were mainly married women (92.7%, mean age =27.6, SD =4.5, mainly traders (39% and from Yoruba ethnic backgrounds (87.8% and had secondary education (39%. The respondents reported not being aware of cervical cancer and were not utilizing the services. Though they did not know what cervical cancer screening entailed or the screening methods, they still believed that it is important since like for other diseases will help in early detection and treatment. The participants were eager to get more information from nurses on cervical cancer about cervical cancer screening. The major factors identified by the women that influence screening utilization were ignorance, Illiteracy, belief in not being at risk, having many contending issues, nonchalant attitude to their health, financial constraint and fear of having a positive result

  11. Awareness, perception and factors affecting utilization of cervical cancer screening services among women in Ibadan, Nigeria: a qualitative study.

    Ndikom, Chizoma Millicent; Ofi, Bola Abosede

    2012-08-06

    Over the years awareness and uptake of cervical cancer screening services has remained poor in developing countries. Problems associated with cervical cancer incidence include late reporting, ignorance and cultural issues relating to cervical cancer screening. This study sought to explore the awareness, perception and utilization of cervical cancer screening among women in Ibadan as well as factors that influence utilization. This is a qualitative study that utilized Eight Focus Group Discussions to collect information from women in selected health facilities in Ibadan, South West, Nigeria. The 82 participants were purposely recruited from women attending Antenatal clinics in 4 secondary and 4 primary health care facilities after approval was received from the Institutional Review Board in charge of the facilities. The focus group discussions were tape recorded and transcribed verbatim. The transcripts were analyzed into themes. The study provided qualitative information on the awareness, perception of the utilization of cervical cancer screening services among women in Ibadan. Participants were mainly married women (92.7%), mean age =27.6, SD =4.5, mainly traders (39%) and from Yoruba ethnic backgrounds (87.8%) and had secondary education (39%). The respondents reported not being aware of cervical cancer and were not utilizing the services. Though they did not know what cervical cancer screening entailed or the screening methods, they still believed that it is important since like for other diseases will help in early detection and treatment. The participants were eager to get more information from nurses on cervical cancer about cervical cancer screening. The major factors identified by the women that influence screening utilization were ignorance, Illiteracy, belief in not being at risk, having many contending issues, nonchalant attitude to their health, financial constraint and fear of having a positive result. There is an urgent need for more enlightenment

  12. Ethical aspect of the clinical research. Informed consent in the clinical research for heavy ion radiotherapy of cancer

    Murata, Hajime

    2003-01-01

    The research center for heavy ion therapy of cancer was decided to be built in 1984 as a part of the national 10-year anticancer campaign, and construction of Heavy Ion Medical Accelerator in Chiba (HIMAC) was completed at the National Institute of Radiological Sciences in 1993. The HIMAC is the first heavy ion accelerator for only medical use in the world, and the clinical research of cancer radiotherapy was begun in 1994 using carbon ion generated by HIMAC. The purposes of the clinical research are to evaluate the safety and usefulness of carbon ion for cancer treatment, and to establish carbon ion therapy as a new and valuable tool for cancer therapy. Therefore, to obtain exact data in ethical aspect as well as scientific aspect of the clinical research, many special committees have been organized like as the committees of protocol planning for each organ, clinical study groups for each organ, evaluating committee of clinical data, and the ethical committee. Each clinical research is performed according to the research protocol of each organ, in which study purpose, rationale, patient condition, end-point of the study, adverse reaction are described. The document of informed consent (IC) contains study purpose, patient condition, method, predicted effect and demerit, protection of privacy, etc.. IC to each patient is done precisely by the doctor, and the freely-given IC of the patient is obtained. After the IC was completed, judgement of propriety for carbon ion therapy is done by the ethical committee for IC of each patient. Since 1994 carbon ion therapy has been performed over 1300 patients with cancer in various organs, and its safety and usefulness for cancer treatment has been clarified gradually. The carbon ion therapy is thought to be a new and promising tool for cancer treatment near future. (authors)

  13. Prostate cancer risk and recurrence: the role of nutrition and clinical aspects

    Kok, D.E.G.

    2013-01-01

    Background Prostate cancer is the most common cancer among men in Western countries. Knowledge on prostate cancer aetiology is required for identification of high-risk groups, optimization of treatment strategies, and development of prevention programs. The aim of this thesis

  14. Early Detection of Breast Cancer and Barrier to Screening Programmes amongst Thai Migrant Women in Australia: A Qualitative Study

    Suwankhong, Dusanee; Liamputtong, Pranee

    2018-04-27

    Background: Breast cancer screening programme is seen as the best practice to detect breast cancer early. However, there are circumstances that can prevent immigrant women from attending screening programmes. Little is known about Thai migrants and the barriers to their seeking breast cancer screening when living in a new homeland. This paper aimed to discuss the barriers to attending screening services among Thai migrant women living in Australia. Methods: This study adopted qualitative approach. Semi-structured in-depth interviewing and drawing methods were employed as data collection technique with 25 Thai migrant women who had not experienced breast cancer and were living in Metropolitan Melbourne, Australia. Thematic analysis method was employed to analyse the data. Results: Basing on the Health Belief Model, most Thai migrant women did not perceive that they were at risk of breast cancer. Despite seeing a breast cancer screening programme as important, the women rarely paid attention to breast cancer screening and used the mammography services provided by the Australian health care system. The barriers included the location of the services, unfamiliar patterns of health care provision, and language difficulties. Conclusions: There are many barriers that that they encountered in Australia that prevent Thai migrant women living in Melbourne Australia to pay attention to mammographic screening service provided by Australia health system. Our findings suggest that health services and interventions need to be designed more sensitive to the needs and socio-cultural context of migrant women in general and Thai migrant women in particular. Creative Commons Attribution License

  15. Individual difficulties and resources – a qualitative analysis in patients with advanced lung cancer and their relatives

    Sparla A

    2016-10-01

    Full Text Available Anika Sparla,1 Sebastian Flach-Vorgang,1 Matthias Villalobos,2 Katja Krug,1 Martina Kamradt,1 Kadiatou Coulibaly,1 Joachim Szecsenyi,1 Michael Thomas,2 Sinikka Gusset-Bährer,2 Dominik Ose1,3 1Department of General Practice and Health Services Research, Heidelberg University Hospital, 2Internistische Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H, Member of the German Center for Lung Research, Heidelberg, Germany; 3University of Utah, Department of Population Health Sciences, Health System Innovation and Research, Salt Lake City, UT, USA Purpose: Lung cancer is a disease with a high percentage of patients diagnosed in an advanced stage. In a situation of palliative treatment, both patients and their relatives experience diverse types of distress and burden. Little research has been done to identify the individual difficulties and resources for patients with advanced lung cancer and their relatives. Especially, standardized questionnaire-based exploration may not assess the specific distressing issues that pertain to each individual on a personal level. The purpose of this qualitative study is to explore and compare individual difficulties and resources for lung cancer patients and their relatives within the palliative care context.Methods: Data were collected by qualitative interviews. A total of 18 participants, nine patients diagnosed with advanced lung cancer (International Classification of Diseases, tenth edition, diagnosis C-34, stage IV starting or receiving palliative treatment and nine relatives, were interviewed. Data were interpreted through qualitative content analysis.Results: We identified four main categories of difficulties: communication and conflicts, home and everyday life, thinking about cancer, and treatment trajectory. In general, difficulties were related to interpersonal relationships as well as to impact of chemotherapy. Family

  16. Using continuous sedation until death for cancer patients: A qualitative interview study of physicians' and nurses' practice in three European countries

    J. Seymour (Jane); J.A.C. Rietjens (Judith); S.M. Bruinsma (Sophie); L. Deliens (Luc); S. Sterckx (Sigrid); F. Mortier (Freddy); J. Brown (Jayne); N. Mathers (Nigel); A. van der Heide (Agnes)

    2015-01-01

    textabstractBackground: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. Methods: Qualitative case studies using interviews.

  17. Disruption or innovation? A qualitative descriptive study on the use of electronic patient-physician communication in patients with advanced cancer.

    Voruganti, Teja; Husain, Amna; Grunfeld, Eva; Webster, Fiona

    2018-03-04

    In the advanced cancer context, care coordination is often inadequate, leading to suboptimal continuity of care. We evaluated an electronic web-based tool which assembles the patient, their caregivers, and their healthcare providers in a virtual space for team-based communication. We sought to understand participant perceptions on electronic communication in general and the added value of the new tool in particular. We conducted a qualitative descriptive study with participants (patients, caregivers, cancer physicians) who participated in a 3-month pilot trial evaluating the tool. Interviews were thematically analyzed and the perspectives from patients, caregivers, and cancer physicians were triangulated. Interviews from six patients, five of their caregivers, and seven cancer physicians conducted alongside monthly outcome assessments were analyzed. We identified five themes relating participants' perspectives on electronic communication to their experience of care: (1) apparent gaps in care, (2) uncertainty in defining the circle of care, (3) relational aspects of communication, (4) incongruence between technology and social norms of patient-physician communication, and (5) appreciation but apprehension about the team-based communication tool for improving the experience of care. The potential of tools for electronic communication to bring together a team of healthcare providers with the patient and caregivers is significant but may pose new challenges to existing team structure and interpersonal dynamics. Patients and physicians were worried about the impact that electronic communication may have on the patient-physician relationship. Implementation approaches, which build on the relationship and integrate the team as a whole, could positively position electronic communication to enhance the team-based care.

  18. Cancer rehabilitation in Austria--aspects of Physical Medicine and Rehabilitation.

    Maehr, Bruno; Keilani, Mohammad; Wiltschke, Christoph; Hassler, Marco; Licht, Thomas; Marosi, Christine; Huetterer, Elisabeth; Cenik, Fadime; Crevenna, Richard

    2016-02-01

    In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.

  19. PATIENTS WITH END STAGE CANCER: LIFE HISTORY, PSYCHO-EMOTIONAL ASPECTS, RELATIONSHIP WITH THE NURSING STAFF.

    Ivanete Ribeiro do Nascimento

    2013-12-01

    Full Text Available Breast cancer is one of the cancers most feared by women for its high incidence and its psychological effects that affect the perception of sexuality and self-image. Objective: To identify the difficulties of nursing professionals in the treatment of patients with cancer, from the standpoint of a terminally ill patient of breast cancer. Methodology: This is a case study of a patient who is in the terminal stages of breast cancer. We carried out the survey of literature in journals indexed the databases LILACS and SciELO Open Access and English, on terminally ill cancer. Results: Feelings of loneliness and sadness were softened and smoothed by the attitude and disposition of nursing professionals. In moments of intervention needs of physical care, nursing care was provided. Conclusion: The nursing staff has always demonstrated skills in treating patients with cancer, providing quality care, humane and comprehensive, meeting all your needs biopsicoespiritual.

  20. Methodological exemplar of integrating quantitative and qualitative evidence - supportive care for men with prostate cancer:what are the most important components?

    Huntley, Alyson; King, Anna J L; Moore, Theresa H M; Paterson, Charlotte; Persad, Raj; Sharp, Debbie J; Evans, Maggie A

    2017-01-01

    AIMS: To present a methodological exemplar of integrating findings from a quantitative and qualitative review on the same topic to provide insight into components of care that contribute to supportive care that is acceptable to men with prostate cancer.BACKGROUND: Men with prostate cancer are likely to live a long time with the disease, experience side effects from treatment and therefore have ongoing supportive care needs. Quantitative and qualitative reviews have been published but the find...

  1. Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors.

    Kienle, Gunver S; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

    2016-01-01

    Background. Mistletoe therapy (MT) is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients' general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients' emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations.

  2. A qualitative study on mindfulness-based stress reduction for breast cancer patients: how women experience participating with fellow patients.

    Schellekens, Melanie P J; Jansen, Ellen T M; Willemse, Heidi H M A; van Laarhoven, Hanneke W M; Prins, Judith B; Speckens, Anne E M

    2016-04-01

    Peer support groups for cancer patients show mixed findings regarding effectiveness on psychological wellbeing. When embedded in a psychosocial intervention, such as mindfulness-based stress reduction (MBSR), peer support might be of more benefit to participants. This study is a qualitative exploration of how women with breast cancer experience the possible benefits and impediments of participating with fellow patients in an MBSR training. Five focus groups (n = 37) and three individual interviews (n = 3) were conducted with breast cancer patients who participated in MBSR. The qualitative data were analysed with the constant comparative method in order to develop a grounded theory. We could identify a process where at the start of MBSR, patients experienced anticipatory fear for facing the suffering of fellow patients, especially for those who could not be cured anymore. In most women, this fear gradually subsided during the first two sessions. The atmosphere in the MBSR training was experienced as safe and supportive, providing a context where participants could connect with and trust one another. In turn, this facilitated participants to learn from one another. Our findings do not only show that the peer group facilitates the learning process in MBSR, but the MBSR also seemed to provide an atmosphere that promotes the experienced social support in participants. In addition, the results emphasize the importance for mindfulness teachers to acknowledge and explore the fear for facing fellow patients in the group. Future research should examine whether the results are generalizable to patients with other cancer types.

  3. Yoga Helps Put the Pieces Back Together: A Qualitative Exploration of a Community-Based Yoga Program for Cancer Survivors

    Michael J. Mackenzie

    2016-01-01

    Full Text Available Objective. A qualitative research methods approach was used to explore the experiences of participants in an ongoing community-based yoga program developed for cancer survivors and their support persons. Methods. 25 participants took part in a series of semistructured focus groups following a seven-week yoga program and at three- and six-month follow-ups. Focus groups were transcribed verbatim and analyzed using a process of inductive thematic analysis. Results. The group was comprised of 20 cancer survivors, who were diagnosed on average 25.40 (20.85 months earlier, and five support persons. Participants had completed the yoga program an average of 3.35 (3.66 times previously and attended approximately 1.64 (0.70 of three possible focus groups. Four key themes were identified: (1 safety and shared understanding; (2 cancer-specific yoga instruction; (3 benefits of yoga participation; (4 mechanisms of yoga practice. Conclusions. Qualitative research provides unique and in-depth insight into the yoga experience. Specifically, cancer survivors and support persons participating in a community-based yoga program discussed their experiences of change over time and were acutely aware of the beneficial effects of yoga on their physical, psychological, and social well-being. Further, participants were able to articulate the mechanisms they perceived as underpinning the relationship between yoga and improved well-being as they developed their yoga practice.

  4. Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors

    Gunver S. Kienle

    2016-01-01

    Full Text Available Background. Mistletoe therapy (MT is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients’ general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients’ emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations.

  5. Qualitative study of the communication expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer.

    Stoewen, Debbie L; Coe, Jason B; MacMartin, Clare; Stone, Elizabeth A; E Dewey, Catherine

    2014-10-01

    To describe the process aspects (communication) of the information expectations of clients accessing oncology care services at a tertiary referral center for dogs with life-limiting cancer. Qualitative analysis of data acquired during in-person single and dyadic interviews. 43 dog owners participating in 30 interviews. Independent in-person interviews were conducted with standardized open- and closed-ended questions from April to October 2009. Thematic analysis was performed on transcripts of the interview discussions. The participants expected information to be communicated in a forthright manner; in multiple formats; with understandable language; in an unrushed environment wherein staff took the time to listen, answer all questions, and repeat information when necessary; on a continuous basis, with 24-hour access to address questions or concerns; in a timely manner; with positivity; with compassion and empathy; with a nonjudgmental attitude; and through staff with whom they had established relationships. Results indicated that the manner in which information is communicated is vitally important to clients of dogs with life-limiting cancer in that it not only facilitates comprehension but also creates a humanistic environment from which clients derive the psychosocial support needed to successfully cope with their pet's condition.

  6. Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study.

    Gele, Abdi A; Qureshi, Samera A; Kour, Prabhjot; Kumar, Bernadette; Diaz, Esperanza

    2017-01-01

    Norway has a low incidence and mortality rate of cervical cancer, which is mainly due to the high participation rate of women in cervical cancer screening. However, the attendance of cervical cancer screening was reported to be low among immigrant women. For this reason, we conducted a qualitative study to obtain better insight into perceived barriers and challenges to cervical cancer screening among Somali and Pakistani women in the Oslo region. A convenient sample of 35 (18 Pakistani, 17 Somali) women were recruited for the study in collaboration with Somali and Pakistani community partners. Focus group discussions were used to explore barriers and facilitators to cervical cancer screening, whereas the Ecological Model was used as the framework for the study. The study found three levels of barriers to cervical cancer screening. The individual level included a lack of understanding of the benefits of the screening. The sociocultural level included the stigma attached to the disease and the belief that women who are unmarried are sexually inactive. The system-related level included a lack of trust toward the health care system. Based on the study results, and using a common denominator approach for the immigrant groups included, the study recommends three communication strategies with the potential to improve women's participation in cervical cancer screening: 1) in-person communication and information material at health centers; 2) verbal communication with women through seminars and workshops to educate them about their risk of cancer and the importance of screening and 3) the initiation of better recall through SMS and letters written in native languages. Finally, an intervention study that compares the aforementioned strategies and proves their effectiveness in increasing immigrant women's participation in cervical cancer screening is recommended.

  7. Help seeking for cancer ‘alarm’ symptoms: a qualitative interview study of primary care patients in the UK

    Whitaker, Katriina L; Macleod, Una; Winstanley, Kelly; Scott, Suzanne E; Wardle, Jane

    2015-01-01

    Background Delay in help seeking for cancer ‘alarm’ symptoms has been identified as a contributor to delayed diagnosis. Aim To understand people’s help-seeking decision making for cancer alarm symptoms, without imposing a cancer context. Design and setting Community-based, qualitative interview study in the UK, using purposive sampling by sex, socioeconomic status, and prior help seeking, with framework analysis of transcripts. Method Interviewees (n = 48) were recruited from a community-based sample (n = 1724) of adults aged ≥50 years who completed a health survey that included a list of symptoms. Cancer was not mentioned. Participants reporting any of 10 cancer alarm symptoms (n = 915) and who had consented to contact (n = 482) formed the potential pool from which people were invited to an interview focusing on their symptom experiences. Results Reasons for help seeking included symptom persistence, social influence, awareness/fear of a link with cancer, and ‘just instinct’. Perceiving the symptom as trivial or ‘normal’ was a deterrent, as was stoicism, adopting self-management strategies, and fear of investigations. Negative attitudes to help seeking were common. Participants did not want to be seen as making a fuss, did not want to waste the doctor’s time, and were sometimes not confident that the GP could help. Conclusion Decision making about cancer alarm symptoms was complex. Recognition of cancer risk almost always motivated help seeking (more so than the fear of cancer being a deterrent), assisted by recent public-awareness campaigns. As well as symptom persistence motivating help seeking, it could also have the reverse effect. Negative attitudes to help seeking were significant deterrents. PMID:25624313

  8. Help seeking for cancer 'alarm' symptoms: a qualitative interview study of primary care patients in the UK.

    Whitaker, Katriina L; Macleod, Una; Winstanley, Kelly; Scott, Suzanne E; Wardle, Jane

    2015-02-01

    Delay in help seeking for cancer 'alarm' symptoms has been identified as a contributor to delayed diagnosis. To understand people's help-seeking decision making for cancer alarm symptoms, without imposing a cancer context. Community-based, qualitative interview study in the UK, using purposive sampling by sex, socioeconomic status, and prior help seeking, with framework analysis of transcripts. Interviewees (n = 48) were recruited from a community-based sample (n = 1724) of adults aged ≥50 years who completed a health survey that included a list of symptoms. Cancer was not mentioned. Participants reporting any of 10 cancer alarm symptoms (n = 915) and who had consented to contact (n = 482) formed the potential pool from which people were invited to an interview focusing on their symptom experiences. Reasons for help seeking included symptom persistence, social influence, awareness/fear of a link with cancer, and 'just instinct'. Perceiving the symptom as trivial or 'normal' was a deterrent, as was stoicism, adopting self-management strategies, and fear of investigations. Negative attitudes to help seeking were common. Participants did not want to be seen as making a fuss, did not want to waste the doctor's time, and were sometimes not confident that the GP could help. Decision making about cancer alarm symptoms was complex. Recognition of cancer risk almost always motivated help seeking (more so than the fear of cancer being a deterrent), assisted by recent public-awareness campaigns. As well as symptom persistence motivating help seeking, it could also have the reverse effect. Negative attitudes to help seeking were significant deterrents. © British Journal of General Practice 2015.

  9. Psychological aspects of the cancer patients' education: thoughts, feelings, behavior and body reactions of patients faced with diagnosis of cancer.

    Klikovac, T; Djurdjevic, A

    2010-01-01

    In order to assess the impact of cancer diagnosis on several psychological dimensions, this study was undertaken with the aim to understand, identify and document the psychological responses of cancer patients - their common thoughts, feelings, body sensations and behavior when they faced the cancer diagnosis. The sample consisted of 80 patients who attended psychological lectures during the implementation of the European Educational Programme (EEP) "Learning to live with cancer". At the beginning of the lectures, the patients were asked to fulfill the self-describing questionnaire with 4 open questions: "Describe your common thoughts, feelings, behavior, and body reactions in the first 6 weeks when you learned that you were affected by cancer". A significant proportion of patients reported disease denial (65%) and reexamination in relation to past life experiences, stressful events and bad habits (60%). Depressive feelings and disappointment were reported by 90% of the patients, while 85% of them reported fear, hopelessness and emptiness. They also reported sadness (70%), anger and anxiety (65%), nervousness and irritability (90%). Positive thoughts and attitude in the sense of optimism concerning a successful treatment outcome were reported by 20% and 15% of patients, respectively. The diagnosis of cancer and cancer treatment can cause distress, emotional turmoil and different psychosocial disorders. Taking into consideration different psychological reactions of cancer patients can be helpful for organizing adequate psycho-educational and psychosocial support, and psychotherapy for cancer patients and their families.

  10. Technical aspects of the deep inspiration breath-hold technique in the treatment of thoracic cancer

    Mah, Dennis; Hanley, Joseph; Rosenzweig, Kenneth E.; Yorke, Ellen; Braban, Louise; Ling, C. Clifton; Leibel, Stephen A.; Mageras, Gikas

    2000-01-01

    Purpose: The goal of this paper is to describe our initial experience with the deep inspiration breath-hold (DIBH) technique in conformal treatment of non-small-cell lung cancer with particular emphasis on the technical aspects required for implementation. Methods and Materials: In the DIBH technique, the patient is verbally coached through a modified slow vital capacity maneuver and brought to a reproducible deep inspiration breath-hold level. The goal is to immobilize the tumor and to expand normal lung out of the high-dose region. A physicist or therapist monitors and records patient breathing during simulation, verification, and treatment using a spirometer with a custom computer interface. Examination of internal anatomy during fluoroscopy over multiple breath holds establishes the reproducibility of the DIBH maneuver for each patient. A reference free-breathing CT scan and DIBH planning scan are obtained. To provide an estimate of tumor motion during normal tidal breathing, additional scan sets are obtained at end inspiration and end expiration. These are also used to set the spirometer action levels for treatment. Patient lung inflation is independently verified over the course of treatment by comparing the distance from the isocenter to the diaphragm measured from the DIBH digitally reconstructed radiographs to the distance measured on the portal films. Patient breathing traces obtained during treatment were examined retrospectively to assess the reproducibility of the technique. Results: Data from the first 7 patients, encompassing over 250 treatments, were analyzed. The inferred displacement of the centroid of gross tumor volume from its position in the planning scan, as calculated from the spirometer records in over 350 breath holds was 0.02 ± 0.14 cm (mean and standard deviation). These data are consistent with the displacements of the diaphragm (-0.1 ± 0.4 cm; range, from -1.2 to 1.1 cm) relative to the isocenter, as measured on the (92) portal films

  11. Survived but feeling vulnerable and insecure: a qualitative study of the mental preparation for RTW after breast cancer treatment

    Tiedtke Corine

    2012-07-01

    Full Text Available Abstract Background Improvements in treatment have resulted in an increasing number of cancer survivors potentially being able to return to work after medical treatment. In this paper we focus on the considerations regarding return to work (RTW of breast cancer absentees in the Belgian context and how these considerations are related to reactions from their social environment. Methods A qualitative study was performed to understand the RTW considerations of Belgian breast cancer absentees who had undergone breast cancer surgery in 2006. Twenty-two participants (mean age 46 were included and interviewed between May 2008 and August 2009 in their personal environment. An in-depth analysis (Grounded Theory took place using the Qualitative Analysis Guide of Leuven (Quagol. Results Before the actual RTW, breast cancer employees try to build an image of the future resumption of work based on medical grounds and their knowledge of the workplace. Four matters are considered prior to RTW: (i women want to leave the sick role and wish to keep their job; (ii they consider whether working is worth the effort; (iii they reflect on their capability; and (iv they have doubts about being accepted in the workplace after returning. These inner thoughts are both product and input for the interaction with the social environment. The whole process is coloured by uncertainty and vulnerability. Conclusion Our study demonstrated that mental preparation for RTW is not a linear process of improvement. It shows a detailed picture of four types of considerations made by breast cancer survivors before they actually resume work. Vulnerability appears to be an overarching theme during mental preparation. As the social environment plays an important role, people from that environment must become more aware of their influence on decreasing or increasing a woman’s vulnerability while preparing for RTW.

  12. Clinical aspects and perspectives of erlotinib in the treatment of patients with biliary tract cancer

    Jensen, Lars Henrik

    2016-01-01

    INTRODUCTION: Patients with non-resectable biliary tract cancer have a poor prognosis even if treated with systemic chemotherapy. One hope for improving treatment is through molecular biology and the characterization of specific cancer driving alterations followed by the design of targeted drugs...... of patients benefitting from erlotinib. Until this subgroup has been defined, erlotinib has no value to biliary tract cancer patients in the daily clinic....

  13. When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence.

    Mutsaers, Brittany; Jones, Georden; Rutkowski, Nicole; Tomei, Christina; Séguin Leclair, Caroline; Petricone-Westwood, Danielle; Simard, Sébastien; Lebel, Sophie

    2016-10-01

    Fear of cancer recurrence (FCR) is a common experience for cancer survivors. However, it remains unclear what characteristics differentiate non-clinical from clinical levels of FCR. The goal of this study was to investigate the potential hallmarks of clinical FCR. A convenience sample of 40 participants (n = 19 female) was drawn from another study (Lebel et al. in Qual Life Res 25:311-321. doi: 10.1007/s11136-015-1088-2 , 2016). The semi-structured interview for fear of cancer recurrence (Simard and Savard in J Cancer Surviv 9:481-491. doi: 10.1007/s11764-015-0424-4 , 2015) was used to identify participants with non-clinical and clinical FCR and qualitative analysis of these interviews was performed. Individuals with clinical FCR reported the following features: death-related thoughts, feeling alone, belief that the cancer would return, experiencing intolerance of uncertainty, having cancer-related thoughts and imagery that were difficult to control, daily and recurrent, lasted 30 minutes or more, increased over time, caused distress and impacted their daily life. Triggers of FCR and coping strategies did not appear to be features of clinical FCR as they were reported by participants with a range of FCR scores. While features of clinical FCR found in this analysis such as intrusive thoughts, distress and impact on functioning confirmed previous FCR research, other features spontaneously emerged from the interviews including "death-related thoughts," "feeling alone," and "belief that the cancer will return." The participants' descriptions of cancer-specific fear and worry suggest that FCR is a distinct phenomenon related to cancer survivorship, despite similarities with psychological disorders (e.g., Anxiety Disorders). Future research investigating the construct of FCR, and the distinguishing features of clinical FCR across a range of cancer types and gender is required.

  14. New Horizon of Spiritual Well-Being and Hope among Cancer Patients: A Psychological Aspect

    Liaquat, Sidra; Sultan, Sarwat; Hussain, Irshad

    2013-01-01

    The purpose of this study was to address the importance of spiritual well-being and hope among cancer patients diagnosed with its different stages. Through stratified sampling techniques, 120 cancer patients from four stages evenly divided into male and female participated in this study. Spiritual Well-being Scale (Paloutzian & Ellison, 1982)…

  15. Patient perspectives on delays in diagnosis and treatment of cancer: a qualitative analysis of free-text data.

    Parsonage, Rachel K; Hiscock, Julia; Law, Rebecca-Jane; Neal, Richard D

    2017-01-01

    Earlier cancer diagnosis is crucial in improving cancer survival. The International Cancer Benchmarking Partnership Module 4 (ICBP4) is a quantitative survey study that explores the reasons for delays in diagnosis and treatment of breast, colorectal, lung, and ovarian cancer. To further understand the associated diagnostic processes, it is also important to explore the patient perspectives expressed in the free-text comments. To use the free-text data provided by patients completing the ICBP4 survey to augment the understanding of patients' perspectives of their diagnostic journey. Qualitative analysis of the free-text data collected in Wales between October 2013 and December 2014 as part of the ICBP4 survey. Newly-diagnosed patients with either breast, ovarian, colorectal, or lung cancer were identified from registry data and then invited by their GPs to participate in the survey. A thematic framework was used to analyse the free-text comments provided at the end of the ICBP4 survey. Of the 905 patients who returned a questionnaire, 530 included comments. The free-text data provided information about patients' perspectives of the diagnostic journey. Analysis identified factors that acted as either barriers or facilitators at different stages of the diagnostic process. Some factors, such as screening, doctor-patient familiarity, and private treatment, acted as both barriers and facilitators depending on the context. Factors identified in this study help to explain how existing models of cancer diagnosis (for example, the Pathways to Treatment Model) work in practice. It is important that clinicians are aware of how these factors may interact with individual clinical cases and either facilitate, or act as a barrier to, subsequent cancer diagnosis. Understanding and implementing this knowledge into clinical practice may result in quicker cancer diagnoses. © British Journal of General Practice 2017.

  16. Cancer survivors’ perspectives and experience on western medicine and traditional Chinese medicine treatment and rehabilitation: a qualitative study

    Wang JW

    2014-12-01

    Full Text Available Ji-Wei Wang,1 Zhi-Qi Yang,1 Cong Liu,1 Si-Jia Chen,1 Qian Shen,1 Tian-Rui Zhang,1 Nancy S Partike,2 Zheng-Ping Yuan,3 Jin-Ming Yu1 1School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Shanghai, People’s Republic of China; 2School of Public Health, University of Hawaii at Manoa, Honolulu, HI, USA; 3Shanghai Cancer Rehabilitation Club, Shanghai, People’s Republic of China Background: In the People’s Republic of China, both western medicine (WM and traditional Chinese medicine (TCM are the main treatment and rehabilitation options for cancer patients. This study aimed to explore cancer survivors’ perspectives and experience of treatment and rehabilitation, in order to promote patient-centered activities of treatment and rehabilitation.Methods: Using a qualitative research approach, 68 cancer survivors were recruited from eight community cancer rehabilitation organizations in Shanghai, People’s Republic of China. Eight focus group interviews were conducted. All these interviews were transcribed verbatim, and the data were analyzed by theme analysis.Results: WM was the main choice in treatment phase though study participants noted more side effects. TCM was primarily used in the recovery phase. The lack of communication between doctors and cancer patients appears to affect treatment adherence and impair the doctor–patient relationship. WM was expensive for diagnostic procedures and treatment, while the cumulative costs of frequent use of TCM in the long rehabilitation period were also high. Both treatment options created significant perceived economic burden on patients. Conflicting information about dietary supplements tended to make cancer survivors confused.Conclusion: Improving the communication between doctors and cancer patients helps to ameliorate cancer patient adherence and the effect of treatments. It is essential to educate cancer patients about the effect and cost of both WM and traditional TCM

  17. Controlling liver cancer internationally: A qualitative study of clinicians' perceptions of current public policy needs.

    Bridges, John Fp; Gallego, Gisselle; Blauvelt, Barri M

    2011-07-28

    Liver cancer is the fifth most common cancer in men and the seventh for women. Usually because of late diagnosis, the prognosis for liver cancer remains poor, resulting in liver cancer being the third most common cause of death from cancer. While some countries have treatment guidelines, little is known or understood about the strategies needed for liver cancer control internationally. To explore leading liver cancer clinician's perceptions of the current public policy needs to control liver cancer internationally. Key informant interviews were conducted with a range of liver cancer clinicians involved in policy in eleven countries. Interviews were digitally recorded, transcribed verbatim, translated (where necessary), de-identified and analyzed by two researchers using a constant comparative method. Twenty in-depth semi-structured interviews were conducted in: Australia, China, France, Germany, Italy, Japan, Spain, South Korea, Taiwan, Turkey and the United States. Nine themes were identified and cluster into three groups: 1) Promoting prevention via early risk assessment, focusing on viral hepatitis and other lifestyle factors; 2) Increasing political, public and medical community awareness; and 3) Improving funding for screening, liver cancer surveillance and treatment. This study is an important step towards developing an evidence-based approach to assessing preparedness for implementing comprehensive liver cancer control strategies. Evaluation mechanisms to assess countries' performance on the needs described are needed. Future research will concentrate of understanding how these needs vary across countries and the optimal strategies to improve the diagnosis and prognosis of patients with liver cancer internationally.

  18. Determinants of adherence to recommendations for cancer prevention among Lynch Syndrome mutation carriers : A qualitative exploration

    Visser, Annemiek; Vrieling, Alina; Murugesu, Laxsini; Hoogerbrugge, Nicoline; Kampman, Ellen; Hoedjes, Meeke

    2017-01-01

    Background: Lynch Syndrome (LS) mutation carriers are at high risk for various cancer types, particularly colorectal cancer. Adherence to lifestyle and body weight recommendations for cancer prevention may lower this risk. To promote adherence to these recommendations, knowledge on determinants of

  19. Determinants of adherence to recommendations for cancer prevention among Lynch Syndrome mutation carriers: a qualitative exploration.

    Visser, A.; Vrieling, A.; Murugesu, L.; Hoogerbrugge, N.; Kampman, E.; Hoedjes, M.

    2017-01-01

    Background: Lynch Syndrome (LS) mutation carriers are at high risk for various cancer types, particularly colorectal cancer. Adherence to lifestyle and body weight recommendations for cancer prevention may lower this risk. To promote adherence to these recommendations, knowledge on determinants of

  20. Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research.

    Young, B; Bedford, L; Kendrick, D; Vedhara, K; Robertson, J F R; das Nair, R

    2017-05-09

    This review aimed to better understand experiences of being invited to cancer screening and associated decision-making. Qualitative evidence explaining UK cancer screening attendance decisions was systematically identified. Data were extracted and meta-ethnography used to identify shared themes, synthesize findings and generate higher level interpretations. Thirty-four studies met inclusion criteria. They related to uptake of breast, cervical, colorectal, prostate, ovarian and lung cancer screening. Three primary themes emerged from the synthesis. 'Relationships with the health service' shaped decisions, influenced by trust, compliance with power, resistance to control or surveillance and perceived failures to meet cultural, religious and language needs. 'Fear of cancer screening' was both a motivator and barrier in different ways and to varying degrees. Strategies to negotiate moderate fear levels were evident. 'Experiences of risk' included the creation of alternative personal risk discourses and the use of screening as a coping strategy, influenced by disease beliefs and feelings of health and wellness. The findings highlight the importance of the provider-patient relationship in screening uptake and enrich our understanding of how fear and risk are experienced and negotiated. This knowledge can help promote uptake and improve the effectiveness of cancer screening. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  1. Exploring determinants of care-seeking behaviour of oral cancer patients in India: A qualitative content analysis.

    Rath, Hemamalini; Shah, Swikant; Sharma, Gaurav; Mishra, Ekagrata

    2018-04-01

    A major public health concern in India is the high morbidity and mortality rates of oral cancer because of late diagnosis. Among the several determinants of this late diagnosis, the most important is the healthcare-seeking behaviour of the oral cancer patients. The aim of this study was to explore the care-seeking behaviour and its determinants among oral cancer patients. A face-to-face in-depth interview was conducted among 70 oral cancer patients using a semi-structured questionnaire, and qualitative content analysis of the results was performed. All the patients had squamous-cell carcinoma and none had attended any screening programme. The most common site affected was the buccal mucosa with a non-healing wound. Most of the patients contacted a doctor available nearby; only 7% of patients consulted a dentist. Only one patient approached a traditional healer. The median patient delay was 30 (4-365) days and the professional delay was 40 (4-650) days. Enablers included determinants such as increasing symptoms (80%), influence of the society (74%), fear (10%), and social media (3%). The main barriers were lack of awareness (97%), hope that the lesion will heal spontaneously (90%), lack of perception of seriousness (64%), financial constraints (55%), provider switching (47%), and missed diagnosis (44%). The care-seeking path among oral cancer patients is complex, customised, and influenced by multiple patient-related and system-related factors. Copyright © 2018. Published by Elsevier Ltd.

  2. The Challenges, Emotions, Coping, and Gains of Family Caregivers Caring for Patients With Advanced Cancer in Singapore: A Qualitative Study.

    Leow, Mabel Q H; Chan, Sally W C

    Caring for a family member with advanced cancer at home is demanding as the ill family member is likely to have complex physical and emotional needs. There is a paucity of studies on the experience of home family caregivers of people with advanced cancer in the Asian region. The aim of this study was to describe the experiences of family caregivers caring for a person with advanced cancer at home in Singapore. This was a qualitative study; data were collected by semistructured interviews and analyzed using content analysis. A purposive sample of 19 family caregivers who were taking care of a family member with advanced cancer were recruited from home hospice care services in Singapore. Most of the caregivers were female (n = 14), ranging in age from 21 to 64 years (mean, 46.4 [SD, 10.5] years). Four themes were generated from the data: (1) caregiving challenges, (2) negative emotions, (3) ways of coping, and (4) positive gains of caregiving. This study generated insights into the challenges, emotions, and coping of Asian family caregivers caring for patients with advanced cancer. Such understanding could help in developing appropriate intervention for caregivers to reduce their burden and stress. Caregivers require knowledge on resolving family conflicts and about communicating and enhancing closeness with the ill family member. Support from healthcare professionals is essential even if caregivers have support from family members and friends; nurses can make conscious efforts to show concern for caregivers as well as for patients.

  3. Transition to the new role of caregiving for families of patients with breast cancer: a qualitative descriptive exploratory study.

    Hashemi-Ghasemabadi, Masoumeh; Taleghani, Fariba; Yousefy, Alireza; Kohan, Shahnaz

    2016-03-01

    Families, especially in Eastern and Muslim countries, routinely accept the responsibility of caring for cancer patients. This study describes the transition to the new role of caregiving from the perspective of family caregivers in Iran as part of the current trend of recognizing the experiences of family members of breast cancer patients from different cultural perspectives. A descriptive exploratory qualitative research approach was used to investigate the experiences of family caregivers of patients with breast cancer in the transition to caregiving. The subjects were 23 family caregivers of breast cancer patients referred to cancer centers at Isfahan University hospitals who were selected by purposive sampling. Data was gathered through in-depth interviews. Interview transcripts were analyzed using conventional content analysis with an inductive approach. Data analysis identified the following categories: grasping a new situation without preparation, perceived inefficiency, infinite absence, and abandoned in the role. Caregivers believed that they were not prepared for their new circumstances and did not have the necessary competence and capabilities to meet the challenges of caregiving. They experienced negative consequences resulting from the difficult responsibility of caregiving. Moreover, they believed that they received limited support from relatives, health-care providers, and the community. The transition to the new role of caregiving is affected by experiences specific to the conditions of the caretakers. When these conditions can be understood and identified, it is possible to provide detailed information for policymaking and planning for family-centered care.

  4. Communication difficulties and the experience of loneliness in patients with cancer dealing with fertility issues: a qualitative study.

    Goossens, Joline; Delbaere, Ilse; Beeckman, Dimitri; Verhaeghe, Sofie; Van Hecke, Ann

    2015-01-01

    To explore communication difficulties and the experience of loneliness among patients with cancer dealing with fertility issues. Qualitative study based on grounded theory principles. One university hospital and two general hospitals in Flanders, Belgium. 21 female and 7 male patients with cancer with potential fertility problems as a result of treatment. Grounded theory approach using the constant comparison method; data collection (semistructured face-to-face interviews) and analysis occurred simultaneously. Loneliness was a central theme in the experience of potential fertility loss among patients with cancer. Feelings of loneliness resulted from communication difficulties between the patient and members of his or her social environment or healthcare professionals because of several underlying processes and influencing factors. Loneliness was a strong and common feeling among patients with cancer. Patients, members of their social environment, and healthcare professionals experienced difficulties in communicating about fertility in the context of cancer, leading to patients' feelings of loneliness. Healthcare professionals must be attentive to signs indicating loneliness regarding fertility concerns, and they should provide adequate information and appropriate guidance to support patients. Professionals need further training to improve knowledge and skills.

  5. Coping with changes and uncertainty: A qualitative study of young adult cancer patients' challenges and coping strategies during treatment.

    Lie, Nataskja-Elena Kersting; Larsen, Torill Marie Bogsnes; Hauken, May Aasebø

    2017-07-31

    Young adult cancer patients (YACPs), aged 18-35 years when diagnosed with cancer, are in a vulnerable transitioning period from adolescence to adulthood, where cancer adds a tremendous burden. However, YACPs' challenges and coping strategies are under-researched. The objective of this study was to explore what challenges YACP experience during their treatment, and what coping strategies they applied to them. We conducted a qualitative study with a phenomenological-hermeneutic design, including retrospective, semi-structured interviews of 16 YACPs who had undergone cancer treatment. Data were analysed using thematic analysis and interpreted applying the Cognitive Activation Theory of Stress (CATS). We found "coping with changes and uncertainty" as overarching topic for YACPs' challenges, particularly related to five themes, including (1) receiving the diagnosis, (2) encountering the healthcare system, (3) living with cancer, (4) dealing with the impact of the treatment and (5) reactions from the social network. YACPs' coping strategies applied to these challenges varied broadly and ranged from maladaptive strategies, such as neglecting the situation, to conducive emotional or instrumental approaches to manage their challenges. The findings call for age-specific needs assessments, information and support for YACPs, and their families in order to facilitate YACPs' coping during their treatment. © 2017 John Wiley & Sons Ltd.

  6. Important aspects in relation to patients' attendance at exercise-based cardiac rehabilitation - facilitators, barriers and physiotherapist's role: a qualitative study.

    Bäck, Maria; Öberg, Birgitta; Krevers, Barbro

    2017-03-14

    In order to improve attendance at exercise-based cardiac rehabilitation (CR), a greater insight into patients' perspectives is necessary. The aim of the study was to explore aspects that influence patients' attendance at exercise-based CR after acute coronary artery disease (CAD) and the role of the physiotherapist in patients' attendance at exercise-based CR. A total of 16 informants, (5 women; median age 64.5, range 47-79 years), diagnosed with CAD, were included in the study at the Cardiology Department, Linköping University Hospital, Sweden. Qualitative interviews were conducted and analysed according to inductive content analysis. Four main categories were identified: (i) previous experience of exercise, (ii) needs in the acute phase, (iii) important prerequisites for attending exercise-based CR and (iv) future ambitions. The categories demonstrate that there are connections between the past, the present and the future, in terms of attitudes to facilitators, barriers and the use of strategies for managing exercise. An overall theme, defined as existential thoughts, had a major impact on the patients' attitudes to attending exercise-based CR. The interaction and meetings with the physiotherapists in the acute phase were described as important factors for attending exercise-based CR. Moreover, informants could feel that the physiotherapists supported them in learning the right level of effort during exercise and reducing the fear of exercise. This study adds to previous knowledge of barriers and facilitators for exercise-based CR that patients with CAD get existential thoughts both related to exercise during the rehabilitation process and for future attitudes to exercise. This knowledge might necessitate greater attention to the physiotherapist-patient interaction. To be able to tailor exercise-based CR for patients, physiotherapists need to be aware of patients' past experiences of exercise and previous phases of the rehabilitation process as these are

  7. Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress: a qualitative study.

    Lam, W W T; Yoon, S W; Sze, W K; Ng, A W Y; Soong, I; Kwong, A; Suen, D; Tsang, J; Yeo, W; Wong, K Y; Fielding, R

    2017-02-01

    Most women with advanced breast cancer (ABC) show little distress, but about one in ten show persistent distress over time. It remains unclear if meanings ascribed by patients to ABC differentiate these distress trajectories. This qualitative study (a) compared illness meanings of ABC between women with persistent psychological distress and those with low/transient distress, and (b) examined how illness meanings might influence coping strategies. The sample was drawn from a prior quantitative study exploring psychological distress trajectories following ABC diagnosis. Overall, 42 Cantonese- or Mandarin-speaking Chinese women diagnosed with locally advanced or metastatic ABC were recruited based on their distress trajectory status (low-stable, transient, or persistent distress). Interviews were recorded, transcribed, and analyzed following grounded theory approach using simultaneous analysis. Women with persistent distress viewed their diagnosis as another blow in life, the illness was global, permeating every aspect of their life. Maladaptive rumination and thought suppression were common responses to illness demands. These women had poor social support. A sense of demoralization stood out in their narratives. In contrast, women with transient/low-stable distress encapsulated the illness, with minimum impacts of their life. They did not evidence dysfunctional repetitive thoughts. Living in a supportive environment, they were able to accept and/or live in the present-moment. Rumination, thought suppression, social constraints, and pre-existing exposure to life stress may be potential risks for chronic distress in response to advanced breast cancer. Persistent and transient distress responses to cancer may have different underpinnings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Young female cancer patients? experiences with fertility counselling and fertility preservation?a qualitative small-scale study within the Danish health care setting

    Hoeg, Didde; Schmidt, Lone; Macklon, Kirsten T.

    2016-01-01

    Introduction Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment in the public Danish health care system. Methods Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselli...

  9. Women’s Satisfaction with Genetic Counseling for Hereditary Breast-Ovarian Cancer: Psychological Aspects

    Tercyak, Kenneth P.; DeMarco, Tiffani A.; Mars, Bryn D.; Peshkin, Beth N.

    2004-01-01

    Women who participate in BRCA1/2 cancer genetic counseling do so for a variety of reasons, including learning quantitative risk information about their chances of developing hereditary breast-ovarian cancer at some point during their lifetimes. For these women, obtaining pre-test and disclosure genetic counseling with a professional affords them numerous potential benefits, including adequate preparation for, and accurate interpretation of, their test results. In consequence, women commonly r...

  10. Patient navigation pathway and barriers to treatment seeking in cancer in India: a qualitative inquiry.

    Pati, Sanghamitra; Hussain, Mohammad Akhtar; Chauhan, Abhimanyu Singh; Mallick, Diptimayee; Nayak, Sukdev

    2013-12-01

    Cancer is a leading cause of mortality worldwide. Early diagnosis and treatment of cancer may curb the growing burden of the disease. Understanding cancer patients' navigation pathways for seeking treatment is important in order to facilitate early diagnosis and treatment. With this background we conducted a hospital-based cross-sectional study comprising 68 randomly selected cancer inpatients in a tertiary cancer specialty hospital in Odisha, India, to explore the treatment-seeking pathways of the cancer patients and the barriers and enablers in seeking treatment. Financial constraint is one of the major reasons for the delay in accessing treatment, even when patients are suspected of or diagnosed with cancer. Low awareness of the presenting signs and symptoms of cancer and limited knowledge of the availability of cancer diagnosis and treatment facilities are major factors contributing to delay. Family and friends' support is found to be the major enabling factor toward seeking treatment. Generation of awareness of cancer among the general population and primary-care practitioners - including those in alternative systems of medicine - is important. Information on diagnostic and treatment services appears to be a felt need. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Level of Awareness of Various Aspects of Lung Cancer Among College Teachers in India: Impact of Cancer Awareness Programmes in Prevention and Early Detection.

    Shankar, Abhishek; Roy, Shubham; Malik, Abhidha; Rath, G K; Julka, P K; Kamal, Vineet Kumar; Barnwal, Keshav; Upadhyaya, Sneha; Singh, Rajan; Srivastava, Vivek

    2016-12-01

    Lung cancer is one of the most common causes of cancer mortality among men in India and incidence is increasing, but actually, they are largely preventable diseases. In India, advanced stage at the time of presentation is responsible for high mortality and morbidity and early detection is the only way to reduce it. The purpose of this study is to know the level of awareness of various aspects of lung cancer among college teachers and impact of awareness programmes in its prevention and early detection. This assessment was part of Pink Chain Campaign-a campaign on cancer awareness. During the cancer awareness events in 2011-2013 at various women colleges in different parts in India, pre-test related to lung cancer was followed by awareness programme. Post-test using the same questionnaire was conducted at the end of interactive session, at 6 months and 1 year. A total of 872 out of 985 teachers participated in the study (overall response rate was 88.5 %). Mean age of the study population was 41.6 years (range 26-59 years). There was a significant increase in the level of knowledge regarding lung cancer at 6 months, and this was sustained at 1 year. Among teachers who were just asked yes or no question, 117 teachers (13.4 %) were smokers and 241 teachers (27.6 %) were alcoholics. Magazines and newspapers were sources for knowledge in 50-60 % of teachers, whereas approximately 30 % of teachers were educated by TV and Internet regarding various aspects of lung cancer. Post awareness at 6 months and 1 year, Pink Chain Campaign was the major source of knowledge related to lung cancer in more than 90 % of teachers by continuous and timely update on subject. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not going for check-up were ignorance (83.1 %), fear (30.1 %) and lethargic attitude (29.3 %) initially, but over time, lack of time, lethargic attitude and hesitation became

  12. The use of purposeful sampling in a qualitative evidence synthesis: A worked example on sexual adjustment to a cancer trajectory.

    Benoot, Charlotte; Hannes, Karin; Bilsen, Johan

    2016-02-18

    An increasing number of qualitative evidence syntheses papers are found in health care literature. Many of these syntheses use a strictly exhaustive search strategy to collect articles, mirroring the standard template developed by major review organizations such as the Cochrane and Campbell Collaboration. The hegemonic idea behind it is that non-comprehensive samples in systematic reviews may introduce selection bias. However, exhaustive sampling in a qualitative evidence synthesis has been questioned, and a more purposeful way of sampling papers has been proposed as an alternative, although there is a lack of transparency on how these purposeful sampling strategies might be applied to a qualitative evidence synthesis. We discuss in our paper why and how we used purposeful sampling in a qualitative evidence synthesis about 'sexual adjustment to a cancer trajectory', by giving a worked example. We have chosen a mixed purposeful sampling, combining three different strategies that we considered the most consistent with our research purpose: intensity sampling, maximum variation sampling and confirming/disconfirming case sampling. The concept of purposeful sampling on the meta-level could not readily been borrowed from the logic applied in basic research projects. It also demands a considerable amount of flexibility, and is labour-intensive, which goes against the argument of many authors that using purposeful sampling provides a pragmatic solution or a short cut for researchers, compared with exhaustive sampling. Opportunities of purposeful sampling were the possible inclusion of new perspectives to the line-of-argument and the enhancement of the theoretical diversity of the papers being included, which could make the results more conceptually aligned with the synthesis purpose. This paper helps researchers to make decisions related to purposeful sampling in a more systematic and transparent way. Future research could confirm or disconfirm the hypothesis of conceptual

  13. The use of purposeful sampling in a qualitative evidence synthesis: A worked example on sexual adjustment to a cancer trajectory

    Charlotte Benoot

    2016-02-01

    Full Text Available Abstract Background An increasing number of qualitative evidence syntheses papers are found in health care literature. Many of these syntheses use a strictly exhaustive search strategy to collect articles, mirroring the standard template developed by major review organizations such as the Cochrane and Campbell Collaboration. The hegemonic idea behind it is that non-comprehensive samples in systematic reviews may introduce selection bias. However, exhaustive sampling in a qualitative evidence synthesis has been questioned, and a more purposeful way of sampling papers has been proposed as an alternative, although there is a lack of transparency on how these purposeful sampling strategies might be applied to a qualitative evidence synthesis. We discuss in our paper why and how we used purposeful sampling in a qualitative evidence synthesis about ‘sexual adjustment to a cancer trajectory’, by giving a worked example. Methods We have chosen a mixed purposeful sampling, combining three different strategies that we considered the most consistent with our research purpose: intensity sampling, maximum variation sampling and confirming/disconfirming case sampling. Results The concept of purposeful sampling on the meta-level could not readily been borrowed from the logic applied in basic research projects. It also demands a considerable amount of flexibility, and is labour-intensive, which goes against the argument of many authors that using purposeful sampling provides a pragmatic solution or a short cut for researchers, compared with exhaustive sampling. Opportunities of purposeful sampling were the possible inclusion of new perspectives to the line-of-argument and the enhancement of the theoretical diversity of the papers being included, which could make the results more conceptually aligned with the synthesis purpose. Conclusions This paper helps researchers to make decisions related to purposeful sampling in a more systematic and transparent way

  14. An Avalanche of Ignoring-A Qualitative Study of Health Care Avoidance in Women With Malignant Breast Cancer Wounds

    Lund-Nielsen, Betina; Midtgaard, Julie; Rørth, Mikael

    2011-01-01

    BACKGROUND:: A contributing factor to development of malignant wounds is patient-related delay caused by health care avoidance. OBJECTIVE:: The purpose of this study was to describe the experience of health care avoidance in women with advanced breast cancer who have developed malignant wounds....... METHODS:: A qualitative study was conducted based on semistructured interviews. Seventeen women with advanced breast cancer (median age, 69 years; range, 47-90 years) who had avoided medical treatment despite development of malignant wounds participated. Systematic text-condensation analysis was used....... RESULTS:: The women deliberately avoided health care for a median of 24 months (minimum, 3 months; maximum, 84 months). Despite being aware of the development of a malignant wound from a breast lump, the women avoided health care because of negative health care experiences and extremely burdening life...

  15. Impact of cancer on employment: A qualitative study exploring employment changes and financial coping strategies following breast cancer

    Yek-Ching Kong

    2017-12-01

    Full Text Available Background: Few studies have examined the impact of cancer diagnosis on employment among breast cancer patients. We aim to gain an in-depth understanding on the employment issues faced by breast cancer patients as well as their financial coping strategies in a multi-ethnic Asian setting. Methods: Six focus group discussions (FGDs were carried out with breast cancer patients, representing various ethnicities and socioeconomic backgrounds, who were recruited from Hospital Kuala Lumpur, a public hospital, and University Malaya Medical Centre, a public academic hospital. All FGDs were audio recorded and transcribed verbatim. Thematic content analysis was carried out using the NVivo software. Results: Majority of breast cancer patients quitted their jobs upon diagnosis of breast cancer, with many describing that their bosses were not understanding in terms of their cancer diagnosis. Those who were self-employed meanwhile reported less productivity. Patterns of financial coping strategies due to employment changes were diverse. Some patients chose to do light weight part time jobs, while others described the important role of husbands and relatives in coping with income loss. There were mixed responses regarding return to work, in which money was the major reason to return to work, while stress was cited as a barrier to not return to work. However, many reported barriers in finding a job after cancer due to discrimination against their cancer and their age. Conclusion: It is evident that a breast cancer diagnosis brings about adverse impact on employment. Multidisciplinary interventions are urgently required in Malaysia to improve the employment status of our cancer survivors including legislative reforms to prevent discrimination. This study was funded by AIA Bhd. NMRR ID: NMRR-16-2054-32802 

  16. Fighting for life: a qualitative analysis of the process of psychotherapy-assisted self-help in patients with metastatic cancer.

    Cunningham, Alastair J; Phillips, Catherine; Stephen, Joanne; Edmonds, Claire

    2002-06-01

    This exploratory study is an attempt to define psychological attributes related to longer survival in patients with metastatic cancers. Previous published analyses have been limited in two ways. First, they have almost always been carried out on patients not receiving therapy; we have followed people receiving a year of group therapy, on the assumption that if mental qualities are to affect cancer progression, substantial mental change would be needed to alter the established balance between the cancer cells and host regulatory mechanisms. Second, the methods typically used to characterize patients' psychology have been self-report inventories, and many decades of research with such methods have largely failed to produce a consensus on what mental qualities, if any, promote survival. By contrast, we have used qualitative methods, allowing a much more in-depth analysis of the patients, without preliminary assumptions as to what would be important. The present report describes the results of a detailed qualitative analysis of data collected from 22 participants over a year of weekly group therapy. Using grounded methods, categories were derived from the extensive verbal data (comprising patients' written homework and therapists' notes), and linked in a model of change. By applying ratings to some of these categories, and combining these ratings, we derived a quantitative estimate of patients' "involvement in self-help." Rankings on degree of involvement corresponded quite closely with the quality of patients' experience and with their survival duration. There was a great range in degree of involvement, and various subgroupings could be discerned. Nine of the participants were classed as "highly involved," meaning that they devoted regular daily time, often several hours, to such self-help strategies as relaxation, mental imaging, meditation, cognitive monitoring and journalling. All but 1 of these patients enjoyed a good quality of life and lived at least 2 years

  17. Controlling liver cancer internationally: A qualitative study of clinicians' perceptions of current public policy needs

    Bridges John FP

    2011-07-01

    Full Text Available Abstract Background Liver cancer is the fifth most common cancer in men and the seventh for women. Usually because of late diagnosis, the prognosis for liver cancer remains poor, resulting in liver cancer being the third most common cause of death from cancer. While some countries have treatment guidelines, little is known or understood about the strategies needed for liver cancer control internationally. Objective To explore leading liver cancer clinician's perceptions of the current public policy needs to control liver cancer internationally. Methods Key informant interviews were conducted with a range of liver cancer clinicians involved in policy in eleven countries. Interviews were digitally recorded, transcribed verbatim, translated (where necessary, de-identified and analyzed by two researchers using a constant comparative method. Results Twenty in-depth semi-structured interviews were conducted in: Australia, China, France, Germany, Italy, Japan, Spain, South Korea, Taiwan, Turkey and the United States. Nine themes were identified and cluster into three groups: 1 Promoting prevention via early risk assessment, focusing on viral hepatitis and other lifestyle factors; 2 Increasing political, public and medical community awareness; and 3 Improving funding for screening, liver cancer surveillance and treatment. Conclusion This study is an important step towards developing an evidence-based approach to assessing preparedness for implementing comprehensive liver cancer control strategies. Evaluation mechanisms to assess countries' performance on the needs described are needed. Future research will concentrate of understanding how these needs vary across countries and the optimal strategies to improve the diagnosis and prognosis of patients with liver cancer internationally.

  18. Living with Metastatic Breast Cancer: A Qualitative Analysis of Physical, Psychological, and Social Sequelae

    Mosher, Catherine E.; Johnson, Courtney; Dickler, Maura; Norton, Larry; Massie, Mary Jane; DuHamel, Katherine

    2013-01-01

    Women with metastatic breast cancer face a wide range of medical, practical, and emotional challenges that impact their quality of life. Research to date, however, has not focused on the quality-of-life concerns of metastatic breast cancer patients with significant distress. The present study examined a range of concerns among distressed metastatic breast cancer patients, including physical and emotional distress, social functioning, and existential issues. Forty-four distressed women with me...

  19. Qualitative Improvement Methods Through Analysis of Inquiry Contents for Cancer Registration

    Boo, Yoo-Kyung; Lim, Hyun-Sook; Kim, Jung-Eun; Kim, Kyoung-Beom; Won, Young-Joo

    2017-06-25

    Background: In Korea, the national cancer database was constructed after the initiation of the national cancer registration project in 1980, and the annual national cancer registration report has been published every year since 2005. Consequently, data management must begin even at the stage of data collection in order to ensure quality. Objectives: To determine the suitability of cancer registries’ inquiry tools through the inquiry analysis of the Korea Central Cancer Registry (KCCR), and identify the needs to improve the quality of cancer registration. Methods: Results of 721 inquiries to the KCCR from 2000 to 2014 were analyzed by inquiry year, question type, and medical institution characteristics. Using Stata version 14.1, descriptive analysis was performed to identify general participant characteristics, and chi-square analysis was applied to investigate significant differences in distribution characteristics by factors affecting the quality of cancer registration data. Results: The number of inquiries increased in 2005–2009. During this period, there were various changes, including the addition of cancer registration items such as brain tumors and guideline updates. Of the inquirers, 65.3% worked at hospitals in metropolitan cities and 60.89% of hospitals had 601–1000 beds. Tertiary hospitals had the highest number of inquiries (64.91%), and the highest number of questions by type were 353 (48.96%) for histological codes, 92 (12.76%) for primary sites, and 76 (10.54%) for reportable. Conclusions: A cancer registration inquiry system is an effective method when not confident about codes during cancer registration, or when confronting cancer cases in which previous clinical knowledge or information on the cancer registration guidelines are insufficient. Creative Commons Attribution License

  20. Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study

    Gele AA

    2017-07-01

    Full Text Available Abdi A Gele,1,2 Samera A Qureshi,1 Prabhjot Kour,1 Bernadette Kumar,1 Esperanza Diaz1,3 1Norwegian Center for Minority Health Research, 2Department of Health, Institute of Nursing and Health Promotion, Oslo and Akershus University College, Oslo; 3Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Abstract: Norway has a low incidence and mortality rate of cervical cancer, which is mainly due to the high participation rate of women in cervical cancer screening. However, the attendance of cervical cancer screening was reported to be low among immigrant women. For this reason, we conducted a qualitative study to obtain better insight into perceived barriers and challenges to cervical cancer screening among Somali and Pakistani women in the Oslo region. A convenient sample of 35 (18 Pakistani, 17 Somali women were recruited for the study in collaboration with Somali and Pakistani community partners. Focus group discussions were used to explore barriers and facilitators to cervical cancer screening, whereas the Ecological Model was used as the framework for the study. The study found three levels of barriers to cervical cancer screening. The individual level included a lack of understanding of the benefits of the screening. The sociocultural level included the stigma attached to the disease and the belief that women who are unmarried are sexually inactive. The system-related level included a lack of trust toward the health care system. Based on the study results, and using a common denominator approach for the immigrant groups included, the study recommends three communication strategies with the potential to improve women’s participation in cervical cancer screening: 1 in-person communication and information material at health centers; 2 verbal communication with women through seminars and workshops to educate them about their risk of cancer and the importance of screening and 3 the initiation of better recall

  1. Improving access to supportive cancer care through an eHealth application: a qualitative needs assessment among cancer survivors.

    Lubberding, S.; van Uden-Kraan, C.F.; te Velde, E.A.; Cuijpers, P.; Leemans, C.R.; Verdonck-de Leeuw, I.M.

    2015-01-01

    Aims and objectives: To gain insight into cancer survivors' needs towards an eHealth application monitoring quality of life and targeting personalised access to supportive care. Background: Supportive care in cancer addresses survivors' concerns and needs. However, many survivors are not taking

  2. Psychological aspects of patients with breast cancer depending on the presence of visible postoperative defect

    A. D. Zikiryakhodzhaev

    2015-01-01

    Full Text Available Objective. The study of coping behavior of patients with breast cancer (I, II stages in the postoperative period with «externally visible postoperative defect".Materials and methods. We studied the psychological characteristics of 35 patients with breast cancer (I, II stage, who underwent radical mastectomy, women were characterized in the postoperative period as "externally visible postoperative defect" ("e.v.p.d.", 35 patients with breast cancer (I, II stage who underwent ablative and reconstructive plastic surgery, women were characterized in the postoperative period as "without an externally visible postoperative defect" ("without an e.v.p.d.".The results and conclusions. The results of the study of women in both groups indicate that the patients are moderately using coping strategies for coping with the disease, preferring the strategy of "problem resolution" and "search of social support". Patients with breast cancer "with externally visible postoperative defect in comparing with patients with breast cancer "without an externally visible postoperative defect" often use positive religious coping in coping with the disease. The group of women with «externally visible postoperative defect" usually operate with negative religious coping. Both groups of women focused on the perception of social support. In a greater degree of social support they perceive from family and significant for them. Women with breast cancer and "externally visible postoperative defect” compared with women “without an externally visible postoperative defect" are not satisfied with your opportunities, have a feeling of weakness, doubt ability to evoke respect, sympathy, understanding and approval from others. They seek to change, doubt their self-worth, willing to put themselves in the guilt of their mistakes, failures, have low self-esteem. The group of patients with breast cancer "with externally visible postoperative defect" has an external locus of control

  3. Cancer and the LGBTQ Population: Quantitative and Qualitative Results from an Oncology Providers' Survey on Knowledge, Attitudes, and Practice Behaviors.

    Tamargo, Christina L; Quinn, Gwendolyn P; Sanchez, Julian A; Schabath, Matthew B

    2017-10-07

    Despite growing social acceptance, the LGBTQ population continues to face barriers to healthcare including fear of stigmatization by healthcare providers, and providers' lack of knowledge about LGBTQ-specific health issues. This analysis focuses on the assessment of quantitative and qualitative responses from a subset of providers who identified as specialists that treat one or more of the seven cancers that may be disproportionate in LGBTQ patients. A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. Oncology providers specializing in seven cancer types had poor knowledge of LGBTQ-specific health needs, with fewer than half of the surveyed providers (49.5%) correctly answering knowledge questions. Most providers had overall positive attitudes toward LGBTQ patients, with 91.7% agreeing they would be comfortable treating this population, and would support education and/or training on LGBTQ-related cancer health issues. Results suggest that despite generally positive attitudes toward the LGBTQ population, oncology providers who treat cancer types most prevalent among the population, lack knowledge of their unique health issues. Knowledge and practice behaviors may improve with enhanced education and training on this population's specific needs.

  4. Cancer and the LGBTQ Population: Quantitative and Qualitative Results from an Oncology Providers’ Survey on Knowledge, Attitudes, and Practice Behaviors

    Christina L. Tamargo

    2017-10-01

    Full Text Available Background: Despite growing social acceptance, the LGBTQ population continues to face barriers to healthcare including fear of stigmatization by healthcare providers, and providers’ lack of knowledge about LGBTQ-specific health issues. This analysis focuses on the assessment of quantitative and qualitative responses from a subset of providers who identified as specialists that treat one or more of the seven cancers that may be disproportionate in LGBTQ patients. Methods: A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. Results: Oncology providers specializing in seven cancer types had poor knowledge of LGBTQ-specific health needs, with fewer than half of the surveyed providers (49.5% correctly answering knowledge questions. Most providers had overall positive attitudes toward LGBTQ patients, with 91.7% agreeing they would be comfortable treating this population, and would support education and/or training on LGBTQ-related cancer health issues. Conclusion: Results suggest that despite generally positive attitudes toward the LGBTQ population, oncology providers who treat cancer types most prevalent among the population, lack knowledge of their unique health issues. Knowledge and practice behaviors may improve with enhanced education and training on this population’s specific needs.

  5. Cancer and the LGBTQ Population: Quantitative and Qualitative Results from an Oncology Providers’ Survey on Knowledge, Attitudes, and Practice Behaviors

    Tamargo, Christina L.; Sanchez, Julian A.

    2017-01-01

    Background: Despite growing social acceptance, the LGBTQ population continues to face barriers to healthcare including fear of stigmatization by healthcare providers, and providers’ lack of knowledge about LGBTQ-specific health issues. This analysis focuses on the assessment of quantitative and qualitative responses from a subset of providers who identified as specialists that treat one or more of the seven cancers that may be disproportionate in LGBTQ patients. Methods: A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. Results: Oncology providers specializing in seven cancer types had poor knowledge of LGBTQ-specific health needs, with fewer than half of the surveyed providers (49.5%) correctly answering knowledge questions. Most providers had overall positive attitudes toward LGBTQ patients, with 91.7% agreeing they would be comfortable treating this population, and would support education and/or training on LGBTQ-related cancer health issues. Conclusion: Results suggest that despite generally positive attitudes toward the LGBTQ population, oncology providers who treat cancer types most prevalent among the population, lack knowledge of their unique health issues. Knowledge and practice behaviors may improve with enhanced education and training on this population’s specific needs. PMID:28991160

  6. Institutional (mis)trust in colorectal cancer screening: a qualitative study with Greek, Iranian, Anglo-Australian and Indigenous groups.

    Ward, Paul R; Coffey, Cushla; Javanparast, Sara; Wilson, Carlene; Meyer, Samantha B

    2015-12-01

    Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups - Anglo-Australian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation. © 2014 John Wiley & Sons Ltd.

  7. Patients with pancreatic cancer and relatives talk about preferred place of death and what influenced their preferences: a qualitative study.

    Chapple, Alison; Evans, Julie; McPherson, Ann; Payne, Sheila

    2011-12-01

    To explore reasons why people with pancreatic cancer, who are reaching the end of their lives, say they wish to die at home or elsewhere, and why preferences may change. Qualitative study using semistructured interviews followed by thematic analysis. Respondents recruited from different parts of the UK during 2009/2010. 16 people with experience of pancreatic cancer (8 patients and 8 bereaved relatives) who discussed place of death in detail during an in-depth interview (from a total sample of 32 people with pancreatic cancer and eight relatives of others who had died of this disease). People's preferences were affected by their perceptions and previous experiences of care available at home, in a hospice or hospital. Preferences were also shaped by fears about possible loss of dignity, or fears of becoming a burden. Some people thought that a home death might leave bad memories for other members of the family. People with pancreatic cancer and their relatives were aware that preferences might change (or had changed) as death approached. The National Health Service End of Life Care Strategy for England seeks to meet the needs of people who are dying and promotes better support for home deaths. More information is needed about why patients hold different views about place of care and place of death, why patients' preferences change and what importance patients attach to place of death. Health professionals should bear this in mind if the subject is raised during advance care planning.

  8. Qualitative and quantitative expression status of the human chromosome 20 genes in cancer tissues and the representative cell lines.

    Wang, Quanhui; Wen, Bo; Yan, Guangrong; Wei, Junying; Xie, Liqi; Xu, Shaohang; Jiang, Dahai; Wang, Tingyou; Lin, Liang; Zi, Jin; Zhang, Ju; Zhou, Ruo; Zhao, Haiyi; Ren, Zhe; Qu, Nengrong; Lou, Xiaomin; Sun, Haidan; Du, Chaoqin; Chen, Chuangbin; Zhang, Shenyan; Tan, Fengji; Xian, Youqi; Gao, Zhibo; He, Minghui; Chen, Longyun; Zhao, Xiaohang; Xu, Ping; Zhu, Yunping; Yin, Xingfeng; Shen, Huali; Zhang, Yang; Jiang, Jing; Zhang, Chengpu; Li, Liwei; Chang, Cheng; Ma, Jie; Yan, Guoquan; Yao, Jun; Lu, Haojie; Ying, Wantao; Zhong, Fan; He, Qing-Yu; Liu, Siqi

    2013-01-04

    Under the guidance of the Chromosome-centric Human Proteome Project (C-HPP), (1, 2) we conducted a systematic survey of the expression status of genes located at human chromosome 20 (Chr.20) in three cancer tissues, gastric, colon, and liver carcinoma, and their representative cell lines. We have globally profiled proteomes in these samples with combined technology of LC-MS/MS and acquired the corresponding mRNA information upon RNA-seq and RNAchip. In total, 323 unique proteins were identified, covering 60% of the coding genes (323/547) in Chr.20. With regards to qualitative information of proteomics, we overall evaluated the correlation of the identified Chr.20 proteins with target genes of transcription factors or of microRNA, conserved genes and cancer-related genes. As for quantitative information, the expression abundances of Chr.20 genes were found to be almost consistent in both tissues and cell lines of mRNA in all individual chromosome regions, whereas those of Chr.20 proteins in cells are different from tissues, especially in the region of 20q13.33. Furthermore, the abundances of Chr.20 proteins were hierarchically evaluated according to tissue- or cancer-related distribution. The analysis revealed several cancer-related proteins in Chr.20 are tissue- or cell-type dependent. With integration of all the acquired data, for the first time we established a solid database of the Chr.20 proteome.

  9. Exploring perceptions and preferences of patients, families, physicians, and nurses regarding cancer disclosure: a descriptive qualitative study.

    Abazari, Parvaneh; Taleghani, Fariba; Hematti, Simin; Ehsani, Maryam

    2016-11-01

    The aim of this study was to explore perceptions and preferences of cancer patients, their families, physicians, and nurses in disclosing cancer diagnosis. We selected 35 participants (15 patients, 6 family members, 9 physicians, and 5 nurses) by purposive sampling. We collected data by in-depth interviews and used qualitative content analysis for analysis. Data analysis resulted in three categories: (1) establishing a basis for breaking bad news; (2) adjusting to the tragedy of bad news; and (3) helping the patient cope with the shattering news. The first category comprised the following subcategories: provision of proper background; adhering to a patient-centered approach; and being unhurried. The second category comprised the following subcategories: cancer as a cultural taboo; death as a frightening vision of unattainable dreams and punishment; hope as an opening in the utter darkness of disease; and empathy as liniment for the injuries of disease. The third category comprised the following subcategories: the family as the most powerful healing source for the patient; the force of spirituality in achieving peace; and a multiprofessional, harmonious physician-centered team. The findings of this study can help healthcare teams break the bad news of cancer diagnosis in a more effective, satisfactory, and culture-based manner for patients and their families.

  10. Mechanisms that contribute to the tendency to continue chemotherapy in patients with advanced cancer. Qualitative observations in the clinical setting.

    Brom, Linda; Onwuteaka-Philipsen, Bregje D; Widdershoven, Guy A M; Pasman, H Roeline W

    2016-03-01

    The study aims to describe mechanisms that contribute to the tendency towards continuing chemotherapy in patients with advanced cancer. The study conducted qualitative observations of outpatient clinic visits of 28 patients with advanced cancer (glioblastoma and metastatic colorectal cancer). We uncovered four mechanisms in daily oncology practice that can contribute to the tendency towards continuing chemotherapy in patients with advanced cancer: (1) "presenting the full therapy sets the standard"--patients seemed to base their justification for continuing chemotherapy on the "standard" therapy with the maximum number of cycles as presented by the physician at the start of the treatment; (2) "focus on standard evaluation moments hampers evaluation of care goals"--whether or not to continue the treatment was mostly only considered at standard evaluation moments; (3) "opening question guides towards focus on symptoms"--most patients gave an update of their physical symptoms in answer to the opening question of "How are you doing?" Physicians consequently discussed how to deal with this at length, which often took up most of the visit; (4) "treatment is perceived as the only option"--patients mostly wanted to continue with chemotherapy because they felt that they had to try every available option the physician offered. Physicians also often seemed to focus on treatment as the only option. Discussing care goals more regularly with the patient, facilitated for instance by implementing early palliative care, might help counter the mechanisms and enable a more well-considered decision. This could be either stopping or continuing chemotherapy.

  11. Quantitative aspects of radon daughter exposure and lung cancer in underground miners

    Edling, C.; Axelson, O.

    1983-01-01

    Epidemiological studies have shown an excessive incidence of lung cancer in miners with exposure to radon daughters. The various risk estimates have ranged from six to 47 excess cases per 10 6 person years and working level month, but the effect of smoking has not been fully evaluated. A group of iron ore miners was studied in an attempt to obtain quantitative information about the risk of lung cancer due to radon and its daughters among smoking and non-smoking miners. The results show a considerable risk for miners to develop lung cancer; even non-smoking miners seem to be at a rather high risk. An additive effect of smoking and exposure to radon daughters is indicated and an estimate of about 30-40 excess cases per 10 6 person years and working level month seems to apply on a life time basis to both smoking and non-smoking miners aged over 50. (author)

  12. Endometriosis and Ovarian Cancer: A Review of Clinical, Pathologic, and Molecular Aspects

    Wei, Jian-Jun; William, Josette; Bulun, Serdar

    2014-01-01

    Summary Endometriosis is a chronic disease that affects millions of reproductive-age women. Despite the destructive and invasive nature of endometrioses, most cases are perpetually benign or eventually regress; however, atypical endometriosis is a precursor lesion and can lead to certain types of ovarian cancer. Endometriosis induced inflammation and auto- and paracrine production of sex steroid hormones contribute to ovarian tumorigenesis. These changes provide microenvironment necessary to accumulate enough genetic alterations for endometriosis associated malignant transformation. It takes years for endometriosis to undergo the pathophysiological progression that begins with atypical epithelial proliferation (atypical endometriosis and metaplasia), and then is followed by the formation of well-defined borderline tumors, and finally culminates in fully malignant ovarian cancer. This study is a review of the natural history of endometriosis and the role of microenvironments that favor the accumulation of genetic alterations and endometriosis-associated ovarian cancer progression. PMID:21979592

  13. Do spiritual patients want spiritual interventions?: A qualitative exploration of underserved cancer patients' perspectives on religion and spirituality.

    Stein, Emma M; Kolidas, Evelyn; Moadel, Alyson

    2015-02-01

    This study examines religion and spirituality among advanced cancer patients from an underserved, ethnically-diverse population by exploring patient conceptualizations of religion and spirituality, the role of religion and spirituality in coping with cancer, and patient interest in spiritual support. Qualitative semi-structured interviews were conducted with patients who had participated in a study of a "mind-body" support group for patients with all cancer types. Analysis based on grounded theory was utilized to identify themes and theoretical constructs. With regard to patient conceptualizations of religion and spirituality, three categories emerged: (1) Spirituality is intertwined with organized religion; (2) Religion is one manifestation of the broader construct of spirituality; (3) Religion and spirituality are completely independent, with spirituality being desirable and religion not. Religion and spirituality played a central role in patients' coping with cancer, providing comfort, hope, and meaning. Patients diverged when it came to spiritual support, with some enthusiastic about interventions incorporating their spiritual values and others stating that they already get this support through religious communities. Spirituality plays a central role in the cancer experience of this underserved ethnically-diverse population. While spirituality seems to be a universal concern in advanced cancer patients, the meaning of spirituality differs across individuals, with some equating it with organized religion and others taking a more individualized approach. It is important that psychosocial interventions are developed to address this concern. Future research is needed to further explore the different ways that patients conceptualize spirituality and to develop spiritually-based treatments that are not "one size fits all."

  14. Uptake of breast cancer preventive therapy in the UK: results from a multicentre prospective survey and qualitative interviews.

    Hackett, Julia; Thorneloe, Rachael; Side, Lucy; Wolf, Michael; Horne, Rob; Cuzick, Jack; Smith, Samuel G

    2018-04-24

    Uptake of preventive therapy for women at increased breast cancer risk in England is unknown following the introduction of UK clinical guidelines in 2013. Preventive therapy could create socioeconomic inequalities in cancer incidence if it is more readily accepted by particular socio-demographic groups. In this multicentre study, we investigated uptake of tamoxifen and evaluated socio-demographic and clinical factors associated with initiation. We explored women's experiences of treatment decision-making using qualitative interview data. Between September 2015 and December 2016, women (n = 732) attending an appointment at one of 20 centres in England to discuss breast cancer risk were approached to complete a survey containing socio-demographic details and nulliparity. Of the baseline survey respondents (n = 408/732, 55.7% response rate), self-reported uptake of tamoxifen at 3-month follow-up was reported in 258 (63.2%). Sixteen women participated in semi-structured interviews. One in seven (38/258 = 14.7%) women initiated tamoxifen. Women who had children were more likely to report use of tamoxifen than those without children (OR = 5.26; 95%CI: 1.13-24.49, p = 0.035). Interview data suggested that women weigh up risks and benefits of tamoxifen within the context of familial commitments, with exposure to significant other's beliefs and experiences of cancer and medication a basis for their decision. Uptake of tamoxifen is low in clinical practice. There were no socio-demographic differences in uptake, suggesting that the introduction of breast cancer preventive therapy is unlikely to create socioeconomic inequalities in cancer incidence. Women's decision-making was influenced by familial priorities, particularly having children.

  15. A qualitative exploration of barriers and motivators to physical activity participation in women treated for breast cancer.

    Brunet, Jennifer; Taran, Samantha; Burke, Shaunna; Sabiston, Catherine M

    2013-01-01

    The adoption and maintenance of a physically active lifestyle among women after breast cancer is an important priority for public health and rehabilitation science. The purpose of this qualitative study was to explore breast cancer survivors' perceptions of the factors influencing their ability to maintain a self-directed physical activity program. Nine women participated in semi-structured, in-depth interviews. Data were coded into perceived barriers and motivators to maintenance of physical activity using thematic analysis. Women identified a range of physical (e.g. cancer-related physical symptoms), environmental/organizational (e.g. bad weather, lack of equipment/facilities, lack of knowledge, time constraints) and psychosocial (e.g. lack of motivation, low social support, low confidence/skill) barriers. They also identified perceived physical (e.g. weight management, health improvement or maintenance, increase energy) and psychosocial (e.g. improve body image, experience enjoyment, social support, positive emotions) motivators. These findings are consistent with research on barriers and motivators to physical activity initiation, and can be used to develop self-directed physical activity programs that target active breast cancer survivors to sustain regular engagement. Furthermore, the barriers and motivators identified represent key variables for further investigation. The present study identifies a number of perceived physical, psychosocial and organizational/environmental barriers to naturally occurring physical activity participation among active breast cancer survivors that should be addressed to ensure they maintain a physically active lifestyle This study also provides evidence that comprehensive approaches that address physical and psychosocial motivators to physical activity should be developed to assist women with a history of breast cancer maintain their physical activity levels.

  16. Qualitative study of men's perceptions of why treatment delays occur in the UK for those with testicular cancer.

    Chapple, Alison; Ziebland, Sue; McPherson, Ann

    2004-01-01

    Many studies (but not all) have shown that for men with testicular cancer a longer treatment delay is associated with additional treatments, greater morbidity, and shorter survival. This paper explores patients' perspectives on why treatment delays occur. Qualitative study using narrative interviews Interviews in patient's homes throughout the United Kingdom (UK). Interviews with a maximum variation sample of 45 men with testicular cancer, recruited through general practitioners (GPs), urologists, support groups, and charities. Those who sought help relatively quickly responded to symptoms, had heard about testicular cancer in the media, had seen leaflets in GPs' surgeries, or knew others with this disease. Men delayed because they did not recognise signs and symptoms; feared appearing weak, a hypochondriac, or lacking in masculinity; recalled past illness or painful examinations; were embarrassed; feared the consequences of treatment; or lacked time to consult their doctors. Beliefs about symptoms and pessimistic associations with cancer also led to delay. Treatment delays also resulted from misdiagnosis or waiting lists. Whether or not men should be taught to examine themselves routinely to check for testicular cancer is much debated. This study suggests that it is important that men are aware of the normal shape and feel of their testicles, and may benefit from information about signs and symptoms of testicular cancer and the excellent cure rate. Information, provided in surgeries where men feel welcome, might encourage men to seek help promptly when a problem arises. Our study also suggests that GPs may need to accept a low threshold for ultrasound investigation of testicular symptoms and that the ultrasound service needs to be improved. These measures may further reduce mortality and morbidity.

  17. Psychosocial Aspects of Hereditary Cancer (PAHC) questionnaire: development and testing of a screening questionnaire for use in clinical cancer genetics

    Eijzenga, W.; Bleiker, E.M.A.; Hahn, D.E.E.; Kluijt, I.; Sidharta, G.N.; Gundy, C.; Aaronson, N.K.

    2014-01-01

    Background: Up to three-quarters of individuals who undergo cancer genetic counseling and testing report psychosocial problems specifically related to that setting. The objectives of this study were to develop and evaluate the screening properties of a questionnaire designed to assess specific

  18. An interactive portal to empower cancer survivors: a qualitative study on user expectations

    Kuijpers, Wilma; Groen, Wim G.; Loos, Romy; Oldenburg, Hester S.A.; Wouters, Michel W.J.M.; Aaronson, Neil K.; van Harten, Willem H.

    2015-01-01

    Purpose Portals are increasingly used to improve patient empowerment, but are still uncommon in oncology. In this study, we explored cancer survivors’ and health professionals’ expectations of possible features of an interactive portal. Methods We conducted three focus groups with breast cancer

  19. Care provided by the father to the child with cancer under the influence of masculinities: qualitative meta-synthesis

    Naiara Barros Polita

    Full Text Available ABSTRACT Objective: To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. Method: Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. Results: Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. Final Considerations: The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.

  20. Patients' and clinicians' experiences of holistic needs assessment using a cancer distress thermometer and problem list: A qualitative study.

    Biddle, Lucy; Paramasivan, Sangeetha; Harris, Susan; Campbell, Rona; Brennan, James; Hollingworth, William

    2016-08-01

    Psychosocial needs assessment is recommended for patients undergoing cancer treatment, but trials of effectiveness of assessment tools provide mixed results. This qualitative study aimed to understand how such tools are experienced by patients and clinicians in order to optimise use in the future. Qualitative interviews were used in a mixed-methods sequential design following a randomised controlled trial of needs assessment using the Distress Thermometer and Problem List (DT&PL), and explored patients' and clinicians' evaluations of the needs assessment process. Benefits of needs assessment using the DT&PL included the potential to detect hidden distress, allow opportunity for distress to be discussed, and to deliver outcomes to address problems. However, effectiveness and patient willingness to report all forms of distress could be hindered by: clinicians feeling ill-equipped to deal with 'non-physical' distress and patients questioning their appropriateness to do so; time constraints; insufficient support services and referral guidelines; inappropriate timing; and lack of follow-up. The benefits of a holistic needs assessment cannot be realised without matching time and frequency of administration to the dynamic nature of distress during cancer, and making changes to the context of delivery - for instance, providing protected time, increasing referral options and clinician training. Significant investment is needed to optimise potential benefits for patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Coping with side effects from cancer treatment in daily life from the perspective of cancer patients: A qualitative empirical study

    Pedersen, Birgith; Koktved, Dorte Pallesen; Nielsen, Lene Lyngø

    Aim The aim of this paper is to deepen our understanding of how patients cope with side effects from cancer treatment in daily life. Background Patients receiving cancer treatment experience acute side effects and need individualized information and guidance in order to manage treatment......-related adverse events in everyday life. However development in cancer treatment and the societal demands for efficiency may limit the possibility for individualized support. Methods Nine patients were interviewed from March to July 2009 to explore the patients’ experience of coping with side effects in daily...

  2. Mobile Breast Cancer e-Support Program for Chinese Women With Breast Cancer Undergoing Chemotherapy (Part 1): Qualitative Study of Women's Perceptions.

    Zhu, Jiemin; Ebert, Lyn; Guo, Dongmei; Yang, Sumei; Han, Qiuying; Chan, Sally Wai-Chi

    2018-04-11

    Women with breast cancer undergoing chemotherapy experience difficulty in accessing adequate cancer care in China. Mobile apps have the potential to provide easily accessible support for these women. However, there remains a paucity of randomized controlled trials to evaluate the effectiveness of app-based programs targeting specifically women with breast cancer undergoing chemotherapy. Moreover, women's perceptions and experiences related to using and interacting within the app-based program have rarely been reported. Therefore, an app-based Breast Cancer e-Support program was developed and evaluated using a randomized controlled trial. Based on the incorporation of Bandura's self-efficacy and social exchange theory, Breast Cancer e-Support program lasted for 12 weeks covering 4 cycles of chemotherapy and had 4 components: (1) a Learning forum, (2) a Discussion forum, (3) an Ask-the-Expert forum, and (4) a Personal Stories forum. As a part of the randomized controlled trial, the aim of this study was to explore the participants' perception of Breast Cancer e-Support program, its strengths and weaknesses, and suggestions to improve the program. A descriptive qualitative study was employed. Thirteen women with breast cancer from 2 university-affiliated hospitals in China, who were randomly allocated to the Breast Cancer e-Support program in the randomized controlled trial, were interviewed from November 2016 to February 2017. Purposive sampling was used based on women's scores of self-efficacy after the completion of the intervention. Inductive content analysis was used to analyze the transcripts, allowing the categories and subcategories to flow from the data. The qualitative interviews revealed that participants perceived the Breast Cancer e-Support program to be helpful in enhancing knowledge, improving confidence level, and promoting emotional well-being. Women also identified access to tailored advice from experts and convenience as the benefits of this program

  3. Efficiency aspects of design and analysis of prospective cohort studies on diet, nutrition and cancer

    Kaaks, R.J.

    1994-01-01

    This thesis presents and analyzes methodological approaches to improve the design and analysis of prospective cohort studies on the relations between diet, nutritional status and cancer. The first chapters discuss methods to optimize the measurement of the individuals' habitual dietary

  4. Molecular control of the cell cycle in cancer: biological and clinical aspects

    Møller, Michael Boe

    2003-01-01

    The RB1 pathway and the p53 pathway represent important, interconnected biochemical units frequently perturbed in human cancer. Essential tumor protective mechanisms, such as cellular growth control and apoptosis, are regulated through these systems. Comprehensive studies of these pathways, inclu...

  5. Mammographic Breast Density and Breast Cancer Molecular Subtypes: The Kenyan-African Aspect

    Asim Jamal Shaikh

    2018-01-01

    Full Text Available Introduction. Data examining mammographic breast density (MBD among patients in Sub-Saharan Africa are sparse. We evaluated how MBD relates to breast cancer characteristics in Kenyan women undergoing diagnostic mammography. Methods. This cross-sectional study included women with pathologically confirmed breast cancers (n=123. Pretreatment mammograms of the unaffected breast were assessed to estimate absolute dense area (cm2, nondense area (cm2, and percent density (PD. Relationships between density measurements and clinical characteristics were evaluated using analysis of covariance. Results. Median PD and dense area were 24.9% and 85.3 cm2. Higher PD and dense area were observed in younger women (P<0.01. Higher dense and nondense areas were observed in obese women (P-trend < 0.01. Estrogen receptor (ER positive patients (73% had higher PD and dense area than ER-negative patients (P≤0.02. Triple negative breast cancer (TNBC patients (17% had lower PD and dense area (P≤0.01 compared with non-TNBCs. No associations were observed between MBD and tumor size and grade. Conclusions. Our findings show discordant relationships between MBD and molecular tumor subtypes to those previously observed in Western populations. The relatively low breast density observed at diagnosis may have important implications for cancer prevention initiatives in Kenya. Subsequent larger studies are needed to confirm these findings.

  6. Barriers to rehabilitative care for young breast cancer survivors: a qualitative understanding.

    Miedema, Baukje; Easley, Julie

    2012-06-01

    The goal of this study was to assess the rehabilitation needs of young women breast cancer survivors under the age of 50 and to identify factors that may impact or prevent cancer rehabilitation utilization. Utilizing a grounded theory methodology, 35 young breast cancer survivors were interviewed twice in four Atlantic Canadian provinces. A considerable number of barriers exist to receiving rehabilitative care post-treatment for young breast cancer survivors. The systemic barriers include the lack of availability of services, travel issues, cost of services, and the lack of support to address the unique needs for this age group. However, the most complicated barriers to accessing rehabilitative care were personal barriers which related more to choice and circumstances, such as the lack of time due to family responsibilities and appointment fatigue. Many of these personal barriers were rooted in the complex set of gender roles of young women as patients, mothers, workers, and caregivers. The contexts of young women's lives can have a substantial impact on their decisions to seek and receive rehabilitative care after breast cancer treatment. The systemic barriers can be reduced by introducing more services or financial assistance; however, the personal barriers to rehabilitation services are difficult to ameliorate due to the complex set of roles within and outside the family for this group of young breast cancer survivors. Health care providers need to take into consideration the multiple contexts of women's lives when developing and promoting breast cancer rehabilitation services and programs.

  7. Identifying factors to improve oral cancer screening uptake: a qualitative study.

    Fatemeh Vida Zohoori

    Full Text Available To engage with high risk groups to identify knowledge and awareness of oral cancer signs and symptoms and the factors likely to contribute to improved screening uptake.Focus group discussions were undertaken with 18 males; 40+ years of age; smokers and/or drinkers (15+ cigarettes per day and/or 15+ units of alcohol per week, irregular dental attenders living in economically deprived areas of Teesside.There was a striking reported lack of knowledge and awareness of oral cancer and its signs and symptoms among the participants. When oral/mouth cancer leaflets produced by Cancer Research UK were presented to the participants, they claimed that they would seek help on noticing such a condition. There was a preference to seek help from their general practitioner rather than their dentist due to perceptions that a dentist is 'inaccessible' on a physical and psychological level, costly, a 'tooth specialist' not a 'mouth specialist', and also not able to prescribe medication and make referrals to specialists. Interestingly, none of the 18 participants who were offered a free oral cancer examination at a dental practice took up this offer.The uptake of oral cancer screening may be improved by increasing knowledge of the existence and signs and symptoms of oral cancer. Other factors that may increase uptake are increased awareness of the role of dentists in diagnosing oral cancer, promotion of oral cancer screening by health professionals during routine health checks, and the use of a "health" screening setting as opposed to a "dental" setting for such checks.

  8. Factors contributing to delayed diagnosis of cancer among Aboriginal people in Australia: a qualitative study

    Shahid, Shaouli; Teng, Tiew-Hwa Katherine; Bessarab, Dawn; Aoun, Samar; Baxi, Siddhartha; Thompson, Sandra C

    2016-01-01

    Background/objectives Delayed presentation of symptomatic cancer is associated with poorer survival. Aboriginal patients with cancer have higher rates of distant metastases at diagnosis compared with non-Aboriginal Australians. This paper examined factors contributing to delayed diagnosis of cancer among Aboriginal Australians from patient and service providers' perspectives. Methods In-depth, open-ended interviews were conducted in two stages (2006–2007 and 2011). Inductive thematic analysis was assisted by use of NVivo looking around delays in presentation, diagnosis and referral for cancer. Participants Aboriginal patients with cancer/family members (n=30) and health service providers (n=62) were recruited from metropolitan Perth and six rural/remote regions of Western Australia. Results Three broad themes of factors were identified: (1) Contextual factors such as intergenerational impact of colonisation and racism and socioeconomic deprivation have negatively impacted on Aboriginal Australians' trust of the healthcare professionals; (2) health service-related factors included low accessibility to health services, long waiting periods, inadequate numbers of Aboriginal professionals and high staff turnover; (3) patient appraisal of symptoms and decision-making, fear of cancer and denial of symptoms were key reasons patients procrastinated in seeking help. Elements of shame, embarrassment, shyness of seeing the doctor, psychological ‘fear of the whole health system’, attachment to the land and ‘fear of leaving home’ for cancer treatment in metropolitan cities were other deterrents for Aboriginal people. Manifestation of masculinity and the belief that ‘health is women's domain’ emerged as a reason why Aboriginal men were reluctant to receive health checks. Conclusions Solutions to improved Aboriginal cancer outcomes include focusing on the primary care sector encouraging general practitioners to be proactive to suspicion of symptoms with appropriate

  9. Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.

    Gross, Cary P; Fried, Terri R; Tinetti, Mary E; Ross, Joseph S; Genao, Inginia; Hossain, Sabina; Wolf, Elizabeth; Lewis, Carmen L

    2015-03-01

    To understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screening. We conducted interviews with adults >65 years old with at least two chronic conditions who were taking ≥five medications daily. Patients were first asked how age and multimorbidity influence their cancer screening decisions. After showing them an educational prompt that explained the relationship between life expectancy and the benefits of cancer screening, respondents were then asked about screening in the context of specific health scenarios. Using grounded theory, three independent readers coded responses for salient themes. Sample size was determined by thematic saturation. Most respondents (26 of 28) initially indicated that their overall health or medical conditions do not influence their cancer screening decisions. After viewing the educational prompt, respondents described two broad approaches to cancer screening in the setting of increasing age or multi-morbidity. The first was a "benefits versus harms" approach in which participants weighed direct health benefits (e.g. reducing cancer incidence or mortality) and harms (e.g. complications or inconvenience). The second was a heuristic approach. Some heuristics favored screening, such as a persistent belief in unspecified benefits from screening, value of knowledge about cancer status, and not wanting to "give up", whereas other heuristics discouraged screening, such as fatalism or a reluctance to learn about their cancer status. When considering cancer screening, some older persons with MCC employ heuristics which circumvent the traditional quantitative comparison of risks and benefits, providing an important challenge to informed decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. STOMATOLOGIC ASPECTS IN THERAPY OF LOCALLY DISTRIBUTED CANCER OF ORAL CAVITY MUCUS

    G. G. Matyakin

    2013-01-01

    Full Text Available Aim of the investigation: to improve prophylaxis of dental complications during the therapy in the patients with locally distributed cancer of oral cavity mucus.Materials. Results of sanation of oral cavity in 305 patients with cancer of oral and pharyngeal area are analyzed.Results. The best results are noted in the patients given surgical sanation before chemo-radial therapy. The most number of complications is observed when teeth were extracted after chemical therapy in the period of radial therapy at summary focal dose above 20 Gy as well as in the late periods after radial therapy.Conclusion. A complex of preventive measures with using haemostatic sponge with canamycin in such patients decreases the number of complications and the terms of healing of alveoli of extracted teeth.

  11. Some aspects of cancer biomarkers and their clinical application in solid tumors – revisited

    Isaac D

    2017-07-01

    Full Text Available Cancer biomarkers can be used for a variety of purposes related to screening, prediction, stratification, detection, diagnosis, prognosis, treatment design, and monitoring of a therapeutic response. One of the most important characteristics of a given biomarker includes ease of collection allowing for a non-invasive approach and frequent sampling. Such samples may be obtained from serum or plasma, sputum, bronchoalveolar lavage, saliva, nipple discharge, pleural, or peritoneal effusions. Validation of different biomarkers is considered a mandatory method for useful evaluation. In this review, we highlight the clinical applicability of some cancer biomarkers, as well as future approaches for their development and collection, which may help guide clinicians and researchers. The role of liquid biopsies will also be summarized. Further studies using liquid biopsies are needed to elucidate the significance of various sources of biomarkers suitable for clinical application.

  12. Collaboration and communication in colorectal cancer care: a qualitative study of the challenges experienced by patients and health care professionals

    Kamradt, Martina; Baudendistel, Ines; Längst, Gerda; Kiel, Marion; Eckrich, Felicitas; Winkler, Eva; Szecsenyi, Joachim; Ose, Dominik

    2015-01-01

    Background. Colorectal cancer is becoming a chronic condition. This has significant implications for the delivery of health care and implies the involvement of a range of health care professionals (HCPs) from different settings to ensure the needed quality and continuity of care. Objectives. To explore the challenges that patients and HCPs experience in the course of colorectal cancer care and the perceived consequences caused by these challenges. Methods. Ten semi-structured focus groups were conducted including patients receiving treatment for colorectal cancer, representatives of patient support groups, physicians and other non-physician HCPs from different health care settings. Participants were asked to share their experiences regarding colorectal cancer care. All data were audio- and videotaped, transcribed verbatim and thematically analysed using qualitative content analysis. Results. Patients and HCPs (total N = 47) experienced collaboration and communication as well as exchange of information between HCPs as challenging. Particularly communication and information exchange with GPs appeared to be lacking. The difficulties identified restricted a well-working coordination of care and seemed to cause inappropriate health care. Conclusion. Colorectal cancer care seems to require an effective, well-working collaboration and communication between the different HCPs involved ensuring the best possible care to suit patients’ individual needs. However, the perceived challenges and consequences of our participants seem to restrict the delivery of the needed quality of care. Therefore, it seems crucial (i) to include all HCPs involved, especially the GP, (ii) to support an efficient and standardized exchange of health-related information and (iii) to focus on the patients’ entire pathway of care. PMID:26311705

  13. A qualitative study of lung cancer risk perceptions and smoking beliefs among national lung screening trial participants.

    Park, Elyse R; Streck, Joanna M; Gareen, Ilana F; Ostroff, Jamie S; Hyland, Kelly A; Rigotti, Nancy A; Pajolek, Hannah; Nichter, Mark

    2014-02-01

    The National Comprehensive Cancer Network and the American Cancer Society recently released lung screening guidelines that include smoking cessation counseling for smokers undergoing screening. Previous work indicates that smoking behaviors and risk perceptions of the National Lung Screening Trial (NLST) participants were relatively unchanged. We explored American College of Radiology Imaging Network (ACRIN)/NLST former and current smokers' risk perceptions specifically to (a) determine whether lung screening is a cue for behavior change, (b) elucidate risk perceptions for lung cancer and smoking-related diseases, and (c) explore postscreening behavioral intentions and changes. A random sample of 35 participants from 4 ACRIN sites were qualitatively interviewed 1-2 years postscreen. We used a structured interview guide based on Health Belief Model and Self-Regulation Model constructs. Content analyses were conducted with NVivo 8. Most participants endorsed high-risk perceptions for lung cancer and smoking-related diseases, but heightened concern about these risks did not appear to motivate participants to seek screening. Risk perceptions were mostly attributed to participants' heavy smoking histories; former smokers expressed greatly reduced risk. Lung cancer and smoking-related diseases were perceived as very severe although participants endorsed low worry. Current smokers had low confidence in their ability to quit, and none reported quitting following their initial screen. Lung screening did not appear to be a behavior change cue to action, and high-risk perceptions did not translate into quitting behaviors. Cognitive and emotional dissonance and avoidance strategies may deter engagement in smoking behavior change. Smoking cessation and prevention interventions during lung screening should explore risk perceptions, emotions, and quit confidence.

  14. Current aspects in reconstructive surgery for nasal cavity and paranasal sinus cancer

    Shtin, V. I.; Novikov, V. A.; Gjunter, V. E.; Choinzonov, E. L.; Ryabova, A. I.; Sirkashev, V. A.; Surkova, P. V.; Vasilev, R. V.; Menkova, E. N.

    2017-09-01

    Tumors of the nasal cavity and paranasal sinuses present a challenge to treat them. A combination of surgery and radiation therapy can improve treatment outcomes in 49-56% [1, 2] of the patients with locally advanced nasal cavity and paranasal sinus cancer. The midface reconstruction poses a formidable challenge to the reconstructive surgeon due to the region's complex skeletal and soft-tissue anatomy. The rehabilitation program including the reconstruction of the resected orbital walls using the porous and mesh implants from titanium nickelid (TiNi) was developed at the Cancer Research institute jointly with the Research Institute of Medical Materials. The technique was proven effective, allowing the natural position of the eye and visual function to be preserved in 90% [1-3] of the patients. A long period of reparative processes and risk of developing inflammation in the implant area, as well as the need to decrease length of surgery, contributed to the development of a novel approach to repairing the midface bone structures using the implant based on the microporous wire and TiNi mesh. Eighteen patients with nasal cavity and paranasal sinus cancer were treated using the combined thin implants. The novel technique allowed the time of the implant installation to be reduced to 5-10 min. The structure of the implant contributed to prevention of inflammatory processes in 97% [1, 2] of cases. Thus, the natural position of the eyeball and visual function were preserved in 100% [1, 3, 4] of patients. The use of the TiNi implants in reconstructive surgery for patients with nasal cavity and paranasal sinus cancer led to reduced time of surgery and rehabilitation, increased level of social adaptation of patients and improved cosmetic and functional results.

  15. Systemic aspects of conjugal resilience in couples with a child facing cancer and marrow transplantation

    Martin, Julie; P?loquin, Katherine; Vachon, Marie-France; Duval, Michel; Sultan, Serge

    2016-01-01

    Introduction: The negative impact of paediatric cancer on parents is well known and is even greater when intensive treatments are used. This study aimed to describe how couples whose child has received a transplant for the treatment of leukaemia view conjugal resilience and to evaluate the role of we-ness as a precursor of conjugal adjustment.Methods: Four parental couples were interviewed. Interviews were analysed in two ways: inductive thematic analysis and rating of verbal content with the...

  16. Combining quantitative and qualitative breast density measures to assess breast cancer risk.

    Kerlikowske, Karla; Ma, Lin; Scott, Christopher G; Mahmoudzadeh, Amir P; Jensen, Matthew R; Sprague, Brian L; Henderson, Louise M; Pankratz, V Shane; Cummings, Steven R; Miglioretti, Diana L; Vachon, Celine M; Shepherd, John A

    2017-08-22

    Accurately identifying women with dense breasts (Breast Imaging Reporting and Data System [BI-RADS] heterogeneously or extremely dense) who are at high breast cancer risk will facilitate discussions of supplemental imaging and primary prevention. We examined the independent contribution of dense breast volume and BI-RADS breast density to predict invasive breast cancer and whether dense breast volume combined with Breast Cancer Surveillance Consortium (BCSC) risk model factors (age, race/ethnicity, family history of breast cancer, history of breast biopsy, and BI-RADS breast density) improves identifying women with dense breasts at high breast cancer risk. We conducted a case-control study of 1720 women with invasive cancer and 3686 control subjects. We calculated ORs and 95% CIs for the effect of BI-RADS breast density and Volpara™ automated dense breast volume on invasive cancer risk, adjusting for other BCSC risk model factors plus body mass index (BMI), and we compared C-statistics between models. We calculated BCSC 5-year breast cancer risk, incorporating the adjusted ORs associated with dense breast volume. Compared with women with BI-RADS scattered fibroglandular densities and second-quartile dense breast volume, women with BI-RADS extremely dense breasts and third- or fourth-quartile dense breast volume (75% of women with extremely dense breasts) had high breast cancer risk (OR 2.87, 95% CI 1.84-4.47, and OR 2.56, 95% CI 1.87-3.52, respectively), whereas women with extremely dense breasts and first- or second-quartile dense breast volume were not at significantly increased breast cancer risk (OR 1.53, 95% CI 0.75-3.09, and OR 1.50, 95% CI 0.82-2.73, respectively). Adding continuous dense breast volume to a model with BCSC risk model factors and BMI increased discriminatory accuracy compared with a model with only BCSC risk model factors (C-statistic 0.639, 95% CI 0.623-0.654, vs. C-statistic 0.614, 95% CI 0.598-0.630, respectively; P breasts and fourth

  17. Clinical and Genetic Aspects of Sporadic Non-Medullar Thyroid Cancer

    U Rumjanzeva

    2006-03-01

    Full Text Available The role of somatic mutations in sporadic thyroid cancer is unclear today. Probably they coming out as aetiological factors in carcinogenesis as well as, respectfully to many authors, can to participate in TC pathogenesis and to determine the clinical course and prognosis of the disease. For today as main oncogenes taking part in initiation of thyroid malignant tumors are considered: RET/PTC, TRK, PTEN, P53, RAS, MET, PPARγ. By means of genetic investigations scientists are trying to solve problems with thyroid cancer differentiated diagnostics (cytokeratin-19, cytokeratin-20, mesothelial cells antigen (Hector Battifora MEsotelial (cell or HBME-1, loss of heterozigitoty (LOH in short arm of 3 chromosome (gene VHL -von Hippel Lindau, 3р26. Recently in foreign literature appeared reports of activated mutations in gene BRAF which most frequently are occurred in melanoma and papillary TC. Prognosis of thyroid cancer may reflected by the LOH as a biological breakage as well as changes of tumor suppressive gene P53 which fraught with decrease of disease prognosis. Thus, both researchers and clinicians have many questions concerning the role of genome, particularly in order to precise of genetic abnormality influence on tumor growth and therefore for assessment of clinical prognosis and with aim to chose adequate treatment tactic in each case.

  18. Prognostic aspects of dynamic contrast-enhanced magnetic resonance imaging in synchronous distant metastatic rectal cancer

    Yu, Jing; Xu, Qing; Song, Jia-Cheng; Li, Yan; Xu, Lu-Lu; Shi, Hai-Bin [First Affiliated Hospital of Nanjing Medical University, Department of Radiology, Nanjing (China); Huang, Dong-Ya [First Affiliated Hospital of Nanjing Medical University, Department of General Surgery, Nanjing (China)

    2017-05-15

    To explore the correlations between DCE-MRI quantitative parameters and synchronous distant metastasis and the clinicopathological factors in rectal cancers. Sixty-three patients with rectal cancer (synchronous distant metastasis, n = 31; non-metastasis, n = 32) were enrolled in this study. Student's t test and ANOVA were used to compare DCE-MRI parameters (K{sup trans}, K{sub ep} and V{sub e}). The receiver operating characteristic (ROC) analysis was used to find the reasonable threshold of DCE-MRI parameters to differentiate lesions with synchronous distant metastasis from those without metastasis. The K{sup trans}, K{sub ep}, and V{sub e} value were significantly higher in the lesions with distant metastasis than in the lesions without distant metastasis (0.536 ± 0.242 vs. 0.299 ± 0.118 min{sup -1}, p < 0.001; 1.598 ± 0.477 vs. 1.341 ± 0.390 min{sup -1}, p = 0.022; and 0.324 ± 0.173 vs. 0.249 ± 0.091, p = 0.034; respectively). The K{sup trans} showed the highest AUCs of 0.788 (p < 0.001), with sensitivity of 61.29 % and specificity of 87.5 %, respectively. DCE-MRI parameters may represent a prognostic indicator for synchronous distant metastases in patients with rectal cancer. (orig.)

  19. Cervical cancer: a qualitative study on subjectivity, family, gender and health services

    López-Cervantes Malaquías; Mohar-Betancourt Alejandro; Tirado-Gómez Laura L; Pelcastre-Villafuerte Blanca E

    2007-01-01

    Abstract Background In 2002, cervical cancer was one of the leading causes of death in Mexico. Quantitative techniques allowed for the identification of socioeconomic, behavioral and biological characteristics that are part of its etiology. However such characteristics, are inadequate to explain sufficiently the role that emotions, family networks and socially-constructed categories such as gender play in the demand and utilization of health services for cervical cancer diagnosis and treatmen...

  20. Qualitative evaluation of mobile cancer apps with particular attention to the target group, content, and advertising.

    Böhme, Cathleen; von Osthoff, Marc Baron; Frey, Katrin; Hübner, Jutta

    2018-01-01

    Medical apps are gaining importance rapidly. Also in the field of cancer care, apps are offered. Yet, so far little is known with respect to their quality. In a pilot phase we developed a rating tool based on formal and content-related criteria for the assessment of cancer apps. We used this instrument on cancer apps available in the App Store (iOS) concerning breast, prostate and colorectal cancer. The results were stratified according to target group, content and advertising. We assessed 41 mobile cancer apps. Six apps (14.63%) scored very high, fifteen apps (36.59%) high, seventeen apps (41.46%) were deficient, and three apps (7.32%) were insufficient. The largest group of apps represents those apps with the "deficient" rating. The very good to good apps had reliable sources, a concrete intent/ purpose in their app description, and a strict distinction of scientific content and advertisement. Apps with the predicates "deficient" or "insufficient" had particularly poor ratings, e.g. in the subscales "information on sources" and "data protection". Almost half of the tested apps were deficient or insufficient. In order to improve safety of patients using apps, some regulation seems mandatory. Putting apps under the legislation for medical products might be one way to better regulate and control quality. Second, efforts should focus on the development of checklists that make it easier for patients to search for suitable cancer apps.

  1. The recruitment of patients to trials in head and neck cancer: a qualitative study of the EaStER trial of treatments for early laryngeal cancer.

    Hamilton, D W; de Salis, I; Donovan, J L; Birchall, M

    2013-08-01

    We aimed to investigate the factors contributing to poor recruitment to the EaStER trial "Early Stage glottic cancer: Endoscopic excision or Radiotherapy" feasibility study. We performed a prospective qualitative assessment of the EaStER trial at three centres to investigate barriers to recruitment and implement changes. Methods used included semi-structured interviews, focus groups and audio-recordings of recruitment encounters. First, surgeons and recruiters did not all accept the primary outcome as the rationale for the trial. Surgeons did not always adhere to the trial eligibility criteria leading to variations between centres in the numbers of "eligible" patients. Second, as both treatments were considered equally successful, recruiters and patients focused on the pragmatics of the different trial arms, favouring surgery over radiotherapy. The lack of equipoise was reflected in the way recruiters presented trial information. Third, patient views, beliefs and preferences were not fully elicited or addressed by recruiters. Fourth, in some centres, logistical issues made trial participation difficult. This qualitative research identified several major issues that explained recruitment difficulties. While there was insufficient time to address these in the EaStER trial, several factors would need to be addressed to launch further RCTs in head and neck cancer. These include the need for clear ongoing agreement among recruiting clinicians regarding details in the study protocol; an understanding of the logistical issues hindering recruitment at individual centres; and training recruiters to enable them to explain the need for randomisation and the rationale for the RCT to patients.

  2. Beginning level nursing students' experiences with cancer patients in their first clinical placement: a qualitative appraisal in Turkey.

    Yildiz, Hicran; Akansel, Neriman

    2011-01-01

    This study was conducted to evaluate beginning nursing students' point of view related to caring cancer patients in their first clinical placement. Data were collected by evaluating the diaries kept by four beginning level nursing students who were assigned to do their fundamentals of nursing clinical practice in hematology clinic from February to May 2011. A qualitative research method was used and data were analyzed using inductive method. Nursing students experienced anxiety, had difficulties while communicating with cancer patients and observed some negative practices related to patient care and treatment. During their clinical placement nursing students were able to differentiate right and wrong practices in clinical environment, they tried to tailor their theoretical knowledge to the clinical practice and reported decrease in their anxiety by the end of clinical rotation. Being assigned to care for cancer patients was a stressful experience for the first year students. According to these results, it can be said that clinics such as hematology can be used as a clinical placement only in mandatory conditions for beginning level nursing students because of their limited clinical experience and the knowledge requirement related to these patients.

  3. Acceptability of, and Information Needs Regarding, Next-Generation Sequencing in People Tested for Hereditary Cancer: A Qualitative Study.

    Meiser, Bettina; Storey, Ben; Quinn, Veronica; Rahman, Belinda; Andrews, Lesley

    2016-04-01

    Next generation sequencing (NGS) for patients at risk of hereditary cancer syndromes can also identify non-cancer related mutations, as well as variants of unknown significance. This study aimed to determine what benefits and shortcomings patients perceive in relation to NGS, as well as their interest and information preferences in regards to such testing. Eligible patients had previously received inconclusive results from clinical mutation testing for cancer susceptibility. Semi-structured telephone interviews were subjected to qualitative analysis guided by the approach developed by Miles and Huberman. The majority of the 19 participants reported they would be interested in panel/genomic testing. Advantages identified included that it would enable better preparation and allow implementation of individualized preventative strategies, with few disadvantages mentioned. Almost all participants said they would want all results, not just those related to their previous diagnosis. Participants felt that a face-to-face discussion supplemented by an information booklet would be the best way to convey information and achieve informed consent. All participants wanted their information stored and reviewed in accordance with new developments. Although the findings indicate strong interest among these individuals, it seems that the consent process, and the interpretation and communication of results will be areas that will require revision to meet the needs of patients.

  4. Does implementation matter if comprehension is lacking? A qualitative investigation into perceptions of advance care planning in people with cancer.

    Ugalde, Anna; O'Callaghan, Clare; Byard, Clem; Brean, Samantha; MacKay, Jenelle; Boltong, Anna; Davoren, Sondra; Lawson, Deborah; Parente, Phillip; Michael, Natasha; Livingston, Patricia

    2018-05-11

    While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended advance care plans and examine how accurately advance care planning documentation represented patient wishes. This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants' existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate, Statement of Choices, and/or Enduring Power of Attorney (Medical Treatment) at one cancer treatment centre. Fourteen participants were involved in the study. Twelve participants were female (86%). The mean age was 77 (range: 61-91), and participants had completed their advance care planning documentation between 8 and 72 weeks prior to the interview (mean 33 weeks). Three themes were evident from the data: incomplete advance care planning understanding and confidence, limited congruence for attitude and documentation, advance care planning can enable peace of mind. Complete advance care planning understanding was unusual; most participants demonstrated partial comprehension of their own advance care plan, and some indicated very limited understanding. Participants' attitudes and their written document congruence were limited, but advance care planning was seen as helpful. This study highlighted advance care planning was not a completely accurate representation of patient wishes. There is opportunity to improve how patients comprehend their own advance care planning documentation.

  5. Coping with side effects from cancer treatment in daily life from the perspective of cancer patients: A qualitative empirical study

    Pedersen, Birgith; Koktved, Dorte Pallesen; Nielsen, Lene Lyngø

    Aim The aim of this paper is to deepen our understanding of how patients cope with side effects from cancer treatment in daily life. Background Patients receiving cancer treatment experience acute side effects and need individualized information and guidance in order to manage treatment......-related adverse events in everyday life. However development in cancer treatment and the societal demands for efficiency may limit the possibility for individualized support. Methods Nine patients were interviewed from March to July 2009 to explore the patients’ experience of coping with side effects in daily...... their identity but the side effects can control the daily life. Patients do not always possess the knowledge of how to handle the side effects and adaptation to the institutional efficiency can lead to lack of confidence and feelings of responsibility and guilt concerning coping with these side effects...

  6. Psychological aspects of breast conserving therapy (BCT) in early breast cancer

    Jeziorski, A.

    1994-01-01

    Psychological and social status of 40 women who underwent BCT in early cancer was compared with 40 women after radical mastectomy. Women in BCT group showed significantly less anxiety about overall body image. The majority of them reported adjustment to work or ability to carry out household tasks. Almost all returned to normal social activities and interpersonal relationships. The majority of patients treated with BCT were fully satisfied in spite of unsatisfactory cosmetic results achieved in some of them and in spite of long duration of combined modality treatment. (author)

  7. Patient experiences and outcomes following facial skin cancer surgery: A qualitative study.

    Lee, Erica H; Klassen, Anne F; Lawson, Jessica L; Cano, Stefan J; Scott, Amie M; Pusic, Andrea L

    2016-08-01

    Early melanoma and non-melanoma skin cancer of the facial area are primarily treated with surgery. Little is known about the outcomes of treatment for facial skin cancer patients. The objective of the study was to identify concerns about aesthetics, procedures and health from the patients' perspective after facial skin surgery. Semi-structured in-depth interviews were conducted with 15 participants. Line-by-line coding was used to establish categories and develop themes. We identified five major themes on the impact of skin cancer surgery: appearance-related concerns; psychological (e.g., fear of new cancers or recurrence); social (e.g. impact on social activities and interaction); physical (e.g. pain and swelling) concerns and satisfaction with the experience of care (e.g., satisfaction with surgeon). The priority of participants was the removal of the facial skin cancer, as this reduced their overall worry. The aesthetic outcome was secondary but important, as it had important implications on the participants' social and psychological functioning. The participants' experience with the care provided by the surgeon and staff also contributed to their satisfaction with their treatment. This conceptual framework provides the basis for the development of a new patient-reported outcome instrument. © 2015 The Australasian College of Dermatologists.

  8. Esophageal cancer prediction based on qualitative features using adaptive fuzzy reasoning method

    Raed I. Hamed

    2015-04-01

    Full Text Available Esophageal cancer is one of the most common cancers world-wide and also the most common cause of cancer death. In this paper, we present an adaptive fuzzy reasoning algorithm for rule-based systems using fuzzy Petri nets (FPNs, where the fuzzy production rules are represented by FPN. We developed an adaptive fuzzy Petri net (AFPN reasoning algorithm as a prognostic system to predict the outcome for esophageal cancer based on the serum concentrations of C-reactive protein and albumin as a set of input variables. The system can perform fuzzy reasoning automatically to evaluate the degree of truth of the proposition representing the risk degree value with a weight value to be optimally tuned based on the observed data. In addition, the implementation process for esophageal cancer prediction is fuzzily deducted by the AFPN algorithm. Performance of the composite model is evaluated through a set of experiments. Simulations and experimental results demonstrate the effectiveness and performance of the proposed algorithms. A comparison of the predictive performance of AFPN models with other methods and the analysis of the curve showed the same results with an intuitive behavior of AFPN models.

  9. Barriers to cervical cancer screening among ethnic minority women: A qualitative study

    Marlow, L.; Waller, J.; Wardle, J.

    2015-01-01

    Background Ethnic minority women are less likely to attend cervical screening. Aim To explore self-perceived barriers to cervical screening attendance among ethnic minority women compared to white British women. Design Qualitative interview study. Setting Community groups in ethnically diverse London boroughs. Methods Interviews were carried out with 43 women from a range of ethnic minority backgrounds (Indian, Pakistani, Bangladeshi, Caribbean, African, Black British, Black other, White othe...

  10. Laparoscopic subtotal gastrectomy for advanced gastric cancer: technical aspects and surgical, nutritional and oncological outcomes.

    Nakauchi, Masaya; Suda, Koichi; Nakamura, Kenichi; Shibasaki, Susumu; Kikuchi, Kenji; Nakamura, Tetsuya; Kadoya, Shinichi; Ishida, Yoshinori; Inaba, Kazuki; Taniguchi, Keizo; Uyama, Ichiro

    2017-11-01

    Higher morbidity in total gastrectomy than in distal gastrectomy has been reported, but laparoscopic subtotal gastrectomy (LsTG) has been reported to be safe and feasible in early gastric cancer (GC). We determined the surgical, nutritional and oncological outcomes of LsTG for advanced gastric cancer (AGC). Of the 816 consecutive patients with GC who underwent radical gastrectomy at our institution between 2008 and 2012, 253 who underwent curative laparoscopic gastrectomy (LG) for AGC were enrolled. LsTG was indicated for patients with upper stomach third tumors, who hoped to avoid total gastrectomy, nutritional status were primarily assessed. Of 253 patients, the morbidity (Clavien-Dindo classification grade ≥ III) was 17.0% (43 patients). The 3-year overall survival and 3-year recurrence-free survival rates were 80.2 and 73.5%, respectively. LcDG, LsTG and LTG were performed in 121, 27 and 105 patients, individually. Morbidity was strongly associated with LTG (P = 0.001). Postoperative loss of body weight was significantly greater after LTG in comparison with LcDG or LsTG (P nutritional point of view.

  11. Using drawing tests to explore the multidimensional psychological aspects of children with cancer.

    Hatano, Yutaka; Yamada, Miwa; Nakagawa, Kanae; Nanri, Hiromi; Kawase, Masatoshi; Fukui, Kenji

    2014-10-01

    In seeking to understand how life-threatening illness affects children psychologically, projective testing may be beneficial, particularly when attempting to identify psychological problems in younger adolescents. The advantages of projective testing are that it does not depend on patients' verbal ability and is not invasive. Three cancer inpatients from Kyoto Prefectural University of Medicine, aged between 10 and 16 years old, participated in the study. Projective testing was used to measure the depth of participants' distress and included a tree-drawing test, a person-drawing test and a free drawing test. Results from the tree- and person-drawing tests indicated energy loss, anxiety and a sense of emptiness. However, results from the free drawing test suggested that the children had hope and a desire to recover from their illness. The combination of drawing tests in this study may increase the understanding of the internal psychological difficulties faced by children hospitalized with cancer. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses' practice in three European countries

    Seymour, J.; Rietjens, J.; Bruinsma, S.; Deliens, L.; Sterckx, S.; Mortier, F.; Brown, J.; Mathers, N.; van der Heide, A.; Consortium, UNBIASED

    2015-01-01

    Background: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses.\\ud Methods: Qualitative case studies using interviews.\\ud Setting: Hospitals, the domestic home and hospices or palliative care units.\\ud Participants: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer patients.\\ud Results: UK respondents repor...

  13. Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countries

    Seymour, Jane; Rietjens, Judith; Bruinsma, Sophie; Deliens, Luc; Sterckx, Sigrid; Mortier, Freddy; Brown, Jayne; Mathers, Nigel; van der Heide, Agnes

    2014-01-01

    Open access article BACKGROUND: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. METHODS: Qualitative case studies using interviews. SETTING: Hospitals, the domestic home and hospices or palliative care units. PARTICIPANTS: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer pati...

  14. Use of black vulture (Coragyps atratus) in complementary and alternative therapies for cancer in Colombia: A qualitative study

    Sánchez-Pedraza Ricardo; Gamba-Rincón Magda R; González-Rangel Andrés L

    2012-01-01

    Abstract Background Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. Methods This study used a qualitative design based on twenty in-depth interviews of patients...

  15. The Yin and Yang aspects of IL-27 in induction of cancer-specific T-cell responses and immunotherapy.

    Li, Ming-Song; Liu, Zhenzhen; Liu, Jin-Qing; Zhu, Xiaotong; Liu, Zhihao; Bai, Xue-Feng

    2015-01-01

    Accumulating evidences from animal studies have indicated that both endogenous and exogenous IL-27, an IL-12 family of cytokine, can increase antitumor T-cell activities and inhibit tumor growth. IL-27 can modulate Treg responses, and program effector T cells into a unique T-effector stem cell (TSEC) phenotype, which enhances T-cell survival in the tumor microenvironment. However, animal studies also suggest that IL-27 induces molecular pathways such as IL-10, PD-L1 and CD39, which may downregulate tumor-specific T-cell responses. In this review paper, we will discuss the Yin and Yang aspects of IL-27 in the induction of tumor-specific T-cell responses, and the potential impacts of these functions of IL-27 in the design of cancer immunotherapy.

  16. Fertility concerns among child and adolescent cancer survivors and their parents: A qualitative analysis.

    Ellis, Sarah J; Wakefield, Claire E; McLoone, Jordana K; Robertson, Eden G; Cohn, Richard J

    2016-01-01

    Cancer diagnoses and treatment may have long-term effects on fertility. Semistructured interviews were administered to young cancer survivors (Fertility related concerns were reported by 45 participants (46.4%). Themes included: distress regarding potential infertility; the effect of infertility on future relationships, self-esteem, and miscommunications/confusion about fertility status; access to fertility testing; and preservation options. Parents also reported challenges regarding how and when it was developmentally appropriate to talk to their children about fertility. The development of comprehensive consumer-driven approaches to managing the fertility concerns of young survivors and their families is essential.

  17. Environmental, structural and process barriers in breast cancer screening for women with physical disability: A qualitative study

    Peters, K.; Cotton, A.

    2016-01-01

    Breast cancer is the most common cancer in women internationally and is responsible for the deaths of thousands of women annually. Early detection of breast cancer is integral to ensure early intervention which increases survival rates and health outcomes for women. Despite the availability of breast cancer screening (BCS), previous research has identified that women with physical disability are less likely to access BCS and when they do, they encounter substantial barriers to these services. This paper presents the environmental, systemic and process barriers that women with physical disability face in undertaking BCS in New South Wales, Australia. A qualitative design was used to collect data via in-depth interviews which were audio-recorded, transcribed verbatim and thematically analysed. Twelve women with physical disability participated in interviews to share their experiences of BCS. Findings revealed that participants had both negative and positive experiences during BCS and are presented in the following four themes: Needing better access, Feeling like the machines aren't made for people like me; Experiencing health workers as being clinical and detached and; Facilitating and improving the experience of breast screening. Participants encountered substantial difficulties with the inflexibility of the diagnostic equipment. Further some conveyed that negative experiences of the procedure and interactions with staff while accessing mammography would deter them from returning for BCS. Informed and individualised care is required to enhance the experience of women with physical disability and thus increase uptake rates of this service. - Highlights: • Women with physical disabilities have unique needs in accessing mammography. • Significant difficulties were reported in accessing and negotiating equipment. • Staff attitudes considerably influenced participants' breast screening experience. • Participants recommend changes to mammography to

  18. The impact of meticillin-resistant Staphylococcus aureus on patients with advanced cancer and their family members: A qualitative study.

    Gleeson, Aoife; Larkin, Philip; O'Sullivan, Niamh

    2016-04-01

    Little is known about the impact of meticillin-resistant Staphylococcus aureus on patients with advanced cancer, such as its impact on the quality of life of this vulnerable group. To date, research on meticillin-resistant Staphylococcus aureus in the palliative care setting has had a quantitative focus. The purpose of this study was to explore the impact of a meticillin-resistant Staphylococcus aureus diagnosis on patients and their carers. This article reports upon a qualitative interview study of nine patients with advanced cancer and meticillin-resistant Staphylococcus aureus and nine family members (n = 18). Framework analysis was used to analyse the data. Patients and family members of patients with advanced cancer either admitted to the specialist palliative care unit or receiving palliative care in the hospital setting, who had a laboratory confirmed diagnosis of meticillin-resistant Staphylococcus aureus colonisation, were considered for inclusion in the study. Four themes were identified using framework analysis: reactions to receiving a meticillin-resistant Staphylococcus aureus diagnosis, the need for effective communication of the meticillin-resistant Staphylococcus aureus diagnosis, the enigmatic nature of meticillin-resistant Staphylococcus aureus, and lessons to guide the future care of meticillin-resistant Staphylococcus aureus patients. This article indicates that meticillin-resistant Staphylococcus aureus can have a significant impact on advanced cancer patients and their families. This impact may be underestimated, but early and careful face-to-face explanation about meticillin-resistant Staphylococcus aureus and its implications can help patients and their families to cope better with it. These findings should be considered when developing policy relating to meticillin-resistant Staphylococcus aureus management and infection control in specialist palliative care settings. © The Author(s) 2015.

  19. Understanding the role of embarrassment in gynaecological screening: a qualitative study from the ASPIRE cervical cancer screening project in Uganda.

    Teng, Flora F; Mitchell, Sheona M; Sekikubo, Musa; Biryabarema, Christine; Byamugisha, Josaphat K; Steinberg, Malcolm; Money, Deborah M; Ogilvie, Gina S

    2014-04-11

    To define embarrassment and develop an understanding of the role of embarrassment in relation to cervical cancer screening and self-collected human papillomavirus (HPV) DNA testing in Uganda. Cross-sectional, qualitative study using semistructured one-to-one interviews and focus groups. 6 key-informant health workers and 16 local women, purposively sampled. Key informant inclusion criteria: Ugandan members of the project team. Focus group inclusion criteria: woman age 30-69 years, Luganda or Swahili speaking, living or working in the target Ugandan community. unwillingness to sign informed consent. Primary and tertiary low-resource setting in Kampala, Uganda. In Luganda, embarrassment relating to cervical cancer is described in two forms. 'Community embarrassment' describes discomfort based on how a person may be perceived by others. 'Personal embarrassment' relates to shyness or discomfort with her own genitalia. Community embarrassment was described in themes relating to place of study recruitment, amount of privacy in dwellings, personal relationship with health workers, handling of the vaginal swab and misunderstanding of HPV self-collection as HIV testing. Themes of personal embarrassment related to lack of knowledge, age and novelty of the self-collection swab. Overall, embarrassment was a barrier to screening at the outset and diminished over time through education and knowledge. Fatalism regarding cervical cancer diagnosis, worry about results and stigma associated with a cervical cancer diagnosis were other psychosocial barriers described. Overcoming psychosocial barriers to screening can include peer-to-peer education, drama and media campaigns. Embarrassment and other psychosocial barriers may play a large role at the onset of a screening programme, but over time as education and knowledge increase, and the social norms around screening evolve, its role diminishes. The role of peer-to-peer education and community authorities on healthcare cannot be

  20. What do stakeholders need to implement shared decision making in routine cancer care? A qualitative needs assessment.

    Müller, Evamaria; Hahlweg, Pola; Scholl, Isabelle

    2016-12-01

    Shared decision making (SDM) is particularly relevant in oncology, where complex treatment options with varying side effects may lead to meaningful changes in the patient's quality of life. For several years, health policies have called for the implementation of SDM, but SDM remains poorly implemented in routine clinical practice. Implementation science has highlighted the importance of assessing stakeholders' needs to inform the development of implementation programs. Thus, the aim of the present study was to assess different stakeholders' needs regarding the implementation of SDM in routine care. A qualitative study using focus groups and interviews was conducted. Focus groups were carried out with junior physicians, senior physicians, nurses and other healthcare providers (HPCs) (e.g. psycho-oncologists, physiotherapists), patients and family members. Head physicians as well as other HPCs in management positions were interviewed. Audiotapes of focus groups and interviews were transcribed verbatim and analyzed using content analysis. Six focus groups with a total of n = 42 stakeholders as well as n = 17 interviews were conducted. Focus groups and interviews revealed five main categories of needs to be fulfilled in order to achieve a better implementation of SDM in routine cancer care: 1) changes in communication, 2) involvement of other parties, 3) a trustful patient-physician relationship, 4) culture change and 5) structural changes. Stakeholders discussed four clusters of intervention strategies that could foster the implementation of SDM in routine cancer care: 1) clinician-mediated interventions, 2) patient-mediated interventions, 3) provision of patient information material and 4) the establishment of a patient advocate. Study results show that stakeholders voiced a diversity of needs to foster implementation of SDM in routine cancer care, of which some can be directly addressed by intervention strategies. Present results can be used to develop an

  1. Understanding domains of health-related quality of life concerns of Singapore Chinese patients with advanced cancer: a qualitative analysis.

    Lee, G L; Pang, G S Y; Akhileswaran, R; Ow, M Y L; Fan, G K T; Wong, C C F; Wee, H L; Cheung, Y B

    2016-03-01

    Quality of life concerns in patients with advanced diseases might be different from other patients and are shaped by sociocultural context. The objective of this qualitative study was to identify domains and themes of health-related quality of life (HRQoL) that Chinese patients with advanced cancer in Singapore considered relevant and important. English- and Chinese-speaking patients with advanced solid cancer were recruited from a tertiary cancer center and a community-based hospice for in-depth interview or focused group discussion. Thematic analysis was used to identify subthemes, themes, and domains from the transcripts. Forty-six ethnic Chinese (aged 26-86, 48% male) participated in the study. Six domains of HRQoL concerns were identified: pain and suffering, physical health, social health, mental health, financial well-being, and spiritual health. Pain and suffering are not limited to the physical domain, reflecting the multidimensional nature of this concept. Pain and suffering must also be understood within the cultural context. Healthcare relations (i.e., social health), existential well-being and religious well-being (i.e., spiritual health), and suffering (i.e., pain and suffering) are not fully captured in the existing HRQoL instruments. In addition, financial issues and the practice of secrecy in interpersonal relationships emerged as unique features possibly arising from our sociocultural context and healthcare financing landscape. Socioculturally specific issues not measured by the existing HRQoL instruments for use in patients with advanced cancers or terminal diseases were found in our study. These are non-physical pain and suffering, meaning of illness, meaning of death, financial issues, and practice of secrecy in interpersonal relationships.

  2. Dealing with taste and smell alterations-A qualitative interview study of people treated for lung cancer.

    Kerstin Belqaid

    Full Text Available Taste and smell alterations have been recognized as common symptoms in relation to various cancers. However, previous research suggests that patients do not receive sufficient support in managing taste and smell alterations. Therefore, the objective of this study is to investigate how persons with experience from lung cancer-related taste and smell alterations reason about resources and strategies offered and used to manage these symptoms. Data from semi-structured individual interviews with 13 women and four men were analyzed with qualitative content analysis. We used Kleinman's now classic medical anthropological model of local health care systems, consisting of the personal, professional, and folk sector, to interpret and understand how people respond to sickness experiences in their daily lives. By presenting the findings using this model, we demonstrate that most strategies for dealing with taste and smell alterations were undertaken in the personal sector, i.e. in participants' daily lives, on an individual level and in interaction with family, social networks and communities. Taste and smell alterations implied two overarching challenges: 1 adjusting to no longer being able to trust information provided by one's own senses of taste and/or smell, and 2 coming to terms with taste and smell alterations as a part of having lung cancer. Health care professionals' involvement was described as limited, but appeared to fulfil most participants' expectations. However, through provision of normalizing information, practical advice, and to some extent, emotional support, health care professionals had potential to influence strategies and resources used for dealing with taste and smell alterations. With this study, we further the understanding of how people deal with lung cancer-related taste and smell alterations and discuss the role of health care professionals for this process.

  3. Breast cancer genetic testing awareness, attitudes and intentions of Latinas living along the US-Mexico border: a qualitative study.

    Chalela, Patricia; Pagán, José A; Su, Dejun; Muñoz, Edgar; Ramirez, Amelie G

    2012-01-01

    Genetic testing for breast cancer may facilitate better-informed decisions regarding cancer prevention, risk reduction, more effective early detection, and better determination of risk for family members. Despite these potential benefits, significant portions of the US population-particularly Latinas-lack awareness of genetic testing for breast cancer susceptibility. Among women who are tested, less than 4% are Latina. To uncover reasons for Latinas' low participation, this study explores awareness, attitudes and behavioral intentions to undergo genetic testing among average-risk Latinas along the Texas-Mexico border. Eight focus groups were conducted with 58 Latinas aged 19-69 living in Hidalgo County, a largely Latino region of South Texas. Focus group discussions were digitally recorded, transcribed and analyzed using qualitative content analysis to assess, categorize and interpret them. Two experienced study team members analyzed transcripts to identify major concepts grouped into theme categories. Participants mostly had less than a high-school education (43%), spoke primarily Spanish (52%), were of Mexican-American origin (90%) and had a family income of $30,000 or less (75%). Focus groups found that most participants had positive attitudes and strong interest in genetic testing, yet lacked general awareness and knowledge about genetic testing, its risks, benefits, and limitations. Participants also identified several key cultural-based influencers, such as family, religious beliefs and fear of testing. The delivery of culturally adapted risk information is needed to increase and ensure Latinas' understanding of breast cancer genetic testing during their decision-making processes. Key Latino values-religiosity, importance of family and the influential role of health care providers in health decisions-should also be considered when designing interventions targeting this specific group. Further research is needed to identify effective ways to communicate

  4. Dealing with taste and smell alterations-A qualitative interview study of people treated for lung cancer.

    Belqaid, Kerstin; Tishelman, Carol; Orrevall, Ylva; Månsson-Brahme, Eva; Bernhardson, Britt-Marie

    2018-01-01

    Taste and smell alterations have been recognized as common symptoms in relation to various cancers. However, previous research suggests that patients do not receive sufficient support in managing taste and smell alterations. Therefore, the objective of this study is to investigate how persons with experience from lung cancer-related taste and smell alterations reason about resources and strategies offered and used to manage these symptoms. Data from semi-structured individual interviews with 13 women and four men were analyzed with qualitative content analysis. We used Kleinman's now classic medical anthropological model of local health care systems, consisting of the personal, professional, and folk sector, to interpret and understand how people respond to sickness experiences in their daily lives. By presenting the findings using this model, we demonstrate that most strategies for dealing with taste and smell alterations were undertaken in the personal sector, i.e. in participants' daily lives, on an individual level and in interaction with family, social networks and communities. Taste and smell alterations implied two overarching challenges: 1) adjusting to no longer being able to trust information provided by one's own senses of taste and/or smell, and 2) coming to terms with taste and smell alterations as a part of having lung cancer. Health care professionals' involvement was described as limited, but appeared to fulfil most participants' expectations. However, through provision of normalizing information, practical advice, and to some extent, emotional support, health care professionals had potential to influence strategies and resources used for dealing with taste and smell alterations. With this study, we further the understanding of how people deal with lung cancer-related taste and smell alterations and discuss the role of health care professionals for this process.

  5. A qualitative metasynthesis exploring the impact of prostate cancer and its management on younger, unpartnered and gay men.

    Matheson, L; Watson, E K; Nayoan, J; Wagland, R; Glaser, A; Gavin, A; Wright, P; Rivas, C

    2017-11-01

    Prostate cancer (PCa) can negatively impact on men's sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (≥65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (identity-illustrating the multiple threats to men's work, sexual and social identities; shifting into different communities of practice-such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups. © 2017 John Wiley & Sons Ltd.

  6. Adolescents and young adults with cancer: aspects of adherence – a questionnaire study

    Kleinke AM

    2018-05-01

    Full Text Available Anne Marie Kleinke, Carl Friedrich Classen Oncology and Hematology Unit, Children’s Hospital, University Medicine Rostock, Rostock, Germany Purpose: For adolescents and young adults (AYAs, a cancer diagnosis represents an extraordinary strike in a vulnerable phase of life. They have special needs that the medical system has to take into consideration, and they exhibit a lower degree of therapy adherence than both older and younger patients. The purpose of this study was first to analyze the adherence of AYAs with cancer compared to a group of older patients and, second, to determine correlated parameters, with focus on the psychosocial interaction between physicians and patients. Patients and methods: In 2012, a complete 1 year cohort of patients reported, by use of a questionnaire, to the Rostock clinical cancer registry, and a group of older patients were invited to answer a multi-item set of questionnaires on a volunteer basis, leading to a population-based cross-sectional analysis. This included a bias due to non-answering which is unavoidable in such a setting. The questionnaire consisted of well-established standard questionnaires, a questionnaire on adherence that has just recently been published, and a self-written questionnaire focusing on patient–physician relationship. The responses were analyzed for our current study. Results: Gender, religion, education, age, anxiety, family atmosphere, or physician–patient relationship were not significantly correlated to adherence in AYAs. However, markedly more AYAs, as compared to the older patients group, considered breaking off therapy and reported suboptimal communication with the physicians. Only the perceived physical illness could be identified as a factor related to adherence among the AYA group.Conclusion: Our findings confirm the need for more focused approaches to serve the special needs of AYAs, with particular attention on specific items that showed up discriminating AYAs from

  7. The radiobiology of prostate cancer including new aspects of fractionated radiotherapy

    Fowler, Jack F.

    2005-01-01

    Total radiation dose is not a reliable measure of biological effect when dose-per-fraction or dose-rate is changed. Large differences in biological effectiveness (per gray) are seen between the 2 Gy doses of external beam radiotherapy and the large boost doses given at high dose-rate from afterloading sources. The effects are profoundly different in rapidly or slowly proliferating tissues, that is for most tumors versus late complications. These differences work the opposite way round for prostate tumors versus late complications compared with most other types of tumor. Using the Linear-Quadratic formula it is aimed to explain these differences, especially for treatments of prostate cancer. The unusually slow growth rate of prostate cancers is associated with their high sensitivity to increased fraction size, so a large number of small fractions, such as 35 or 40 'daily' doses of 2 Gy, is not an optimum treatment. Theoretical modeling shows a stronger enhancement of tumor effect than of late complications for larger (and fewer) fractions, in prostate tumors uniquely. Biologically Effective Doses and Normalized Total Doses (in 2 Gy fraction equivalents) are given for prostate tumor, late rectal reactions, and - a new development - acute rectal mucosa. Tables showing the change of fraction-size sensitivity (the alpha/beta ratio) with proliferation rates of tissues lead to the association of slow cell doubling times in prostate tumors with small alpha/beta ratios. Clinical evidence to confirm this biological expectation is reviewed. The alpha/beta ratios of prostate tumors appear to be as low as 1.5 Gy (95% confidence interval 1.3-1.8 Gy), in contrast with the value of about 10 Gy for most other types of tumor. The important point is that alpha/beta ratio=1.5 Gy appears to be significantly less than the alpha/beta ratio=3 Gy for late complications in rectal tissues. Such differences are also emerging from recent clinical results. From this important difference stems

  8. Aspects of posttraumatic stress disorder in long-term testicular cancer survivors

    Dahl, A.; Østby-Deglum, Maria; Oldenburg, J.

    2016-01-01

    Purpose: The purpose of this research is to study the prevalence of posttraumatic stress disorder (PTSD) and variables associated with PTSD in Norwegian long-term testicular cancer survivors (TCSs) both cross-sectionally and longitudinally. Methods: At a mean of 11 years after diagnosis, 1418 TCSs....../depression, chronic fatigue, and neurotoxic adverse effects were significantly associated with Probable PTSD in bivariate analyses. Probable anxiety disorder, poor self-rated health, and neurotoxicity remained significant with Probable PTSD in multivariate analyses at the 11-year study. In bivariate analyses......, probable PTSD at that time significantly predicted socio-demographic variables, somatic health, anxiety/depression, chronic fatigue, and neurotoxicity among participants of the 19-year study, but only probable anxiety disorder remained significant in multivariable analysis. Conclusions: In spite...

  9. Systemic aspects of conjugal resilience in couples with a child facing cancer and marrow transplantation.

    Martin, Julie; Péloquin, Katherine; Vachon, Marie-France; Duval, Michel; Sultan, Serge

    The negative impact of paediatric cancer on parents is well known and is even greater when intensive treatments are used. This study aimed to describe how couples whose child has received a transplant for the treatment of leukaemia view conjugal resilience and to evaluate the role of we-ness as a precursor of conjugal adjustment. Four parental couples were interviewed. Interviews were analysed in two ways: inductive thematic analysis and rating of verbal content with the We-ness Coding Scale . Participants report that conjugal resilience involves the identification of the couple as a team and cohesion in the couple. Being a team generates certain collaborative interactions that lead to conjugal resilience. A sense of we-ness in parents is associated with fluctuation in the frequency of themes. Participants' vision of conjugal resilience introduced novel themes. The sense of we-ness facilitates cohesion and the process of conjugal resilience.

  10. Postoperative radiation therapy and adjuvant chemoimmunotherapy in breast cancer. Aspects of timing and immune competence

    Klefstroem, P.; Nuortio, L.; Taskinen, E.

    The effects of radiation therapy and adjuvant chemoimmunotherapy on the immune competence of patients with breast cancer were investigated. The tests performed included intradermal tuberculin tests, T- and B-lymphocyte counts, and lymphocyte blast transformation tests; phytohemagglutinin (PHA), concanavalin A (ConA) and pokeweed mitogen (PMW) were used as mitogens. Enhancement in lymphocyte proliferative response to mitogenic stimulation by PHA and PMW was seen in patients after 3 courses of chemotherapy + levamisole, whereas irradiation given after chemotherapy caused long-lasting depression in response to PHA and PWM (not significant). T-lymphocyte counts were also lower after irradiation than after chemoimmunotherapy. Clinically, the 16 patients treated with radiation therapy after chemotherapy exhibited a higher recurrence rate than the 24 patients treated first by irradiation. Enhanced reactivity to tuberculin tests occurred generally in patients receiving a planned treatment including irradiation, chemotherapy (5-fluorouracil, doxorubicin, cyclophosphamide) and levamisole. Enhancement of reactivity was seen more often in patients who had not relapsed.

  11. Systemic aspects of conjugal resilience in couples with a child facing cancer and marrow transplantation

    Julie Martin

    2016-09-01

    Full Text Available Introduction: The negative impact of paediatric cancer on parents is well known and is even greater when intensive treatments are used. This study aimed to describe how couples whose child has received a transplant for the treatment of leukaemia view conjugal resilience and to evaluate the role of we-ness as a precursor of conjugal adjustment. Methods: Four parental couples were interviewed. Interviews were analysed in two ways: inductive thematic analysis and rating of verbal content with the We-ness Coding Scale. Results: Participants report that conjugal resilience involves the identification of the couple as a team and cohesion in the couple. Being a team generates certain collaborative interactions that lead to conjugal resilience. A sense of we-ness in parents is associated with fluctuation in the frequency of themes. Discussion: Participants’ vision of conjugal resilience introduced novel themes. The sense of we-ness facilitates cohesion and the process of conjugal resilience.

  12. Cervix cancer: clinical aspects of tumoral control and radiotherapy treatment time

    Petitto, J.V.

    1994-01-01

    The author analyzed 35 patients with recurrence or residual tumor at the end of the radiotherapy program. These patients were selected out of a group of 338 patients cervix cancer who had also undergone on the same radiotherapy program. Those patients were compared with control group of 30 patients without clinical evidence of the disease, from the same group of 338 patients. It has studied the clinical results considering the total radiotherapy time to developed the radiation program and factors that could modify the time for a longer program, and also modify the final survival results. No significant difference was shown in this study, but it should be taken in consideration the total radiotherapy time, because this is a factor that could change the final results if the time would be longer than what was shown in this work. (author). 26 refs, 10 tabs

  13. Conceptualizing patient empowerment in cancer follow-up by combining theory and qualitative data

    Johnsen, Anna Thit; Eskildsen, Nanna Bjerg; Thomsen, Thora Grothe

    2017-01-01

    and sensitive questionnaire for this population. Material and Methods: A theoretical model of PE was made, based on Zimmerman’s theory of psychological empowerment. Patients who were in follow-up after first line treatment for their cancer (n = 16) were interviewed about their experiences with follow...

  14. Information needs of cancer patients and survivors regarding diet, exercise and weight management: a qualitative study.

    James-Martin, G; Koczwara, B; Smith, E L; Miller, M D

    2014-05-01

    While advanced cancer is often associated with weight loss, curative cancer treatment is often associated with weight gain. Weight gain during treatment may be associated with greater risk of cancer recurrence and development of lifestyle diseases. Currently, limited resources are available to cancer patients focussed on weight control. This study assessed the information needs of patients undergoing curative chemotherapy regarding diet, exercise and weight management for the purpose of developing weight management resources. Focus groups were held with oncology practitioners, patients and survivors to determine current information provision and needs. Focus groups highlighted a perception that information provision regarding diet, exercise and weight management is insufficient and no routine assessment of weight occurs during chemotherapy. Barriers to information provision described included lack of resources and time, and practitioners' uncertainty regarding appropriate messages to provide. Patients wanted more information regarding diet, exercise and weight during treatment time. The findings of this study suggest an increase in provision of diet, exercise and weight management information is needed. This information should be evidence-based and delivered at an appropriate time by the preferred health care professional. It would also be beneficial to implement protocols regarding assessment of weight during treatment. © 2013 John Wiley & Sons Ltd.

  15. Immigrant to Canada, newcomer to childhood cancer: a qualitative study of challenges faced by immigrant parents.

    Klassen, Anne F; Gulati, Sonia; Watt, Lisa; Banerjee, Ananya T; Sung, Lillian; Klaassen, Robert J; Dix, David; Poureslami, Iraj M; Shaw, Nicola

    2012-05-01

    Given the increasing numbers of immigrant families in Canada, it is imperative that healthcare providers (HCPs) understand the caregiving experiences of immigrant family caregivers. Our study aimed to explore any special challenges faced by immigrant parents of children with cancer and to identify supportive factors. A constructivist grounded theory approach was used. Participants included 50 first generation Chinese and South Asian parents of children with cancer who were at least six months post-diagnosis. Recruitment took place at six Canadian pediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi. Analysis involved coding and the use of the constant comparison method. Interviewing continued until no new themes emerged. While immigrant parents described many challenges faced by any parent of a child with cancer, the context of being an immigrant made certain experiences particularly challenging. Parents described challenges in the following areas: managing caregiving demand and financial strain, accessing support from others, and interfacing with the healthcare system. Parents described receiving a range of practical, emotional, social and informational support from extended family, their workplace, other cancer families, community organizations and HCPs. Our study addresses an important gap in the research literature by providing practical insight into the experiences of immigrant family caregivers. Our findings may help to inform the development of pediatric oncology policies and programs in ways that respond to the unique needs and challenges of culturally and linguistically diverse families. Copyright © 2011 John Wiley & Sons, Ltd.

  16. Patients' perceptions of the side-effects of prostate cancer treatment--a qualitative interview study

    Korfage, Ida Joanna; Hak, Tony; de Koning, Harry J.; Essink-Bot, Marie-Louise

    2006-01-01

    Primary prostate cancer treatment often results in suboptimal urinary, bowel and/or sexual function. These effects are not inevitable. After treatment patients typically report high health related quality of life (QoL) scores. This discrepancy between disease-specific and generic results raises the

  17. Hope, Life, and Death: A Qualitative Analysis of Dying Cancer Patients' Talk about Hope

    Eliott, Jaklin A.; Olver, Ian N.

    2009-01-01

    Although deemed vital to patient well-being, hope in persons who are terminally ill is often thought to be problematic, particularly when centered on cure. As part of a study on end-of-life decision-making, we asked 28 patients with cancer, believed to be within weeks of their death, to talk about hope. Responses were transcribed and discursively…

  18. Work-related experiences of head and neck cancer survivors: an exploratory and descriptive qualitative study

    Dewa, Carolyn S.; Trojanowski, Lucy; Tamminga, Sietske J.; Ringash, Jolie; McQuestion, Maurene; Hoch, Jeffrey S.

    2017-01-01

    This exploratory and descriptive study contributes to the growing knowledge about the return-to-work (RTW) experience of head and neck cancer (HNC) survivors. Viewing RTW as a process, participants were asked to consider the work-related experience with HNC at different phases: (1) at

  19. Understanding behavioral mechanisms for physical activity in head and neck cancer patients: a qualitative study

    Sealy, Martine; Stuiver, M.M.; Midtgard, Julie; van der Schans, Cees; Roodenburg, Jan L N; Jager-Wittenaar, Harriët

    2017-01-01

    Rationale: Head and neck cancer (HNC) patients often have adverse changes in body composition. Loss of muscle mass and strength frequently occur, even when dietary intake is adequate. Nascent evidence suggests that a healthy lifestyle, including adequate physical activity (PA) and diet, may prevent

  20. A qualitative study exploring male cancer patients' experiences with percutaneous nephrostomy

    Bigum, Lene Hyldgaard; Spielmann, Marlène Elisabeth; Juhl, Gitte

    2015-01-01

    of this study was to describe how a nephrostomy is perceived by patients and its effects on their everyday lives. Material and methods. Semi-structured interviews were conducted in the patients' home using a mind map. The inclusion criteria were locally advanced or metastatic urological cancer treated...

  1. Adjuvant endocrine therapy after breast cancer: a qualitative study of factors associated with adherence

    Brett J

    2018-02-01

    Full Text Available Jo Brett,1 Mary Boulton,1 Debbie Fenlon,2 Nick J Hulbert-Williams,3 Fiona M Walter,4 Peter Donnelly,5 Bernadette A Lavery,6 Adrienne Morgan,7 Carolyn Morris,7 Eila K Watson1 1Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, 2College of Human and Health Sciences, Swansea University, Swansea, Wales, 3Department of Psychology, Chester Research Unit for the Psychology of Health, University of Chester, Chester, 4Department of Public Health and Primary Care, University of Cambridge, Cambridge, 5South Devon Healthcare NHS Foundation Trust, Torbay Hospital, Torquay, 6Cancer Services, Oxford University Hospitals Foundation NHS Trust, Oxford, 7Independent Cancer Patients’ Voice, London, UK Introduction: Despite evidence of the efficacy of adjuvant endocrine therapy (AET in reducing the risk of recurrence and mortality after treatment for primary breast cancer, adherence to AET is suboptimal. This study aimed to explore factors that influence adherence and nonadherence to AET following breast cancer to inform the development of supportive interventions.Methods: Interviews were conducted with 32 women who had been prescribed AET, 2–4 years following their diagnosis of breast cancer. Both adherers (n=19 and nonadherers (n=13 were recruited. The analysis was conducted using the Framework approach.Results: Factors associated with adherence were as follows: managing side effects including information and advice on side effects and taking control of side effects, supportive relationships, and personal influences. Factors associated with nonadherence were as follows: burden of side effects, feeling unsupported, concerns about long-term AET use, regaining normality, including valuing the quality of life over length of life, and risk perception.Conclusion: Provision of timely information to prepare women for the potential side effects of AET and education on medication management strategies are needed, including provision of timely and

  2. Health seeking behavior for cervical cancer in Ethiopia: a qualitative study

    Birhanu Zewdie

    2012-12-01

    Full Text Available Abstract Background Although cervical cancer is a leading cause of cancer related morbidity and mortality among women in Ethiopia, there is lack of information regarding the perception of the community about the disease. Methods Focus group discussions were conducted with men, women, and community leaders in the rural settings of Jimma Zone southwest Ethiopia and in the capital city, Addis Ababa. Data were captured using voice recorders, and field notes were transcribed verbatim from the local languages into English language. Key categories and thematic frameworks were identified using the health belief model as a framework, and presented in narratives using the respondents own words as an illustration. Results Participants had very low awareness of cervical cancer. However, once the symptoms were explained, participants had a high perception of the severity of the disease. The etiology of cervical cancer was thought to be due to breaching social taboos or undertaking unacceptable behaviors. As a result, the perceived benefits of modern treatment were very low, and various barriers to seeking any type of treatment were identified, including limited awareness and access to appropriate health services. Women with cervical cancer were excluded from society and received poor emotional support. Moreover, the aforementioned factors all caused delays in seeking any health care. Traditional remedies were the most preferred treatment option for early stage of the disease. However, as most cases presented late, treatment options were ineffective, resulting in an iterative pattern of health seeking behavior and alternated between traditional remedies and modern treatment methods. Conclusion Lack of awareness and health seeking behavior for cervical cancer was common due to misconceptions about the cause of the disease. Profound social consequences and exclusion were common. Access to services for diagnosis and treatment were poor for a variety of psycho

  3. Use of black vulture (Coragyps atratus in complementary and alternative therapies for cancer in Colombia: A qualitative study

    Sánchez-Pedraza Ricardo

    2012-05-01

    Full Text Available Abstract Background Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. Methods This study used a qualitative design based on twenty in-depth interviews of patients with cancer or caregivers of patients with the disease. The analysis of the text was based on an inductive thematic approach. Results Resistance to disease and immune enhancement are properties attributed to Coragyps atratus when used for cancer treatment. The most recommended method of use is fresh blood ingestion, and the associated mechanism of action is transfer of immune factors to the individual who consumes it. Conclusions Use of Coragyps atratus as a treatment for cancer is a popular alternative therapy in Colombia. More studies are needed to understand the clinical effects of this intervention in cancer patients. Spanish abstract Introducción Aunque Coragyps atratus se usa tradicionalmente como terapia para pacientes con cáncer, no existe suficiente información en la literatura científica sobre su forma de utilización ni sobre los mecanismos explicativos que subyacen a esta práctica terapéutica. Objetivos Conocer métodos de utilización y mecanismos explicativos dados por los pacientes y cuidadores de pacientes sobre el uso de Coragyps atratus en el tratamiento del cáncer. Materiales y métodos Diseño cualitativo basado en veinte entrevistas en profundidad de pacientes con cáncer o cuidadores de pacientes con esta enfermedad. Análisis de texto basado en enfoque temático inductivo. Resultados Al Coragyps atratus se le atribuyen propiedades de resistencia y fortalecimiento del sistema inmune de personas enfermas de cáncer. La forma de

  4. Use of black vulture (Coragyps atratus) in complementary and alternative therapies for cancer in Colombia: A qualitative study

    2012-01-01

    Background Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. Methods This study used a qualitative design based on twenty in-depth interviews of patients with cancer or caregivers of patients with the disease. The analysis of the text was based on an inductive thematic approach. Results Resistance to disease and immune enhancement are properties attributed to Coragyps atratus when used for cancer treatment. The most recommended method of use is fresh blood ingestion, and the associated mechanism of action is transfer of immune factors to the individual who consumes it. Conclusions Use of Coragyps atratus as a treatment for cancer is a popular alternative therapy in Colombia. More studies are needed to understand the clinical effects of this intervention in cancer patients. Spanish abstract Introducción Aunque Coragyps atratus se usa tradicionalmente como terapia para pacientes con cáncer, no existe suficiente información en la literatura científica sobre su forma de utilización ni sobre los mecanismos explicativos que subyacen a esta práctica terapéutica. Objetivos Conocer métodos de utilización y mecanismos explicativos dados por los pacientes y cuidadores de pacientes sobre el uso de Coragyps atratus en el tratamiento del cáncer. Materiales y métodos Diseño cualitativo basado en veinte entrevistas en profundidad de pacientes con cáncer o cuidadores de pacientes con esta enfermedad. Análisis de texto basado en enfoque temático inductivo. Resultados Al Coragyps atratus se le atribuyen propiedades de resistencia y fortalecimiento del sistema inmune de personas enfermas de cáncer. La forma de utilización mas común es la

  5. [Application study of qualitatively diagnosing prostate cancer using ultrahigh b-value DWI].

    Ji, L B; Lu, Z H; Yao, H H; Cao, Y; Lu, W W; Qian, W X; Wang, X M; Hu, C H

    2017-07-18

    Objective: To explore the value of ultrahigh b-value DWI in diagnosis of prostate cancer. Methods: From October 2015 to October 2016, a total of 84 cases from Affiliated Changshu Hospital of Soochow University(39 cases of prostate cancer with a total of 57 lesions, 45 cases of benign prostate hyperplasia) were examined with T(2)WI, high b-value DWI (b=1 000 s/mm(2)) and ultrahigh b-value DWI (b=2 000 s/mm(2)) .Three image sets were rated respectively based on PI-RADS V2 by two radiologists and the scores were compared with biopsy results.The differences of the area under the ROC curve (AUC) among the three groups of each observer were compared by Z test. Results: The difference of AUC between ultrahigh b-value DWI and T(2)WI in the diagnosis of peripheral and transitional zone cancer was statistically significant between the two observers ( P =0.009 9, 0.008 2, 0.010 8 and 0.004 5 respectively), and there was no significant difference of AUC between ultrahigh b-value DWI and high b-value DWI in the diagnosis of peripheral and transitional zone cancer.The inter-reader agreement was found to be perfect for all lesions, peripheral zone lesions and transition zone lesions at ultrahigh b-value DWI ( kappa values were 0.738, 0.709 and 0.768 respectively). Conclusion: The diagnostic performance of ultrahigh b-value DWI is superior to high b-value DWI and T(2)WI in both peripheral zone and transition zone cancers.

  6. A Qualitative Study of the UK Academic Role: Positive Features, Negative Aspects and Associated Stressors in a Mainly Teaching-Focused University

    Darabi, Mitra; Macaskill, Ann; Reidy, Lisa

    2017-01-01

    The literature demonstrates that stress in the working life of academics has increased over recent years. However, qualitative research on how academics cope with this is very scarce. Using online interviewing with thematic analysis, this paper examines how 31 academics in a post-92 predominantly teaching-focused UK university cope with the…

  7. Indications and technical aspects of brachytherapy in breast conserving treatment of breast cancer

    Erik Van, Limbergen

    2003-01-01

    Improved local control rates have been demonstrated in retrospective studies as well as in randomized trials on brachytherapy with increasing doses to the tumour bed. The higher local control obtained by interstitial breast implants, as compared to external photon or electron beam boosts, have been mainly attributed to the higher doses actually delivered to the tumour bed by these implants for the same nominal dose as compared to external beam radiotherapy (RT). On the other hand, poor cosmesis has also been correlated with radiation dose to the breast skin (radiation telangiectases), and breast tissue (retraction due to fibrosis), the latter depending not only on RT dose but also on the treated boost volume. For this reason, a possible benefit of interstitial implants will only be realized when the gain in local control goes together with minimal cosmetic damage. Therefore, the ballistic advantages of interstitial implants have to be maximally exploited: i.e. the treated volume should be maximally adapted to the target volume, and additional irradiation of the breast skin by the boost technique should be avoided. This paper deals in detail with the technical aspects of breast brachytherapy that seem to be relevant for high quality outcome. (author)

  8. Aspects of the application of complementary brachytherapy for early invasive breast cancer

    Homma, L.A.H. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares; Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital das Clinicas]. E-mail: luciahomma@terra.com.br; Campos, T.P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares]. E-mail: campos@nuclear.ufmg.br; Silva, S.Z.C. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital das Clinicas; Lima, C.F. [ECOGRAF, Belo Horizonte, MG (Brazil). Nucleo de Diagnostico

    2007-07-01

    Initial studies of brachytherapy with the 'Mammosite Radiation Therapy System', a device consisted by a catheter centered inside a inflate balloon, to perform breast brachytherapy was revised. A high activity source was applied into the balloon, exposing to the tumor bed to a high absorbed dose, while the surrounding areas receives one reduced by to a factor 1/r{sup 2}, during a short interval of time. The high acute dose provides a booster to conventional radiation therapy, resulting in a better local control. The acceptable esthetic impact achieved and an easier device setting stimulated the present dosimetric study. The brachytherapy with Ir{sup 192} was simulated through the development of a computerized digital voxels phantom, which represented the breast anatomy. The Monte Carlo Code (MCNP {sup TM}, 1977) was used to evaluate the radiation of the tumor bed and health tissues. Results from simulations shows, as example, an amount of radiation absorbed by the tumor bed of 11.30 Gy up to 5 mm around the balloon surface. Radiation selectivity is also shown, in which tumour bed absorbed more radiation than the surrounding tissues, whose maximum values were: skin (6.73 Gy), muscle (7.69 Gy), and lung (3.02 Gy), for a fifteen-minute exposure of a Ir-152 source. The simulation results are presented. Reliability of this radiotherapy technique as a postoperative booster in early breast cancer is presented and confirmed in this work. (author)

  9. Aspects of the application of complementary brachytherapy for early invasive breast cancer

    Homma, L.A.H.; Universidade Federal de Minas Gerais; Campos, T.P.R.; Silva, S.Z.C.; Lima, C.F.

    2007-01-01

    Initial studies of brachytherapy with the 'Mammosite Radiation Therapy System', a device consisted by a catheter centered inside a inflate balloon, to perform breast brachytherapy was revised. A high activity source was applied into the balloon, exposing to the tumor bed to a high absorbed dose, while the surrounding areas receives one reduced by to a factor 1/r 2 , during a short interval of time. The high acute dose provides a booster to conventional radiation therapy, resulting in a better local control. The acceptable esthetic impact achieved and an easier device setting stimulated the present dosimetric study. The brachytherapy with Ir 192 was simulated through the development of a computerized digital voxels phantom, which represented the breast anatomy. The Monte Carlo Code (MCNP TM , 1977) was used to evaluate the radiation of the tumor bed and health tissues. Results from simulations shows, as example, an amount of radiation absorbed by the tumor bed of 11.30 Gy up to 5 mm around the balloon surface. Radiation selectivity is also shown, in which tumour bed absorbed more radiation than the surrounding tissues, whose maximum values were: skin (6.73 Gy), muscle (7.69 Gy), and lung (3.02 Gy), for a fifteen-minute exposure of a Ir-152 source. The simulation results are presented. Reliability of this radiotherapy technique as a postoperative booster in early breast cancer is presented and confirmed in this work. (author)

  10. Aspects of radiation protection during the treatment of liver cancer using yttrium-90 labelled microspheres

    Klemp, P.F.B.; Perry, A.M.; Fox, R.A.; Gray, B.N.; Burton, M.A.

    1989-01-01

    Twenty eight patients have received treatment for liver cancer by the intra-hepatic arterial injection of between 1 and 4 GBq of yttrium-90 labelled microspheres. The injection was performed at laparotomy. If 11.1 MBq of yttrium-90 are distributed evenly over 1 sq cm of tissue, the tissue surface will suffer an initial beta dose rate of 16.2 Gy h -1 . Special precautions are therefore essential during the injection procedure, subsequently in nursing the patient and if further intervention becomes necessary. A specially designed apparatus is used for the injection, glass spectacles are worn and if the active liver is to be handled, lead rubber gloves are used. The theatre is prepared so that contaminated items can be easily isolated and a 'spill pack' is readily available. At completion of the operation, the bremsstrahlung dose rate at 15 cm from the liver is initially 15 μSv h -1 GBq -1 . Contamination of urine is typically 20 to 50 kBq L -1 while the contamination of other body fluids is negligible. Finger doses to the surgeons has varied from 2 to 5 mSv GBq -1 injected while personnel film badges used to monitor the dose equivalent to the surgeons and ward staff have recorded maximum doses of 1.5 mSv and 300 μSv respectively. 11 refs., 1 fig., 3 tabs

  11. Characterization and anti-settlement aspects of surface micro-structures from Cancer pagurus

    Sullivan, T; Regan, F; McGuinness, K; Connor, N E O’

    2014-01-01

    Tuning surface and material properties to inhibit or prevent settlement and attachment of microorganisms is of interest for applications such as antifouling technologies. Here, optimization of nano- and microscale structures on immersed surfaces can be utilized to improve cell removal while reducing adhesion strength and the likelihood of initial cellular attachment. Engineered surfaces capable of controlling cellular behaviour under natural conditions are challenging to design due to the diversity of attaching cell types in environments such as marine waters, where many variations in cell shape, size and adhesion strategy exist. Nevertheless, understanding interactions between a cell and a potential substrate for adhesion, including topographically driven settlement cues, offers a route to designing surfaces capable of controlling cell settlement. Biomimetic design of artificial surfaces, based upon microscale features from natural surfaces, can be utilized as model surfaces to understand cell–surface interactions. The microscale surface features of the carapace from the crustacean Cancer pagurus has been previously found to influence the rate of attachment of particular organisms when compared to smooth controls. However, the nature of microscale topographic features from C. pagurus have not been examined in sufficient detail to allow design of biomimetic surfaces. In this work, the spatial distribution, chemical composition, size and shape descriptors of microscale surface features from C. pagurus are characterized in detail for the first time. Additionally, the influence of topography from C. pagurus on the settlement of marine diatoms is examined under field conditions. (paper)

  12. [Molecular aspects of human papillomaviruses and their relation to uterine cervix cancer].

    García-Carrancá, A; Gariglio, P V

    1993-01-01

    Papillomaviruses (wart viruses) are responsible for the development of benign and malignant epithelial lesions in mammals. More than 60 different types of human papillomaviruses (HPVs) have been isolated to date. Some of them are major candidates as etiologic agents in cervical cancer. DNA from HPV types 16, 18 and 33 is usually found integrated in about 90 percent of genital carcinomas. Integration of the viral DNA into the cellular genome may be an important step towards the development of malignancy. Two early genes of HPVs (E6 y E7) are involved in cellular transformation. Another early gene (E2) participates in gene control by directly binding to conserved DNA motifs in the viral genome. Several protein factors of viral and cellular origin interact with the regulatory region of HPVs and participate in the regulation transcription of oncogenes E6 and E7. Cellular factors, such as immune system and oncogene and anti-oncogene alterations, seem to play an important role in papillomavirus-associated cervical carcinogenesis.

  13. Barriers to colorectal cancer screening in community health centers: A qualitative study

    Fletcher Robert H

    2008-02-01

    Full Text Available Abstract Background Colorectal cancer screening rates are low among disadvantaged patients; few studies have explored barriers to screening in community health centers. The purpose of this study was to describe barriers to/facilitators of colorectal cancer screening among diverse patients served by community health centers. Methods We identified twenty-three outpatients who were eligible for colorectal cancer screening and their 10 primary care physicians. Using in-depth semi-structured interviews, we asked patients to describe factors influencing their screening decisions. For each unscreened patient, we asked his or her physician to describe barriers to screening. We conducted patient interviews in English (n = 8, Spanish (n = 2, Portuguese (n = 5, Portuguese Creole (n = 1, and Haitian Creole (n = 7. We audiotaped and transcribed the interviews, and then identified major themes in the interviews. Results Four themes emerged: 1 Unscreened patients cited lack of trust in doctors as a barrier to screening whereas few physicians identified this barrier; 2 Unscreened patients identified lack of symptoms as the reason they had not been screened; 3 A doctor's recommendation, or lack thereof, significantly influenced patients' decisions to be screened; 4 Patients, but not their physicians, cited fatalistic views about cancer as a barrier. Conversely, physicians identified competing priorities, such as psychosocial stressors or comorbid medical illness, as barriers to screening. In this culturally diverse group of patients seen at community health centers, similar barriers to screening were reported by patients of different backgrounds, but physicians perceived other factors as more important. Conclusion Further study of these barriers is warranted.

  14. Gynecological cancer patients’ differentiated use of help from a nurse navigator: a qualitative study

    Thygesen Marianne K

    2012-06-01

    Full Text Available Abstract Background Fragmentation in healthcare can present challenges for patients with suspected cancer. It can add to existing anxiety, fear, despair and confusion during disease trajectory. In some circumstances patients are offered help from an extra contact person, a Nurse Navigator (NN. Scientific studies showing who will benefit from the extra help offered are missing. This study aims to explore who could benefit from the help on offer from a nurse appointed as NN in the early part of a cancer trajectory, and what would be meaningful experiences in this context. Methods A longitudinal study with a basis in phenomenology and hermeneutics was performed among Danish women with gynecological cancer. Semi-structured interviews provided data for the analysis, and comprehensive understanding was arrived at by first adopting an open-minded approach to the transcripts and by working at three analytical levels. Results Prior experience of trust, guarded trust or distrust of physicians in advance of encountering the NN was of importance in determining whether or not to accept help from the NN. For those lacking trust in physicians and without a close relationship to a healthcare professional, the NN offered a new trusting relationship and they felt reassured by her help. Conclusions Not everyone could use the help offered by the NN. This knowledge is vital both to healthcare practitioners and to administrators, who want to do their best for cancer patients but who are obliged to consider financial consequences. Moreover patients’ guarded trust or distrust in physicians established prior to meeting the NN showed possible importance for choosing extra help from the NN. These findings suggest increased focus on patients’ trust in healthcare professionals. How to find the most reliable method to identify those who can use the help is still a question for further debate and research.

  15. Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence.

    Carolan, C M; Smith, A; Davies, G R; Forbat, L

    2018-03-01

    Many individuals affected by cancer who experience emotional distress report not wanting help. This review aims to understand why individuals affected by cancer seek, accept or decline help for emotional distress and what influences these actions. A systematic review and thematic synthesis of the qualitative literature was conducted. Using pre-defined search terms, four electronic databases were searched from January 2000 to May 2016. Pre-determined inclusion and exclusion criteria were then applied. Identified papers were quality appraised. In total, 32 papers were included in the synthesis. Four themes emerged from data synthesis: attaining normality-the normality paradox; being emotionally literate; perceptions of help; needs-support gap. Attaining normality is ideographic, context dependent and temporally situated; some individuals maintain normality by not seeking/declining help whereas others seek/accept help to achieve a new normality. Thus, attaining normality paradoxically functions to explain both why individuals sought/accepted help or did not seek/declined help. Data indicate that a context dependent, systems thinking approach is merited to enhance psychosocial care. In particular, clinicians must actively explore the personal context of an individual's distress to ensure that help desired and help offered are mutually understood. Further research must address the limitations of the current evidence base to advance theoretical understanding. © 2017 John Wiley & Sons Ltd.

  16. Knowledge and Attitudes of Cervical Cancer Screening Among Caribbean Women: A Qualitative Interview Study From Barbados.

    Christian, Trudy; Guell, Cornelia

    2015-01-01

    The purpose of this study was to explore Barbadian women's attitudes toward and knowledge of routine cervical cancer screening (Pap tests). We conducted semi-structured individual interviews with fourteen female patients between the ages of 20 and 60 years who attended a selected public clinic in Barbados in May and June 2013. Interviews were audio-recorded with participants' consent. The interviews were then transcribed verbatim and, using thematic content analysis, indexed and coded inductively for emerging similar themes. We identified four themes: (1) women had poor knowledge of the purpose of Pap tests. The most frequently occurring misconception was that the test was for the detection of sexually transmitted infections. (2) The women displayed limited cervical cancer awareness. (3) Health professionals were identified by the women as the main driving force behind women taking up screening. (4) The screening procedure was perceived as painful, but women's overriding attitude was that screening was necessary. These findings suggest that Barbadian women would benefit from focused health education efforts surrounding cervical cancer screening to eradicate the misconception that the purpose of the Pap test is the detection of sexually transmitted diseases.

  17. Returning to School After Adolescent Cancer: A Qualitative Examination of Australian Survivors' and Their Families' Perspectives.

    McLoone, Jordana K; Wakefield, Claire E; Butow, Phyllis; Fleming, Catharine; Cohn, Richard J

    2011-06-01

    To examine key factors related to adolescent cancer survivors' return to school after cancer treatment completion, which can be a time of complex transition. Seventy semi-structured interviews were conducted with 19 adolescent cancer survivors (mean age 16.1 years), 21 mothers, 15 fathers, and 15 siblings from 22 Australian families. The conceptual framework of Miles and Huberman (1994) was employed to analyze interview data and emergent themes were organized using the software package QSR NVivo 8.0. Barriers to successful school re-entry included symptoms of fatigue, anxiety (particularly regarding examinations), and poor communication between families and the broader school community. Changing grade or school typically extinguished pre-existing support networks and was perceived by parents as a period of unmet need. Support from friends, teachers, tutors, and the hospital outreach nurse were seen as instrumental in creating a positive school re-entry experience. However, the majority of participants reported that support from the school counselor was minimal. Siblings reported this period as relatively non-impactful regarding their own education. Additional support is needed to help parents navigate the education system and to advocate effectively for their child's academic needs beyond the immediate re-entry period. There is strong potential for school counselors to increase the level of support they provide adolescents and their parents during the school re-entry period. The impact of this period on siblings' education is under-studied and warrants further research.

  18. Breast cancer coverage in the media in malaysia: a qualitative content analysis of star newspaper articles.

    Al-Naggar, Redhwan Ahmed; Al-Jashamy, Karim

    2011-01-01

    The media play big roles in the public understanding of many health issues, and the information relayed to the public through the media clearly influences behavior. The objectives of this study were to determine whether the content of articles on breast cancer in women published in the Star newspaper in 1997 differed from that of those published in 2007 and also to determine what factors may have caused any differences. About 45 articles were identified for the year 1997 and 97 from the year 2007. Copies of the articles were obtained through the Star newspaper library. All the articles were read an initial time. The final sample for analysis consisted of 18 newspaper articles published in 1997 and 79 in 2007. Once data collection sheets were completed for all articles, the data were transferred to two spreadsheets and analyzed manually. Living with breast cancer was the main theme of many articles in both years. Family history was emphasized as a risk factor in articles from 2007, while an inappropriate bra, electrical power lines, stress, smoking and alcohol were emphasized in 1997 as risk factors. In general, articles in 2007 focused on overall health practices, especially exercise, while in 1997, mammography was considered as the dominant prevention method. The content of the articles on breast cancer that were published in the Star newspaper in Malaysia in 1997 totally differed from that of those published in 2007. The differences seem to reflect social, political, and scientific occurrences over the period studied.

  19. Impact of gender on decisions to participate in faecal immunochemical test-based colorectal cancer screening: a qualitative study.

    Clarke, Nicholas; Gallagher, Pamela; Kearney, Patricia M; McNamara, Deirdre; Sharp, Linda

    2016-12-01

    Faecal immunochemical tests (FITs) are increasingly being used in population-based colorectal cancer-screening programmes. Uptake of FIT is lower in men than women; however, the reasons for this are not well understood. We aimed to explore gender differences in influences on decisions to participate in FIT screening. This is a qualitative study using in-depth face-to-face interviews of four groups of screening invitees (male and female screening users and male and female screening non-users), purposively sampled from the database of a population-based FIT screening programme. Recruitment continued until saturation was reached. Interviews were audio recorded and transcribed verbatim. Thematic analysis using the framework approach was employed with the theoretical domains framework guiding analysis. Forty-seven screening invitees were interviewed. Six theoretical domains influenced screening uptake: 'environmental context and resources', 'beliefs about capabilities', 'beliefs about consequences', 'emotions', 'social influences' and 'knowledge'. Male non-users were often fatalistic, less knowledgeable and misinformed about cancer and FIT screening compared with other groups. Female non-users expressed negative attitudes, beliefs and emotions towards FIT screening, cancer, social influences and the medical profession and were over-confident about their health. Negative attitudes and emotions to screening dominated non-user decision-making but differed by gender. Opportunities to improve uptake in men and women exist. Greater national discussions on the benefits of FIT screening, and development of screening materials tackling negative attitudes and beliefs while recognising male/female differences, may improve screening uptake. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  20. "I don't want to take chances.": A qualitative exploration of surgical decision making in young breast cancer survivors.

    Rosenberg, Shoshana M; Greaney, Mary L; Patenaude, Andrea F; Sepucha, Karen R; Meyer, Meghan E; Partridge, Ann H

    2018-06-01

    Young women with unilateral breast cancer are increasingly choosing contralateral prophylactic mastectomy (CPM), despite its limited medical benefit for most women. The purpose of this study was to better understand this choice through a qualitative exploration of surgical decision-making in young survivors, including how issues particular to younger women affected their decision and the post-surgical experience. Women age ≤ 40 years with stage 0 to III breast cancer, 1 to 3 years from diagnosis who had undergone breast cancer surgery were recruited to participate. Four focus groups were conducted: 2 with women who had bilateral mastectomy and 2 with women who kept their contralateral breast. Focus groups were recorded and transcribed with identifiers removed. Emergent themes were identified by thematic content analysis using NVivo 11. Of the 20 participants, median age at diagnosis was 37 years. Emergent themes were categorized into the following domains: (1) emotions/feelings surrounding surgery/decision about surgery; (2) factors affecting the decision; (3) communication and interaction with the healthcare team; (4) impact on post-surgical life and recovery; and (5) support needs. Young women who chose CPM often were concerned about a future breast event, despite this low risk, suggesting some gain peace of mind by choosing CPM. Young survivors also had many physical and emotional concerns after surgery for which they did not always feel prepared. Informational resources and decision aids may enhance patient-doctor communication and help young survivors better understand risk and manage expectations surrounding short and longer-term physical and emotional effects after surgery. Copyright © 2018 John Wiley & Sons, Ltd.

  1. The varied contribution of significant others to Complementary and Alternative Medicine (CAM) uptake by men with cancer: a qualitative analysis.

    Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

    2014-06-01

    To explore how men's Significant Others (SOs), including family members and close friends, contribute to the uptake and maintenance of specific CAM therapies. This study was the second, qualitative phase of a mixed-methods project investigating the use of CAM in an Australian male cancer population. Male participants were purposefully selected from a pool of 403 patients who answered a survey in the first quantitative phase (94% response rate and 86% consent rate for follow-up interview). Then semi-structured interviews among 26 men with a variety of cancers and 24 SOs were conducted. All 43 interviews were recorded, transcribed, and analysed thematically. Men used CAM/Natural products to cope with physical concerns, and this was actively supported by men's SOs who contributed to the uptake and maintenance of these CAMs. The shared CAM preparation and consumption functioned to strengthen the bond between men and their SOs, and also helped men's SOs to cope with uncertainty and regain control. In contrast, men practiced CAM/Mind-body medicine to receive emotional benefits, and only rarely shared this practice with their SOs, indicating a need for coping with emotions in a private way. Men's CAM use is a multifaceted process that can be better understood by considering CAM categories separately. CAM/Natural products help men to cope with physical concerns, while CAM/Mind-body medicine assist men to cope with their emotions in a private way. Oncology professionals can use this information to better promote and implement integrative cancer care services. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Barriers to Translation of Physical Activity into the Lung Cancer Model of Care. A Qualitative Study of Clinicians' Perspectives.

    Granger, Catherine L; Denehy, Linda; Remedios, Louisa; Retica, Sarah; Phongpagdi, Pimsiri; Hart, Nicholas; Parry, Selina M

    2016-12-01

    Evidence-based clinical practice guidelines recommend physical activity for people with lung cancer, however evidence has not translated into clinical practice and the majority of patients do not meet recommended activity levels. To identify factors (barriers and enablers) that influence clinicians' translation of the physical activity guidelines into practice. Qualitative study involving 17 participants (three respiratory physicians, two thoracic surgeons, two oncologists, two nurses, and eight physical therapists) who were recruited using purposive sampling from five hospitals in Melbourne, Victoria, Australia. Nine semistructured interviews and a focus group were conducted, transcribed verbatim, and independently cross-checked by a second researcher. Thematic analysis was used to analyze data. Five consistent themes emerged: (1) the clinicians perception of patient-related physical and psychological influences (including symptoms and comorbidities) that impact on patient's ability to perform regular physical activity; (2) the influence of the patient's past physical activity behavior and their perceived relevance and knowledge about physical activity; (3) the clinicians own knowledge and beliefs about physical activity; (4) workplace culture supporting or hindering physical activity; and (5) environmental and structural influences in the healthcare system (included clinicians time, staffing, protocols and services). Clinicians described potential strategies, including: (1) the opportunity for nurse practitioners to act as champions of regular physical activity and triage referrals for physical activity services; (2) opportunistically using the time when patients are in hospital after surgery to discuss physical activity; and (3) for all members of the multidisciplinary team to provide consistent messages to patients about the importance of physical activity. Key barriers to implementation of the physical activity guidelines in lung cancer are diverse and include

  3. Barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia: a qualitative multicentre study.

    Lim, Jennifer N W; Potrata, Barbara; Simonella, Leonardo; Ng, Celene W Q; Aw, Tar-Ching; Dahlui, Maznah; Hartman, Mikael; Mazlan, Rifhan; Taib, Nur Aishah

    2015-12-21

    To explore and compare barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia. A qualitative interview study with thematic analysis of transcripts. 67 patients with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58 years (range 24-82 years). The number of women diagnosed at early stages of cancer almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a painful lump and 10% had atypical symptoms. University hospital setting in Singapore and Malaysia. Patients revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more advanced cancer compared to Chinese and Indian patients. There are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between Singapore and Malaysia despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Survivorship care and support following treatment for breast cancer: a multi-ethnic comparative qualitative study of women's experiences.

    Tompkins, Charlotte; Scanlon, Karen; Scott, Emma; Ream, Emma; Harding, Seeromanie; Armes, Jo

    2016-08-18

    As the number of breast cancer survivors continues to rise, Western populations become more ethnically and socially diverse and healthcare resources become ever-more stretched, follow-up that focuses on monitoring for recurrence is no longer viable. New models of survivorship care need to ensure they support self-management and are culturally appropriate across diverse populations. This study explored experiences and expectations of a multi-ethnic sample of women with breast cancer regarding post-treatment care, in order to understand potential barriers to receiving care and inform new models of survivorship care. A phenomenological qualitative research design was employed. In-depth interviews were conducted with women from diverse socio-demographic backgrounds in England, who completed treatment for breast cancer in the 12 months prior to the study. Data were analysed using Framework Analysis. Sixty-six women participated and reported expectations and needs were unmet at follow-up. Whilst there were more commonalities in experiences, discernible differences, particularly by ethnicity and age, were identified relating to three key themes: emotional responses on transition to follow-up; challenges communicating with healthcare professionals at follow-up; and challenges finding and accessing information and support services to address unmet needs. There are cultural differences in the way healthcare professionals and women communicate, not necessarily differences in their post-treatment needs. We do not know if new models of care meet survivors' needs, or if they are appropriate for everyone. Further testing and potential cultural and linguistic adaptation of models of care is necessary to ensure their appropriateness and acceptability to survivors from different backgrounds. New ways of providing survivorship care mean survivors will need to be better prepared for the post-treatment period and the role they will have to play in managing their symptoms and care.

  5. The UK-SEA-ME Psychosocial-Cultural Cancer Research Network: setting the stage for applied qualitative research on cancer health behaviour in southeast Asia and the Middle East.

    Lim, Jennifer N W

    2011-01-01

    Psychosocial and cultural factors influencing cancer health behaviour have not been systematically investigated outside the western culture, and qualitative research is the best approach for this type of social research. The research methods employed to study health problems in Asia predominantly are quantitative techniques. The set up of the first psychosocial cancer research network in Asia marks the beginning of a collaboration to promote and spearhead applied qualitative healthcare research in cancer in the UK, Southeast Asia and the Middle East. This paper sets out the rationale, objectives and mission for the UK-SEA-ME Psychosocial-Cultural Cancer Research Network. The UK-SEA-ME network is made up of collaborators from the University of Leeds (UK), the University of Malaya (Malaysia), the National University of Singapore (Singapore) and the University of United Arab Emirates (UAE). The network promotes applied qualitative research to investigate the psychosocial and cultural factors influencing delayed and late presentation and diagnosis for cancer (breast cancer) in partner countries, as well as advocating the use of the mixed-methods research approach. The network also offers knowledge transfer for capacity building within network universities. The mission of the network is to improve public awareness about the importance of early management and prevention of cancer through research in Asia.

  6. Aspects et mesure de la qualité de vie : évolution et renouvellement des tableaux de bord métropolitains

    Pierre J. Hamel

    2008-02-01

    Full Text Available La mesure de la qualité de vie à l’intérieur des espaces urbains préoccupe les administrations publiques depuis nombre d’années. Cet article passe en revue les modèles de mesure de la qualité de vie développés par les métropoles canadiennes. Il s’interroge sur l’évolution de ces modèles de mesure et sur leur capacité à rendre compte des différentes problématiques désormais associées à la notion de qualité de vie comme le développement social, l’environnement, la société du risque, les ambiances urbaines ou la compétitivité urbaine.For a number of years now, government bodies at all levels have been concerned with measuring quality of life within urban areas. This paper reviews the models used by Canada’s metropolises to measure quality of life. It examines how the models have evolved and their capacity to consider various issues which have become associated with the notion of quality of life, such as social development, environment, risk society, urban surroundings, or urban competitiveness.

  7. Religious, Cultural, and Social Beliefs of Iranian Rural Women about Breast Cancer: A Qualitative Study

    Iman Ghaderi

    2014-05-01

    Full Text Available Background: The purpose of this study was to examine religious, cultural, and social beliefs of healthy women about breast cancer in rural settings in Iran.Methods: In the present study, 16 in-depth interviews with health care leaders, social and religious experts and 11 focus group discussions were conducted with 79 women in the rural areas near the capital city of Tehran, Iran. Grounded theory model was used to analyze the data.Results: Some women believed that religious customs and rituals, such as praying, taking a vow, or going on a pilgrimage to a holy place, might have healing effects if performed in addition to seeking medical care medical care. Many believed that God intervenes in the entire course of any illness, from occurrence to cure. Although few had fatalistic views toward cancer, the majority believed that patients could try to change their destiny. With respect to the relationship between moral behavior and disease,  4  types  of  opinions  were  identified; good  people  suffer,  evil  people  get punished,  evil  people  do  not  suffer,  and  everything has  a  scientific  explanation. Participants believed that self-perception, their husbands, deficiencies in the health care system, and financial concerns influence breast cancer outcome.Conclusions: Our study showed that many participants were not aware of any available support in the healthcare system. They generally believed in the healing effect of prayers, only when it is sought in parallel with medical care.

  8. Cancer patients' attitudes and experiences of online access to their electronic medical records: A qualitative study.

    Rexhepi, Hanife; Åhlfeldt, Rose-Mharie; Cajander, Åsa; Huvila, Isto

    2018-06-01

    Patients' access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this article is to provide in-depth understanding of cancer patients' attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians, the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital.

  9. Prospective comparison of PI-RADS version 2 and qualitative in-house categorization system in detection of prostate cancer.

    Gaur, Sonia; Harmon, Stephanie; Mehralivand, Sherif; Bednarova, Sandra; Calio, Brian P; Sugano, Dordaneh; Sidana, Abhinav; Merino, Maria J; Pinto, Peter A; Wood, Bradford J; Shih, Joanna H; Choyke, Peter L; Turkbey, Baris

    2018-03-31

    Prostate Imaging-Reporting and Data System v. 2 (PI-RADSv2) provides standardized nomenclature for interpretation of prostate multiparametric MRI (mpMRI). Inclusion of additional features for categorization may provide benefit to stratification of disease. To prospectively compare PI-RADSv2 to a qualitative in-house system for detecting prostate cancer on mpMRI. Prospective. In all, 338 patients who underwent mpMRI May 2015-May 2016, with subsequent MRI/transrectal ultrasound fusion-guided biopsy. 3T mpMRI (T 2 W, diffusion-weighted [DW], apparent diffusion coefficient [ADC] map, b-2000 DWI acquisition, and dynamic contrast-enhanced [DCE] MRI). One genitourinary radiologist prospectively read mpMRIs using both in-house and PI-RADSv2 5-category systems. In lesion-based analysis, overall and clinically significant (CS) tumor detection rates (TDR) were calculated for all PI-RADSv2 and in-house categories. The ability of each scoring system to detect cancer was assessed by area under receiver operator characteristic curve (AUC). Within each PI-RADSv2 category, lesions were further stratified by their in-house categories to determine if TDRs can be increased by combining features of both systems. In 338 patients (median prostate-specific antigen [PSA] 6.5 [0.6-113.6] ng/mL; age 64 [44-84] years), 733 lesions were identified (47% tumor-positive). Predictive abilities of both systems were comparable for all (AUC 76-78%) and CS cancers (AUCs 79%). The in-house system had higher overall and CS TDRs than PI-RADSv2 for categories 3 and 4 (P house 65%, PI-RADSv2 22.1%). For lesions categorized as PI-RADSv2 = 4, characterization of suspicious/indeterminate extraprostatic extension (EPE) and equivocal findings across all mpMRI sequences contributed to significantly different TDRs for both systems (TDR range 19-75%, P < 0.05). PI-RADSv2 behaves similarly to an existing validated system that relies on the number of sequences on which a lesion is seen. This prospective

  10. Mindfulness-Based Cognitive Therapy for Cancer Patients Delivered via Internet: Qualitative Study of Patient and Therapist Barriers and Facilitators.

    Compen, Félix R; Bisseling, Else M; Schellekens, Melanie Pj; Jansen, Ellen Tm; van der Lee, Marije L; Speckens, Anne Em

    2017-12-18

    The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT. This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists. Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT. Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics. The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found. ©Félix R Compen, Else M Bisseling, Melanie PJ Schellekens, Ellen TM

  11. Understanding barriers to the introduction of precision medicines in non-small cell lung cancer: A qualitative interview protocol.

    Wright, Stuart; Daker-White, Gavin; Newman, William; Payne, Katherine

    2018-01-01

    Background: While precision medicines targeting genetic mutations and alterations in non-small cell lung cancer (NSCLC) have been available since 2010, their adoption into clinical practice has been slow. Evidence suggests that a number of barriers, such as insufficient clinician knowledge, a need for training of test providers, or a lack of specific clinical guidelines, may slow the implementation of precision in general. However, little attention has been given to the barriers to providing precision medicines in NSCLC. The purpose of this protocol is to outline the design for a qualitative interview study to identify the barriers and facilitators to the provision of precision medicines for NSCLC. Methods: This study will use semi-structured interviews with clinicians (n=10), test providers (n=10), and service commissioners (n=10) to identify the perceived barriers and facilitators to providing historical, current, and future precision medicines in NSCLC. Participants will be identified through mailing list advertisements and snowball sampling. Recruitment will continue until data saturation, indicated by no new themes arising from the data. Interviews will be conducted by telephone to facilitate geographical diversity. The qualitative data will be analysed using a framework analysis with themes anticipated to relate to; relevant barriers to providing precision medicines, the impact of different barriers on medicine provision, changes in the ability to provide precision medicines over time, and strategies to facilitate the provision of precision medicines. Ethics: This study has been approved by the University of Manchester Proportionate Review Research Ethics Committee (Reference number: 2017-1885-3619). Written consent will be obtained from all participants. Conclusion: This study is the first to explore the barriers and facilitators to providing precision medicines for NSCLC in the English NHS. The findings will inform strategies to improve the implementation

  12. 18F-FDG PET for detecting recurrent head and neck cancer, local lymph node involvement and distant metastases. Comparison of qualitative visual and semiquantitative analysis

    Schmidt, M.; Schmalenbach, M.; Theissen, P.; Dietlein, M.; Eschner, W.; Schicha, H.; Jungehuelsing, M.; Schroeder, U.; Stennert, E.

    2004-01-01

    Aim: Assessment of the clinical value of 18 F-FDG-PET for detection of recurrent head and neck cancer, local lymph node involvement and distant metastases comparing a qualitative visual with a semiquantitative analysis (SUV values). Patients, methods: Retrospective evaluation of 73 18 F-FDG PET studies in 55 patients by use of a four-step qualitative visual grading system and calculation of standard uptake values in pathological lesions. Calculation of SUV values in normal regions for generating a map of physiological 18 F-FDG distribution. Correlation to histopathological findings and clinical follow-up. Results: 1. Qualitative visual analysis of 18 F-FDG PET studies: a) local recurrence sensitivity 79%, specificity 97%, positive predictive value 95%, negative predictive value 85%, and diagnostic accuracy 89%; b) local metastatic lymph nodes 100%, 95%, 85%, 100%, 96%; c) distant metastases 100%, 98%, 86%, 100%, 98%, respectively. 2. Semiquantitative analysis had only little incremental, non-significant value in comparison to qualitative visual analysis for the detection of a local recurrence in two patients: a) local recurrence: sensitivity 83%, specificity 100%, positive predictive value 100%, negative predictive value 88%, and diagnostic accuracy 93%; b) local metastatic lymph nodes or c) distant metastases did not change in comparison to qualitative visual analysis. Conclusion: 18 F-FDG PET is an effective tool for re-staging of patients with suspected recurrence after therapy for head and neck cancer. (orig.)

  13. Experiences of patients undergoing chemotherapy - a qualitative ...

    Methodology: Using a qualitative descriptive design, seven in-patients with varying cancer diagnoses at the Uganda Cancer. Institute were ... tance of focusing research on persons with cancer in ... variety of cancer types were included.

  14. Challenges in shared decision making in advanced cancer care: a qualitative longitudinal observational and interview study.

    Brom, Linda; De Snoo-Trimp, Janine C; Onwuteaka-Philipsen, Bregje D; Widdershoven, Guy A M; Stiggelbout, Anne M; Pasman, H Roeline W

    2017-02-01

    Patients' preferences and expectations should be taken into account in treatment decision making in the last phase of life. Shared decision making (SDM) is regarded as a way to give the patient a central role in decision making. Little is known about how SDM is used in clinical practice in advanced cancer care. To examine whether and how the steps of SDM can be recognized in decision making about second- and third-line chemotherapy. Fourteen advanced cancer patients were followed over time using face-to-face in-depth interviews and observations of the patients' out-clinic visits. Interviews and outpatient clinic visits in which treatment options were discussed or decisions made were transcribed verbatim and analysed using open coding. Patients were satisfied with the decision-making process, but the steps of SDM were barely seen in daily practice. The creation of awareness about available treatment options by physicians was limited and not discussed in an equal way. Patients' wishes and concerns were not explicitly assessed, which led to different expectations about improved survival from subsequent lines of chemotherapy. To reach SDM in daily practice, physicians should create awareness of all treatment options, including forgoing treatment, and communicate the risk of benefit and harm. Open and honest communication is needed in which patients' expectations and concerns are discussed. Through this, the difficult process of decision making in the last phase of life can be facilitated and the focus on the best care for the specific patient is strengthened. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  15. Emotional and psychosocial aspects of menstrual poverty in resource-poor settings: a qualitative study of the experiences of adolescent girls in an informal settlement in Nairobi.

    Crichton, Joanna; Okal, Jerry; Kabiru, Caroline W; Zulu, Eliya Msiyaphazi

    2013-10-01

    We introduce the concept of "menstrual poverty" to categorize the multiple deprivations relating to menstruation in resource-poor settings across the Global South, and we examine how this affects the psychological well-being of adolescent girls in an urban informal settlement in Kenya. We use qualitative data collected through 34 in-depth interviews and 18 focus group discussions with girls, women, and key informants. Menstrual poverty involved practical and psychosocial challenges affecting girls at home and at school. Its emotional impacts included anxiety, embarrassment, fear of stigma, and low mood. Further research is needed on how menstrual poverty affects girls' psychological and educational outcomes.

  16. Deconstructing Cancer Patient Information Seeking in a Consumer Health Library Toward Developing a Virtual Information Consult for Cancer Patients and Their Caregivers: A Qualitative, Instrumental Case Study.

    Papadakos, Janet; Trang, Aileen; Cyr, Alaina B; Abdelmutti, Nazek; Giuliani, Meredith E; Snow, Michelle; McCurdie, Tara; Pulandiran, Menaka; Urowitz, Sara; Wiljer, David

    2017-05-24

    Cancer patients and their caregivers want information about their disease and are interested in finding health information online. Despite the abundance of cancer information online, it is often fragmented, its quality is highly variable, and it can be difficult to navigate without expert-level knowledge of the cancer system. The Patient & Family Library at the Princess Margaret Cancer Centre offers a broad collection of high-quality cancer health information and staff are available to help patrons refine their questions and explore information needs that they may not have considered. The purpose of this research study was to deconstruct patrons' information-seeking behaviors in the library to assess the feasibility of replicating the services provided in the library through a Web app, extending the service beyond the walls of the cancer centre. The specific aims of this research were to understand (1) how patrons approach information seeking in the library (interface design), (2) how patrons communicate their informational needs (information categorization and metadata requirements), and (3) what resources are provided to address the patrons' information needs (collection development). We employed a qualitative, instrumental case study to deconstruct patrons' health information-seeking behavior. The study population included patients, the librarian, and library volunteers. Ethnographic observation was conducted at the library over 3 days and key informant interviews with library staff were conducted to address the first aim. A closed card-sorting activity was conducted to address the second aim and the library shift logs and Search Request Forms (SRFs) were reviewed to address the third aim. A total of 55 interactions were recorded during the ethnographic observation and nine semistructured interviews were conducted during the key informant interviews. Seven library patron personas were identified: (1) Newbie, (2) Seasoned, (3) Direct, (4) Window Shopper, (5

  17. Microbeam radiation therapy. Physical and biological aspects of a new cancer therapy and development of a treatment planning system

    Bartzsch, Stefan

    2014-11-05

    Microbeam Radiation Therapy (MRT) is a novel treatment strategy against cancer. Highly brilliant synchrotron radiation is collimated to parallel, a few micrometre wide, planar beams and used to irradiate malignant tissues with high doses. The applied peak doses are considerably higher than in conventional radiotherapy, but valley doses between the beams remain underneath the established tissue tolerance. Previous research has shown that these beam geometries spare normal tissue, while being effective in tumour ablation. In this work physical and biological aspects of the therapy were investigated. A therapy planning system was developed for the first clinical treatments at the European Synchrotron Radiation Facility in Grenoble (France) and a dosimetry method based on radiochromic films was created to validate planned doses with measurements on a micrometre scale. Finally, experiments were carried out on a cellular level in order to correlate the physically planned doses with the biological damage caused in the tissue. The differences between Monte Carlo dose and dosimetry are less than 10% in the valley and 5% in the peak regions. Developed alternative faster dose calculation methods deviate from the computational intensive MC simulations by less than 15% and are able to determine the dose within a few minutes. The experiments in cell biology revealed an significant influence of intercellular signalling on the survival of cells close to radiation boundaries. These observations may not only be important for MRT but also for conventional radiotherapy.

  18. Clinical translation and regulatory aspects of CAR/TCR-based adoptive cell therapies-the German Cancer Consortium approach.

    Krackhardt, Angela M; Anliker, Brigitte; Hildebrandt, Martin; Bachmann, Michael; Eichmüller, Stefan B; Nettelbeck, Dirk M; Renner, Matthias; Uharek, Lutz; Willimsky, Gerald; Schmitt, Michael; Wels, Winfried S; Schüssler-Lenz, Martina

    2018-04-01

    Adoptive transfer of T cells genetically modified by TCRs or CARs represents a highly attractive novel therapeutic strategy to treat malignant diseases. Various approaches for the development of such gene therapy medicinal products (GTMPs) have been initiated by scientists in recent years. To date, however, the number of clinical trials commenced in Germany and Europe is still low. Several hurdles may contribute to the delay in clinical translation of these therapeutic innovations including the significant complexity of manufacture and non-clinical testing of these novel medicinal products, the limited knowledge about the intricate regulatory requirements of the academic developers as well as limitations of funds for clinical testing. A suitable good manufacturing practice (GMP) environment is a key prerequisite and platform for the development, validation, and manufacture of such cell-based therapies, but may also represent a bottleneck for clinical translation. The German Cancer Consortium (DKTK) and the Paul-Ehrlich-Institut (PEI) have initiated joint efforts of researchers and regulators to facilitate and advance early phase, academia-driven clinical trials. Starting with a workshop held in 2016, stakeholders from academia and regulatory authorities in Germany have entered into continuing discussions on a diversity of scientific, manufacturing, and regulatory aspects, as well as the benefits and risks of clinical application of CAR/TCR-based cell therapies. This review summarizes the current state of discussions of this cooperative approach providing a basis for further policy-making and suitable modification of processes.

  19. Involvement of patients with cancer in patient safety: a qualitative study of current practices, potentials and barriers.

    Martin, Helle Max; Navne, Laura Emdal; Lipczak, Henriette

    2013-10-01

    Patient involvement in patient safety is widely advocated but knowledge regarding implementation of the concept in clinical practice is sparse. To investigate existing practices for patient involvement in patient safety, and opportunities and barriers for further involvement. A qualitative study of patient safety involvement practices in patient trajectories for prostate, uterine and colorectal cancer in Denmark. Observations from four hospital wards and interviews with 25 patients with cancer, 11 hospital doctors, 10 nurses, four general practitioners and two private practicing gynaecologists were conducted using ethnographic methodology. Patient safety was not a topic of attention for patients or dominant in communication between patients and healthcare professionals. The understanding of patient safety in clinical practice is almost exclusively linked to disease management. Involvement of patients is not systematic, but healthcare professionals and patients express willingness to engage. Invitation and encouragement of patients to become involved could be further systematised and developed. Barriers include limited knowledge of patient safety, of specific patient safety involvement techniques and concern regarding potential negative impact on doctor-patient relationship. Involvement of patients in patient safety must take into account that despite stated openness to the idea of involvement, patients and health professionals may not in practice show immediate concern. Lack of systematic involvement can also be attributed to limited knowledge about how to implement involvement beyond the focus of self-monitoring and compliance and a concern about the consequences of patient involvement for treatment outcomes. To realise the potential of patients' and health professionals' shared openness towards involvement, there is a need for more active facilitation and concrete guidance on how involvement can be practiced by both parties.

  20. When trust is threatened: Qualitative study of parents' perspectives on problematic clinical relationships in child cancer care.

    Davies, Sarah; Salmon, Peter; Young, Bridget

    2017-09-01

    We explored parents' accounts of the parent-clinician relationship in childhood cancer to understand how parents who perceive threats to the relationship can be supported. Multicentre longitudinal qualitative study, with 67 UK parents of children (aged 1-12 years) receiving treatment for acute lymphoblastic leukaemia. Analyses drew on the wider sample but focussed on 50 semistructured interviews with 20 parents and were informed by constant comparison. All 20 parents described problems with clinical care such as inadequate information or mistakes by staff but varied in how much the problems threatened their sense of relationship with clinicians. Some parents saw the problems as having no relevance to the parent-clinician relationship. Others saw the problems as threats to the clinical relationship but worked to "contain" the threat in ways that preserved a trusting relationship with at least one senior clinician. Parents' containment work protected the security they needed from the parent-clinician relationship, but containment was a tenuous process for some. A few parents were unable to contain the problems at all; lacking trust in clinicians, these parents suffered considerably. Given the complexity of childhood cancer care, problems with clinical care are inevitable. By engaging in containment work, parents met their needs to feel secure in the face of these problems, but the extent to which parents should have to do this work is debatable. Parents could benefit from support to seek help when problems arise which threaten their trust in clinicians. Attachment theory can guide clinicians in giving this support. © 2017 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

  1. Patients' perceptions and attitudes on recurrent prostate cancer and hormone therapy: Qualitative comparison between decision-aid and control groups.

    Gorawara-Bhat, Rita; O'Muircheartaigh, Siobhan; Mohile, Supriya; Dale, William

    2017-09-01

    To compare patients' attitudes towards recurrent prostate cancer (PCa) and starting hormone therapy (HT) treatment in two groups-Decision-Aid (DA) (intervention) and Standard-of-care (SoC) (Control). The present research was conducted at three academic clinics-two in the Midwest and one in the Northeast U.S. Patients with biochemical recurrence of PCa (n=26) and follow-up oncology visits meeting inclusion criteria were randomized to either the SoC or DA intervention group prior to their consultation. Analysts were blinded to group assignment. Semi-structured phone interviews with patients were conducted 1-week post consultation. Interviews were audio-taped and transcribed. Qualitative analytic techniques were used to extract salient themes and conduct a comparative analysis of the two groups. Four salient themes emerged-1) knowledge acquisition, 2) decision-making style, 3) decision-making about timing of HT, and 4) anxiety-coping mechanisms. A comparative analysis showed that patients receiving the DA intervention had a better comprehension of Prostate-specific antigen (PSA), an improved understanding of HT treatment implications, an external locus-of-control, participation in shared decision-making and, support-seeking for anxiety reduction. In contrast, SoC patients displayed worse comprehension of PSA testing and HT treatment implications, internal locus-of-control, unilateral involvement in knowledge-seeking and decision-making, and no support-seeking for anxiety-coping. The DA was more effective than the SoC group in helping PCa patients understand the full implications of PSA testing and treatment; motivating shared decision-making, and support-seeking for anxiety relief. DA DVD interventions can be a useful patient education tool for bringing higher quality decision-making to prostate cancer care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Quality of life after radiotherapy for prostate cancer; Qualite de vie apres radiotherapie pour un cancer localise de la prostate

    Joly, F. [Service d' oncologie medicale, CLCC Francois-Baclesse, 14 - Caen (France); CHU Cote-de-Nacre, 14 - Caen (France); Degrendel, A.C. [Service de radiotherapie, CLCC Francois-Baclesse, 14 - Caen (France); Guizard, A.V. [Registre general des tumeurs du Calvados, CLCC Francois-Baclesse, 14 - Caen (France)

    2010-10-15

    The goal of localized prostate cancer radiotherapy is to cure patients. The decision-making must integrate the survival but also the quality of life of patients. Some French validated self-reported questionnaires are available to evaluate quality of life. Whatever the treatments (radical prostatectomy, brachytherapy, external beam radiation, with or without hormono-therapy), even if patients report more sequelae, their long-term quality of life is similar to that of the general population, except for patients treated with hormono-therapy who complain more decline of physical quality of life. In comparison with prostatectomy, patients treated with external beam radiation report less long-lasting urinary symptoms, but more bowel side effects, with no difference in global quality of life. Sexual disorders are initially less important with external beam radiation but increase over time. Brachytherapy shows no sexual function preservation benefit relative to radiation and may be less favourable with more urinary sequelae. The association of hormono-therapy and external beam radiation decreases the quality of life of the patients, with a negative impact on vitality, sexuality and increase urinary disorders. Intensity-modulated radiotherapy (IMRT) seems to better preserve the long-term digestive quality of life in comparison with conformal radiation therapy. Post-prostatectomy could induce more digestive toxicity, such as rectal irritation. The adjunction of hormono-therapy to radiation, the previous medical history of abdominal surgery, the field of radiation and the acute reactions to radiation are the main predictive factors to late toxicity and should be considered in the choice of initial treatment and for the follow-up. (authors)

  3. Patient and family member perspectives on searching for cancer clinical trials: A qualitative interview study.

    Ridgeway, Jennifer L; Asiedu, Gladys B; Carroll, Katherine; Tenney, Meaghan; Jatoi, Aminah; Radecki Breitkopf, Carmen

    2017-02-01

    Clinical trials are vital in the context of ovarian cancer and may offer further treatment options during disease recurrence, yet enrollment remains low. Understanding patient and family member experiences with identifying trials can inform engagement and education efforts. Interviews were conducted with 33 patients who had experience with clinical trial conversations and 39 nominated family members. Thematic analysis examined experiences and generated findings for clinical practice. Trial conversations with providers at diagnosis were uncommon and often overwhelming. Most participants delayed engagement until later in the disease course. With hindsight, though, some wished they considered trials earlier. Difficulty identifying appropriate trials led some to defer searching to providers, but then they worried about missed opportunities. Most family members felt unqualified to search. Trial conversations during clinical encounters should start early and include specifying search responsibilities of providers, patients, and family. Patients and family members can be engaged in searches but need guidance. Trials should be discussed throughout the disease course, even if patients are not ready to participate or are not making a treatment decision. Education should focus on identifying trials that meet search criteria. Transparency regarding each individual's role in identifying trials is critical. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

    Cowley, Alison; Evans, Catrin; Bath-Hextall, Fiona; Cooper, Joanne

    2016-10-01

    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. 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. 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. The review considered studies that investigated the experiences and perceptions of people diagnosed with palliative esophagogastric cancer and staff working with these people. 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. 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. 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 was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument critical

  5. Qualitative and quantitative aspects of drinking water supply in Sardinia, Italy. A descriptive analysis of the ordinances and public notices issued during the years 2010-2015.

    Dettori, M; Piana, A; Castiglia, P; Loria, E; Azara, A

    2016-01-01

    The aim of the study is to analyze the regional district ordinances and the warnings regarding qualitative and quantitavive drinking water abnormalities discovered by the Sardinian Municipalities and the Water Managing Authority between 2010 and 2015 in order to describe and identify the causes leading to an interruption or a limitation of the drinking water supply. We carefully reviewed all ordinances and warnings of non-potable water and service interruption published between 2010 and 2015 by the websites of 377 Sardinian Municipalities and by the main regional newspapers, the Water Managing Authority and the Regional Health Trusts. From 2010 to 2015, 738 warnings/ordinances regarding drinking water supply limitation or interruption were issued. The warnings involved more than half (n. 191, 50.7%) of the 377 Sardinian Municipalities. Considering that these Municipalities included the main Sardinian cities we estimated that 80.3% of the population was affected by the issue. During the 6 years we observed a progressive increase of Municipalities involved beginning with 25 and reaching up 110 in 2014. The initial 29 warnings rose to 256 in 2014 along with an increased number of abnormal values, parameters and standards of the drinking water. Regarding the ordinances issued by the 191 Mayors we noticed that the legal limits were exceeded in 23 cases. Among those, we underline the abnormal levels of chlorites and trihalomethanes (22% of cases), the turbidity, the abnormal concentration of total chemical substances and the abnormal level of coliforms, Escherichia coli, manganese, aluminum, nitrites and iron. According to our observations, the Sardinian drinking water supply system is affected by a major inconvenience and the data suggest that qualitative abnormalities are mainly due to water purification treatments used in addition to the poor water supply network in existence. Considering these results, a cooperation between all Authorities involved would be desirable

  6. 'Was it worth it?' Intrathecal analgesia for cancer pain: A qualitative study exploring the views of family carers.

    Patel, Nishi; Huddart, Melanie; Makins, Helen; Mitchell, Theresa; Gibbins, Jane L; Graterol, Juan; Stevens, Deborah; Perkins, Paul

    2018-01-01

    Intrathecal drug delivery is known to reduce pain in patients where conventional systemic analgesia has been ineffective or intolerable. However, there is little information regarding the effects of intrathecal drug delivery on quality of life and function in those with advanced, incurable cancer. Retrospective exploration of the views of bereaved carers regarding the physical and psychosocial effects of external tunnelled intrathecal drug delivery in patients with advanced incurable cancer. Thematic analysis of qualitative interviews with carers of deceased individuals who received percutaneous external tunnelled intrathecal drug delivery as part of their pain management, within two UK centres. A total of 11 carers were recruited from two UK Palliative Care centres. Family carers of adult patients who had received external tunnelled intrathecal drug delivery analgesia for cancer pain and had died between 6 and 48 months prior to contact were included. Carer relatives who were considered likely to be too vulnerable or who had lodged a complaint about treatment within the recruiting department or who had been treated directly by the interviewer were excluded. In total, 11 interviews took place. The emerging themes were (1) making the decision to have the intrathecal - relatives described desperate situations with severe pain and/or sedation, meaning that the individual would try anything; (2) timing and knowing they were having the best - an increased access to pain and palliative care services, meant carers felt everything possible was being done, making the situation more bearable; (3) was it worth it? - the success of the external tunnelled intrathecal drug delivery was judged on its ability to enable the individual to be themselves through their final illness. Side effects were often considered acceptable, if the external tunnelled intrathecal drug delivery enabled improvements in quality of life. Carers perceived external tunnelled intrathecal drug delivery

  7. Validity in Qualitative Evaluation

    Vasco Lub

    2015-01-01

    This article provides a discussion on the question of validity in qualitative evaluation. Although validity in qualitative inquiry has been widely reflected upon in the methodological literature (and is still often subject of debate), the link with evaluation research is underexplored. Elaborating on epistemological and theoretical conceptualizations by Guba and Lincoln and Creswell and Miller, the article explores aspects of validity of qualitative research with the explicit objective of con...

  8. Why do patients decline surgical trials? Findings from a qualitative interview study embedded in the Cancer Research UK BOLERO trial (Bladder cancer: Open versus Lapararoscopic or RObotic cystectomy).

    Harrop, Emily; Kelly, John; Griffiths, Gareth; Casbard, Angela; Nelson, Annmarie

    2016-01-19

    Surgical trials have typically experienced recruitment difficulties when compared with other types of oncology trials. Qualitative studies have an important role to play in exploring reasons for low recruitment, although to date few such studies have been carried out that are embedded in surgical trials. The BOLERO trial (Bladder cancer: Open versus Lapararoscopic or RObotic cystectomy) is a study to determine the feasibility of randomisation to open versus laparoscopic access/robotic cystectomy in patients with bladder cancer. We describe the results of a qualitative study embedded within the clinical trial that explored why patients decline randomisation. Ten semi-structured interviews with patients who declined randomisation to the clinical trial, and two interviews with recruiting research nurses were conducted. Data were analysed for key themes. The majority of patients declined the trial because they had preferences for a particular treatment arm, and in usual practice could choose which surgical method they would be given. In most cases the robotic option was preferred. Patients described an intuitive 'sense' that favoured the new technology and had carried out their own inquiries, including Internet research and talking with previous patients and friends and family with medical backgrounds. Medical histories and lifestyle considerations also shaped these personalised choices. Of importance too, however, were the messages patients perceived from their clinical encounters. Whilst some patients felt their surgeon favoured the robotic option, others interpreted 'indirect' cues such as the 'established' reputation of the surgeon and surgical method and comments made during clinical assessments. Many patients expressed a wish for greater direction from their surgeon when making these decisions. For trials where the 'new technology' is available to patients, there will likely be difficulties with recruitment. Greater attention could be paid to how messages about

  9. Understanding the importance of therapeutic relationships in the development of self-management behaviours during cancer rehabilitation: a qualitative research protocol.

    Wilkinson, Wendy M; Rance, Jaynie; Fitzsimmons, Deborah

    2017-01-17

    Cancer is a growing health, social and economic problem. 1 in 3 people in the UK will develop cancer in their lifetime. With survival rates rising to over 50%, the long-term needs of cancer survivors are of growing importance. Cancer rehabilitation is tailored to address the physical or psychosocial decline in ability to engage in daily activities. Its use is supported by high-quality international, multicentre research. Incorporating strategies for self-management behaviour development into rehabilitation can prepare individuals for cancer survivorship. However, healthcare professionals will need to adjust their therapeutic interactions accordingly. Research is yet to clarify the impact of the therapeutic relationship on rehabilitation outcomes in cancer. This study aims to explore the impact of therapeutic relationships on self-management behaviours after cancer. This qualitative study aims to understand cancer rehabilitation participants' beliefs regarding the importance of therapeutic relationships in developing self-management behaviours. A sample representative of a local cancer rehabilitation cohort will be asked to complete a semistructured interview to identify their perspectives on the importance of therapeutic relationships in cancer rehabilitation. Data obtained from the interviews will be analysed, coded and entered into a Delphi questionnaire for circulation to a local cancer rehabilitation population to determine if the views expressed by the interviewees are supported by group consensus. This study was approved by Wales Research Ethics Committee 6 (15/WA/0331) in April 2016. Findings will be disseminated through the first author's doctoral thesis; peer-reviewed journals; local, national and international conference presentations; and public events involving research participants and the general public. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Patients' Experiences of Cancer Diagnosis as a Result of an Emergency Presentation: A Qualitative Study.

    Black, Georgia; Sheringham, Jessica; Spencer-Hughes, Vicki; Ridge, Melanie; Lyons, Mairead; Williams, Charlotte; Fulop, Naomi; Pritchard-Jones, Kathy

    2015-01-01

    Cancers diagnosed following visits to emergency departments (ED) or emergency admissions (emergency presentations) are associated with poor survival and may result from preventable diagnostic delay. To improve outcomes for these patients, a better understanding is needed about how emergency presentations arise. This study sought to capture patients' experiences of this diagnostic pathway in the English NHS. Eligible patients were identified in a service evaluation of emergency presentations and invited to participate. Interviews, using an open-ended biographical structure, captured participants' experiences of healthcare services before diagnosis and were analysed thematically, informed by the Walter model of Pathways to Treatment and NICE guidance in an iterative process. Twenty-seven interviews were conducted. Three typologies were identified: A: Rapid investigation and diagnosis, and B: Repeated cycles of healthcare seeking and appraisal without resolution, with two variants where B1 appears consistent with guidance and B2 has evidence that management was not consistent with guidance. Most patients' (23/27) experiences fitted types B1 and B2. Potentially avoidable breakdowns in diagnostic pathways caused delays when patients were conflicted by escalating symptoms and a benign diagnosis given earlier by doctors. ED was sometimes used as a conduit to rapid testing by primary care clinicians, although this pathway was not always successful. This study draws on patients' experiences of their diagnosis to provide novel insights into how emergency presentations arise. Through these typologies, we show that the typical experience of patients diagnosed through an emergency presentation diverges significantly from normative pathways even when there is no evidence of serious service failures. Consultations were not a conduit to diagnosis when they inhibited patients' capacity to appraise their own symptoms appropriately and when they resulted in a reluctance to seek

  11. A qualitative analysis of staff-client interactions within a breast cancer assessment clinic

    Nightingale, J.M.; Murphy, F.; Eaton, C.; Borgen, R.

    2017-01-01

    Objectives: Breast screening clients recalled to an assessment clinic experience high levels of anxiety. The culture of the assessment clinic may impact upon client experience, which may influence their future re-engagement in screening. This study aimed to explore the culture of staff-client interactions within a breast cancer assessment clinic. Materials and methods: Following an ethnographic approach, twenty-three client journeys were observed, followed by semi-structured interviews with the clients. The observation and interview data were analysed to produce research themes, which were then explored within two focus groups to add a practitioner perspective. Results: Multiple staff-client interaction events were observed over a period of several weeks. Client interview feedback was overwhelmingly positive. Three recurrent and sequential themes emerged: breaking down barriers, preparing the ground and sign-posting. These themes outline the changing focus of staff-client interactions during the client's clinic journey, encompassing how anxieties were expressed by clients, and responded to by practitioners. Conclusion: This study was the first to explore in depth the staff-client interaction culture within a breast assessment clinic using an ethnographic approach. A new perspective on professional values and behaviours has been demonstrated via a model of staff-client interaction. The model documents the process of guiding the client from initial confusion and distress to an enhanced clarity of understanding. A recommendation most likely to have a positive impact on the client experience is the introduction of a client navigator role to guide the clients through what is often a lengthy, stressful and confusing process. - Highlights: • This study was the first to explore staff-client interaction within breast assessment clinics. • Assessment clinic culture may affect client perceptions and future re-engagement in screening. • An ethnographic approach

  12. Effects of complex interventions in 'skin cancer prevention and treatment': protocol for a mixed-method systematic review with qualitative comparative analysis.

    Beifus, Karolina; Breitbart, Eckhard; Köberlein-Neu, Juliane

    2017-09-05

    Occurring from ultraviolet radiation combined with impairing ozone levels, uncritical sun exposure and use of tanning beds an increasing number of people are affected by different types of skin cancer. But preventive interventions like skin cancer screening are still missing the evidence for effectiveness and therefore are criticised. Fundamental for an appropriate course of action is to approach the defined parameters as measures for effectiveness critically. A prerequisite should be the critical application of used parameter that are defined as measures for effectiveness. This research seeks to establish, through the available literature, the effects and conditions that prove the effectiveness of prevention strategies in skin cancer. A mixed-method approach is employed to combine quantitative to qualitative methods and answer what effects can display effectiveness considering time horizon, perspective and organisational level and what are essential and sufficient conditions to prove effectiveness and cost-effectiveness in skin cancer prevention strategies. A systematic review will be performed to spot studies from any design and assess the data quantitatively and qualitatively. Included studies from each key question will be summarised by characteristics like population, intervention, comparison, outcomes, study design, endpoints, effect estimator and so on. Beside statistical relevancies for a systematic review the qualitative method of qualitative comparative analysis (QCA) will be performed. The estimated outcomes from this review and QCA are the accomplishment and absence of effects that are appropriate for application in effectiveness assessments and further cost-effectiveness assessment. Formal ethical approval is not required as primary data will not be collected. International Prospective Register for Systematic Reviews number CRD42017053859. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  13. The experiences of family members in the year following the diagnosis of a child or adolescent with cancer: a qualitative systematic review.

    Mu, Pei-Fan; Lee, Mei-Yin; Sheng, Ching-Ching; Tung, Pei-Chi; Huang, Ling-Ya; Chen, Yi-Wei

    2015-06-12

    Research shows that it is stressful for family members when a child or an adolescent within the family unit is diagnosed with cancer and this stress continues over the course of the year after the diagnosis. Qualitative studies have been conducted aimed at exploring parental, siblings' and other family members' experiences when facing health-illness transition-related stress during the first year after the child is diagnosed with cancer. This study integrates the research findings of relevant existing qualitative studies on this topic in order to provide empirical evidence-based suggestions for clinical care. This study intent is to obtain an understanding of the family members' experiences over the course of the following year after learning that a child or adolescent within their family unit has been diagnosed with cancer. The participants of interest are family members of a child or adolescent with cancer who verbally describe the whole experience and/or report on the impact of the diagnosis and disease on their lives. In this systematic review, there were no restrictions on the type, severity and prognosis of cancer. Studies investigating the experiences of the family of a child or adolescent with cancer that were reported verbally and the opinions of others external to the family (e.g. nurses) were excluded from the review. The phenomena of interest were the self-reported experiences over the course of the following year of family members of a child or adolescent with cancer and the impact on the whole family of the child or adolescent receiving a cancer diagnosis. The settings included acute care, home and community settings with any cultural context. Research on other phenomena, such as experiences related to social support intervention for the family, the long-term coping experience of the family, the bereavement experiences of children with cancer, the experiences of a child or adolescent with cancer and experiences more than one year after the diagnosis

  14. Using Qualitative Research to Overcome the Shortcomings of Systematic Reviews When Designing of a Self-Management Intervention for Advanced Cancer Pain

    Kate Flemming

    2016-09-01

    Full Text Available Objectives: To identify the key components for a self-management intervention for advanced cancer pain using evidence drawn from systematic reviews of complex interventions and syntheses of qualitative research. Methods: Evidence from up-to-date systematic reviews was prioritized. Searches were initially undertaken to identify the systematic reviews of effectiveness in Cinahl, Medline, Embase, PsycInfo, and the Cochrane Database of systematic reviews from 2009 to June 2014, using validated search terms. Subsequent searches to identify the qualitative systematic reviews were undertaken in Cinahl, Medline, Embase, and PsycInfo from 2009 to January 2015. The results of the two sets of reviews were integrated using methods based on constant comparative techniques. Results: Four systematic reviews examining interventions for the self-management of advanced cancer pain were identified. Although each review recommended some attributes of a pain management intervention, it was not possible to determine the essential key components. Subsequent searches for qualitative evidence syntheses identified three reviews. These were integrated with the effectiveness reviews. The integration identified key components for a self-management intervention including individualized approaches to care, the importance of addressing patients’ knowledge, skills, and attitudes toward pain management, and the significance of team approaches and inter-disciplinary working in the management of pain. Conclusion: Implementing the findings from systematic reviews of complex interventions is often hindered by a lack of understanding of important contextual components of care, often provided by qualitative research. Using both types of data to provide answers for practice demonstrates the benefits of incorporating qualitative research in reviews of complex interventions by ensuring the strengths of qualitative and quantitative research are combined and that their respective

  15. Qualitative aspects of the effectiveness of Culpeo foxes (Lycalopex culpaeus) as dispersers of Prosopis alba (Fabaceae) in a Bolivian dry valley

    Maldonado, D. E.; Loayza, A. P.; Garcia, E.; Pacheco, L. F.

    2018-02-01

    Foxes disperse several plant species in arid and semi-arid environments, but their effectiveness as dispersal agents still remains unclear. In this study, we examined qualitative components of the effectiveness of L. culpaeus as a disperser of P. alba seeds in an inter-Andean dry valley of La Paz, Bolivia. Specifically, we determined seed deposition microhabitats, and the probabilities of germination, seed removal and seedling recruitment in these microhabitats. Additionally, we assessed the effect of gut-passage on P. alba germination. We collected 159 scats, which contained a total of 3402 endocarps fragments. Foxes dispersed seeds into two microhabitats: open areas and under woody vegetation, but more frequently in the former. The probability of germination did not differ between gut-passed and control seeds, but control seeds germinated faster than gut-passed ones. The likelihood of removal was greater for endocarps fragments in open microhabitats than under woody vegetation. Only a small percentage of the seeds in each microhabitat germinated, but none survived more than a week. We conclude that although the Culpeo fox can defecate intact P. alba seeds, it does not provide effective dispersal services.

  16. The Impact of a Childhood Cancer Diagnosis on the Children and Siblings' School Attendance, Performance, and Activities: A Qualitative Descriptive Study.

    Tsimicalis, Argerie; Genest, Laurence; Stevens, Bonnie; Ungar, Wendy J; Barr, Ronald

    Families of children with cancer are confronted with unexpected out-of-pocket expenses and productivity costs associated with the diagnosis. One productivity cost that falls on children is the impact of cancer on children's school attendance, performance, and activities (eg, play, friendships, and socialization). Nested within the Childhood Cancer Cost Study, this qualitative descriptive study used convenience sampling to recruit and interview parents of children newly diagnosed with cancer. Content analysis techniques were used to inductively descriptive the semistructured interview data. Sixty-six parents of 65 children with cancer and of 73 siblings participated. The most commonly reported productivity loss in children with cancer was school absenteeism mainly due to cancer treatment. Children fell behind their classmates academically and lost important social time with peers. A few siblings also fell behind their peers primarily due to limited parental attention. Parents adopted various strategies to lessen the impact of the diagnosis on their children's school attendance, performance, and activities. Providing parents with additional resources and support may optimize their children's academic and social reintegration into school.

  17. Young female cancer patients' experiences with fertility counselling and fertility preservation-a qualitative small-scale study within the Danish health care setting.

    Hoeg, Didde; Schmidt, Lone; Macklon, Kirsten T

    2016-07-14

    Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment in the public Danish health care system. Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselling by a fertility specialist at the Fertility Clinic, University Hospital of Copenhagen, Denmark before initiation of cancer treatment. Participants were interviewed at a place chosen by them, and interviews were recorded and transcribed verbatim. Data were analysed using systematic text condensation developed by Malterud and inspired by Giorgi's phenomenological analysis. None of the participants were aware that chemotherapy could destroy their eggs. The participants described how specialized fertility counselling and fertility preservation contributed to a belief in life after cancer, which gave them hope that they would survive their cancer disease. Further, the women described how the possibility of fertility preservation removed a huge concern and enabled them to concentrate on their cancer treatment and on getting better. Overall, the specialized fertility counselling and treatment to preserve fertility was highly valued. The women felt it gave them a choice about their future fertility. The fertility expert presented the various fertility-preserving scenarios, and the women were content that they had an actual choice.

  18. Young female cancer patients’ experiences with fertility counselling and fertility preservation—a qualitative small-scale study within the Danish health care setting

    Hoeg, Didde; Schmidt, Lone; Macklon, Kirsten T.

    2016-01-01

    Introduction Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment in the public Danish health care system. Methods Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselling by a fertility specialist at the Fertility Clinic, University Hospital of Copenhagen, Denmark before initiation of cancer treatment. Participants were interviewed at a place chosen by them, and interviews were recorded and transcribed verbatim. Data were analysed using systematic text condensation developed by Malterud and inspired by Giorgi’s phenomenological analysis. Results None of the participants were aware that chemotherapy could destroy their eggs. The participants described how specialized fertility counselling and fertility preservation contributed to a belief in life after cancer, which gave them hope that they would survive their cancer disease. Further, the women described how the possibility of fertility preservation removed a huge concern and enabled them to concentrate on their cancer treatment and on getting better. Conclusion Overall, the specialized fertility counselling and treatment to preserve fertility was highly valued. The women felt it gave them a choice about their future fertility. The fertility expert presented the various fertility-preserving scenarios, and the women were content that they had an actual choice. PMID:27413812

  19. Diagnosis and management of people with venous thromboembolism and advanced cancer: how do doctors decide? A qualitative study.

    Johnson, Miriam J; Sheard, Laura; Maraveyas, Anthony; Noble, Simon; Prout, Hayley; Watt, Ian; Dowding, Dawn

    2012-07-20

    The treatment of cancer associated thrombosis (CAT) is well established, with level 1A evidence to support the recommendation of a low molecular weight heparin (LMWH) by daily injection for 3-6 months. However, registry data suggest compliance to clinical guidelines is poor. Clinicians face particular challenges in treating CAT in advanced cancer patients due to shorter life expectancy, increased bleeding risk and concerns that self injection may be too burdensome. For these reasons decision making around the diagnosis and management of CAT in people with advanced cancer, can be complex, and should focus on its likely net benefit for the patient. We explored factors that influence doctors' decision making in this situation and sought to gain an understanding of the barriers and facilitators to the application of best practice. Think aloud exercises using standardised case scenarios, and individual in depth interviews were conducted. All were transcribed. The think aloud exercises were analysed using Protocol Analysis and the interviews using Framework Analysis. 46 participants took part in the think aloud exercises and 45 participants were interviewed in depth. Each group included oncologists, palliative physicians and general practitioners and included both senior doctors and those in training. Two Strategic Health Authority regions, one in the north of England and one in Wales. The following key issues arose from the data synthesis: the importance of patient prognosis; the concept of "appropriateness"; "benefits and burdens" of diagnosis and treatment; LMWH or warfarin for treatment and sources of information which changed practice. Although interlinked, they do describe distinct aspects of the factors that influence doctors in their decisions in this area. The above factors are issues doctors take into account when deciding whether to send a patient to hospital for investigation or to anticoagulate a patient with confirmed or suspected VTE. Many factors

  20. Diagnosis and management of people with venous thromboembolism and advanced cancer: how do doctors decide? a qualitative study

    Johnson Miriam J

    2012-07-01

    Full Text Available Abstract Background The treatment of cancer associated thrombosis (CAT is well established, with level 1A evidence to support the recommendation of a low molecular weight heparin (LMWH by daily injection for 3–6 months. However, registry data suggest compliance to clinical guidelines is poor. Clinicians face particular challenges in treating CAT in advanced cancer patients due to shorter life expectancy, increased bleeding risk and concerns that self injection may be too burdensome. For these reasons decision making around the diagnosis and management of CAT in people with advanced cancer, can be complex, and should focus on its likely net benefit for the patient. We explored factors that influence doctors’ decision making in this situation and sought to gain an understanding of the barriers and facilitators to the application of best practice. Methods Think aloud exercises using standardised case scenarios, and individual in depth interviews were conducted. All were transcribed. The think aloud exercises were analysed using Protocol Analysis and the interviews using Framework Analysis. Participants: 46 participants took part in the think aloud exercises and 45 participants were interviewed in depth. Each group included oncologists, palliative physicians and general practitioners and included both senior doctors and those in training. Setting: Two Strategic Health Authority regions, one in the north of England and one in Wales. Results The following key issues arose from the data synthesis: the importance of patient prognosis; the concept of “appropriateness”; “benefits and burdens” of diagnosis and treatment; LMWH or warfarin for treatment and sources of information which changed practice. Although interlinked, they do describe distinct aspects of the factors that influence doctors in their decisions in this area. Conclusions The above factors are issues doctors take into account when deciding whether to send a patient to hospital

  1. Assessing the effect of quantitative and qualitative predictors on gastric cancer individuals survival using hierarchical artificial neural network models.

    Amiri, Zohreh; Mohammad, Kazem; Mahmoudi, Mahmood; Parsaeian, Mahbubeh; Zeraati, Hojjat

    2013-01-01

    There are numerous unanswered questions in the application of artificial neural network models for analysis of survival data. In most studies, independent variables have been studied as qualitative dichotomous variables, and results of using discrete and continuous quantitative, ordinal, or multinomial categorical predictive variables in these models are not well understood in comparison to conventional models. This study was designed and conducted to examine the application of these models in order to determine the survival of gastric cancer patients, in comparison to the Cox proportional hazards model. We studied the postoperative survival of 330 gastric cancer patients who suffered surgery at a surgical unit of the Iran Cancer Institute over a five-year period. Covariates of age, gender, history of substance abuse, cancer site, type of pathology, presence of metastasis, stage, and number of complementary treatments were entered in the models, and survival probabilities were calculated at 6, 12, 18, 24, 36, 48, and 60 months using the Cox proportional hazards and neural network models. We estimated coefficients of the Cox model and the weights in the neural network (with 3, 5, and 7 nodes in the hidden layer) in the training group, and used them to derive predictions in the study group. Predictions with these two methods were compared with those of the Kaplan-Meier product limit estimator as the gold standard. Comparisons were performed with the Friedman and Kruskal-Wallis tests. Survival probabilities at different times were determined using the Cox proportional hazards and a neural network with three nodes in the hidden layer; the ratios of standard errors with these two methods to the Kaplan-Meier method were 1.1593 and 1.0071, respectively, revealed a significant difference between Cox and Kaplan-Meier (P neural network, and the neural network and the standard (Kaplan-Meier), as well as better accuracy for the neural network (with 3 nodes in the hidden layer

  2. Using Qualitative Comparative Analysis of Key Informant Interviews in Health Services Research: Enhancing a Study of Adjuvant Therapy Use in Breast Cancer Care.

    McAlearney, Ann Scheck; Walker, Daniel; Moss, Alexandra D; Bickell, Nina A

    2016-04-01

    Qualitative comparative analysis (QCA) is a methodology created to address causal complexity in social sciences research by preserving the objectivity of quantitative data analysis without losing detail inherent in qualitative research. However, its use in health services research (HSR) is limited, and questions remain about its application in this context. To explore the strengths and weaknesses of using QCA for HSR. Using data from semistructured interviews conducted as part of a multiple case study about adjuvant treatment underuse among underserved breast cancer patients, findings were compared using qualitative approaches with and without QCA to identify strengths, challenges, and opportunities presented by QCA. Ninety administrative and clinical key informants interviewed across 10 NYC area safety net hospitals. Transcribed interviews were coded by 3 investigators using an iterative and interactive approach. Codes were calibrated for QCA, as well as examined using qualitative analysis without QCA. Relative to traditional qualitative analysis, QCA strengths include: (1) addressing causal complexity, (2) results presentation as pathways as opposed to a list, (3) identification of necessary conditions, (4) the option of fuzzy-set calibrations, and (5) QCA-specific parameters of fit that allow researchers to compare outcome pathways. Weaknesses include: (1) few guidelines and examples exist for calibrating interview data, (2) not designed to create predictive models, and (3) unidirectionality. Through its presentation of results as pathways, QCA can highlight factors most important for production of an outcome. This strength can yield unique benefits for HSR not available through other methods.

  3. Validity in Qualitative Evaluation

    Vasco Lub

    2015-12-01

    Full Text Available This article provides a discussion on the question of validity in qualitative evaluation. Although validity in qualitative inquiry has been widely reflected upon in the methodological literature (and is still often subject of debate, the link with evaluation research is underexplored. Elaborating on epistemological and theoretical conceptualizations by Guba and Lincoln and Creswell and Miller, the article explores aspects of validity of qualitative research with the explicit objective of connecting them with aspects of evaluation in social policy. It argues that different purposes of qualitative evaluations can be linked with different scientific paradigms and perspectives, thus transcending unproductive paradigmatic divisions as well as providing a flexible yet rigorous validity framework for researchers and reviewers of qualitative evaluations.

  4. In their own words: A qualitative study of the psychosocial concerns of posttreatment and long-term lung cancer survivors

    Rohan, Elizabeth A.; Boehm, Jennifer; Allen, Kristine Gabuten; Poehlman, Jon

    2016-01-01

    Although lung cancer is the deadliest type of cancer, survival rates are improving. To address the dearth of literature about the concerns of lung cancer survivors, the authors conducted 21 in-depth interviews with lung cancer survivors that focused on experiences during diagnosis, treatment, and long-term survivorship. Emergent themes included feeling blamed for having caused their cancer, being stigmatized as throwaways, and long-term survivors? experiencing surprise that they are still ali...

  5. Aspectos culturais na compreensão da periodontite crônica: um estudo qualitativo Cultural aspects in the understanding of chronic periodontitis: a qualitative study

    Sharmênia de Araújo Soares Nuto

    2007-03-01

    Full Text Available Este artigo teve como objetivo analisar concepções, crenças, atitudes e modelos explicativos para a doença em portadores de periodontite crônica, visando a colaborar na comunicação clínica entre cirurgiões-dentistas e pacientes, e contribuir para a adesão consciente ao tratamento. A amostra da pesquisa constou de vinte pacientes provenientes dos cursos de especialização em periodontia da Universidade de Fortaleza e da Associação Brasileira de Odontologia, em Fortaleza, Ceará, Brasil. A coleta de dados deu-se no período de outubro de 2004 a janeiro de 2005. Referencial metodológico qualitativo foi utilizado para a interpretação da subjetividade dos pacientes. Entrevistas semi-estruturadas foram realizadas no intuito de obter relatos de "experiências vividas" dos doentes. Para a análise temática do discurso, empregaram-se: as categorias empíricas constituídas no próprio estudo, as freqüências simples e os percentuais calculados e o refinamento das classificações por temas. A partir dos relatos examinados, foi possível analisar que os pacientes compreendem o processo saúde-doença periodontal por meio da intermediação do conhecimento popular e científico, do envolvimento das condições de vida e de trabalho e do acesso ao serviço de qualidade, ou seja, eles não incorporam somente o discurso biomédico.This study aimed to analyze the concepts, beliefs, attitudes, and explanatory models related to chronic periodontitis among individuals with this disease in order to facilitate communications between dentists and patients and foster conscientious treatment adherence. The study sample consisted of 20 patients from the Periodontics Specialization Courses at Fortaleza University and the Brazilian Dental Association in Fortaleza, Ceará State. Data were gathered from October 2004 to January 2005. A qualitative methodological framework was used to interpret the patients' subjective expression. Semi-structured interviews

  6. Descriptive analysis of work and trends in anaesthesiology from 2005 to 2006: Quantitative and qualitative aspects of effects and evaluation of anaesthesia

    Aleksić Valentina V.

    2010-01-01

    Full Text Available Introduction. In anaesthesiology, economic aspects have been insufficiently studied. Objective. The aim of this paper was the assessment of rational choice of the anaesthesiological services based on the analysis of the scope, distribution, trend and cost. Methods. The costs of anaesthesiological services were counted based on “unit” prices from the Republic Health Insurance Fund. Data were analysed by methods of descriptive statistics and statistical significance was tested by Student’s t-test and χ2-test. Results. The number of general anaesthesia was higher and average time of general anaesthesia was shorter, without statistical significance (t-test, p=0.436 during 2006 compared to the previous year. Local anaesthesia was significantly higher (χ2-test, p=0.001 in relation to planned operation in emergency surgery. The analysis of total anaesthesiological procedures revealed that a number of procedures significantly increased in ENT and MFH surgery, and ophthalmology, while some reduction was observed in general surgery, orthopaedics and trauma surgery and cardiovascular surgery (χ2-test, p=0.000. The number of analgesia was higher than other procedures (χ2-test, p=0.000. The structure of the cost was 24% in neurosurgery, 16% in digestive (general surgery,14% in gynaecology and obstetrics,13% in cardiovascular surgery and 9% in emergency room. Anaesthesiological services costs were the highest in neurosurgery, due to the length anaesthesia, and digestive surgery due to the total number of general anaesthesia performed. Conclusion. It is important to implement pharmacoeconomic studies in all departments, and to separate the anaesthesia services for emergency and planned operations. Disproportions between the number of anaesthesia, surgery interventions and the number of patients in surgical departments gives reason to design relation database.

  7. What made her give up her breasts: a qualitative study on decisional considerations for contralateral prophylactic mastectomy among breast cancer survivors undergoing BRCA1/2 genetic testing.

    Kwong, Ava; Chu, Annie T W

    2012-01-01

    This qualitative study retrospectively examined the experience and psychological impact of contralateral prophylactic mastectomy (CPM) among Southern Chinese females with unilateral breast cancer history who underwent BRCA1/2 genetic testing. Limited knowledge is available on this topic especially among Asians; therefore, the aim of this study was to acquire insight from Chinese females' subjective perspectives. A total of 12 semi-structured in-depth interviews, with 11 female BRCA1/BRCA 2 mutated gene carriers and 1 non-carrier with a history of one-sided breast cancer and genetic testing performed by the Hong Kong Hereditary Breast Cancer Family Registry, who subsequently underwent CPM, were assessed using thematic analysis and a Stage Conceptual Model. Breast cancer history, procedures conducted, cosmetic satisfaction, pain, body image and sexuality issues, and cancer risk perception were discussed. Retrieval of medical records using a prospective database was also performed. All participants opted for prophylaxis due to their reservations concerning the efficacy of surveillance and worries of recurrent breast cancer risk. Most participants were satisfied with the overall results and their decision. One-fourth expressed different extents of regrets. Psychological relief and decreased breast cancer risk were stated as major benefits. Spouses' reactions and support were crucial for post-surgery sexual satisfaction and long-term adjustment. Our findings indicate that thorough education on cancer risk and realistic expectations of surgery outcomes are crucial for positive adjustment after CPM. Appropriate genetic counseling and pre-and post-surgery psychological counseling were necessary. This study adds valuable contextual insights into the experiences of living with breast cancer fear and the importance of involving spouses when counseling these patients.

  8. Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians.

    Datta, S S; Tripathi, L; Varghese, R; Logan, J; Gessler, S; Chatterjee, S; Bhaumik, J; Menon, U

    2017-09-01

    Families are a unique source of support for many cancer patients. Most advanced communication skills training for oncologists are patient centred and do not cover interactions with family members. The current study used in-depth qualitative interviews of patients, relatives and cancer clinicians with thematic analysis to explore the role of family members in the communication process. Forty-one participants included 10 cancer patients, 10 relatives ensuring proportionate representation of both gender and primary cancer site and 21 doctors representing both medical and surgical oncology. Nineteen of 20 patients and relatives wanted an "open and honest" discussion with their doctors. All patients, relatives and doctors preferred involvement of the family at most stages of cancer treatment. Five themes were identified in relation to communication with family members. The participants highlighted the "importance of family for physical and psychological care," they emphasised the need to "balance patient autonomy and relatives desire to be protective" using varied "negotiating strategies" that are influenced by "socioeconomic circumstances of both patient and family." The doctor-patient-relative communication process was not static with preferences changing over time. The data suggests that communication skills training of cancer clinicians should incorporate modules on better communication with relatives. © 2016 John Wiley & Sons Ltd.

  9. Qualitative and Quantitative Analysis of ROS-Mediated Oridonin-Induced Oesophageal Cancer KYSE-150 Cell Apoptosis by Atomic Force Microscopy.

    Jiang Pi

    Full Text Available High levels of intracellular reactive oxygen species (ROS in cells is recognized as one of the major causes of cancer cell apoptosis and has been developed into a promising therapeutic strategy for cancer therapy. However, whether apoptosis associated biophysical properties of cancer cells are related to intracellular ROS functions is still unclear. Here, for the first time, we determined the changes of biophysical properties associated with the ROS-mediated oesophageal cancer KYSE-150 cell apoptosis using high resolution atomic force microscopy (AFM. Oridonin was proved to induce ROS-mediated KYSE-150 cell apoptosis in a dose dependent manner, which could be reversed by N-acetylcysteine (NAC pretreatment. Based on AFM imaging, the morphological damage and ultrastructural changes of KYSE-150 cells were found to be closely associated with ROS-mediated oridonin-induced KYSE-150 cell apoptosis. The changes of cell stiffness determined by AFM force measurement also demonstrated ROS-dependent changes in oridonin induced KYSE-150 cell apoptosis. Our findings not only provided new insights into the anticancer effects of oridonin, but also highlighted the use of AFM as a qualitative and quantitative nanotool to detect ROS-mediated cancer cell apoptosis based on cell biophysical properties, providing novel information of the roles of ROS in cancer cell apoptosis at nanoscale.

  10. Barriers to biomedical care and use of traditional medicines for treatment of cervical cancer: an exploratory qualitative study in northern Uganda.

    Mwaka, A D; Okello, E S; Orach, C G

    2015-07-01

    Use of traditional medicines for treatment of cancers has increased worldwide. We used a qualitative approach to explore barriers to biomedical care and reasons for use of traditional medicines for the treatment of cervical cancer in Gulu, northern Uganda. We carried out 24 focus group discussions involving men and women aged 18-59 years. We employed content analyses technique in data analysis. Traditional medicines were used mainly due to barriers to biomedical care for cervical cancer. The barriers included health system factors, for example long distances to health facilities and unavailability of medicines; health workers' factors, for example negative attitudes towards patients and demands for bribes; individual patient's factors, for example inability to pay for medical care; and socio-cultural beliefs about superiority of traditional medicines and perceived greater privacy in accessing traditional healers. Barriers to biomedical care and community beliefs in the effectiveness of traditional medicines encourage use of traditional medicines for treatment of cervical cancer but might hinder help-seeking at biomedical facilities. There is need for targeted culturally sensitive awareness campaign to promote effectiveness of modern medicine and to encourage cautious use of traditional medicines in the treatment of cervical cancer. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

  11. Political economy of hope as a cultural facet of biomedicalization: A qualitative examination of constraints to hospice utilization among U.S. end-stage cancer patients.

    Mrig, Emily Hammad; Spencer, Karen Lutfey

    2018-03-01

    A growing body of social science literature is devoted to describing processes of biomedicalization. The issue of biomedicalization is especially relevant for individuals suffering from end-stage cancer and hoping that aggressive end-of-life interventions, which are riddled with uncertainty around quantity or quality of life, will produce a 'cure'. To examine hospice underutilization among end-stage cancer patients, we apply the anthropological concept 'political economy of hope,' which describes how personal and collective 'hope' is associated with the political and economic structures that produce biomedicalization processes. Previous studies have examined hospice underutilization among end-stage cancer patients and have identified barriers stemming from patient and physician characteristics or health insurance reimbursement policies. Yet, these studies do not provide an organized synthesis of how barriers articulate, how they are part of the longitudinal decision-making process, or describe the sociocultural context surrounding hospice care enrollment decisions. This paper focuses on US-specific mechanisms and is based on qualitative, in-depth, interviews with physicians at an academic hospital (N = 24). We find that hospice underutilization results from a web of interconnected constraints surrounding end-stage cancer patients. Our research reveals how hospice care contradicts the political and economic structures associated with end-stage cancer care and illustrates how end-stage cancer patients are transformed into a form of biovalue, a fundamental commodity sustaining the political economy of hope. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Development of an explanatory model of sexual intimacy following treatment for localised prostate cancer: A systematic review and meta-synthesis of qualitative evidence.

    Tucker, Samantha R; Speer, Susan A; Peters, Sarah

    2016-08-01

    Prostate cancer is a leading cause of cancer in men, affecting one in eight. An ageing population coupled with increased testing indicates that the incidence of early-stage prostate cancer is rising rapidly. Treatments are effective, but all can result in chronic sexual side effects and impact on the psychological, emotional and relational components of sexual functioning. Whilst the physical consequences of treatment are well documented, we lack a comprehensive picture of the effects of localised prostate cancer treatment on men's experience of sexual intimacy and how this may affect survivorship and recovery. This study synthesises the qualitative literature related to men's experience of sexual intimacy in the context of localised prostate cancer. A systematic search strategy identified 12 studies, which were assessed using a modified version of the Critical Appraisal Skills Programme. Using Noblit and Hare's (1988) approach, a meta-synthesis was conducted. Findings are organised within four inter-related themes that form the basis of a new conceptual explanatory model: (i) Loss and grief: Destroyed intimacy; (ii) Going through the motions: Artificial intimacy; (iii) Fear of failure: Avoiding intimacy and (iv) Breaking barriers: Constructing an alternative intimacy. The LMAC (Loss, Motions, Avoidance and Construction) model provides a new way of conceptualising sexual recovery following prostate cancer treatment and opportunities for health care professionals to support men and their partners. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Resilience for family carers of advanced cancer patients-how can health care providers contribute? A qualitative interview study with carers.

    Røen, Ingebrigt; Stifoss-Hanssen, Hans; Grande, Gunn; Brenne, Anne-Tove; Kaasa, Stein; Sand, Kari; Knudsen, Anne Kari

    2018-05-01

    Caring for advanced cancer patients affects carers' psychological and physical health. Resilience has been defined as "the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat." The aim of this study was to explore factors promoting carer resilience, based on carers' experiences with and preferences for health care provider support. Qualitative, semi-structured, individual interviews with family carers of advanced cancer patients were performed until data saturation. The interviews were recorded, transcribed, and analyzed using systematic text condensation. Carers ( n = 14) of advanced cancer patients, not receiving curative treatment, admitted to an integrated curative and palliative care cancer outpatient clinic or to a university hospital cancer clinic, were included. 14 carers of advanced cancer patients were included; 7 men, 7 women, and mean age of 59 years; 3 were bereaved; 12 were partners; 5 had young and teenage children. Four main resilience factors were identified: (1) being seen and known by health care providers-a personal relation; (2) availability of palliative care; (3) information and communication about illness, prognosis, and death; and (4) facilitating a good carer-patient relation. Health care providers may enhance carers' resilience by a series of simple interventions. Education should address carers' support needs and resilience. Systematic assessment of carers' support needs is recommended. Further investigation is needed into how health care providers can help carers and patients communicate about death.

  14. Qualitative and quantitative analyses of the bifidobacterial microbiota in the colonic mucosa of patients with colorectal cancer, diverticulitis and inflammatory bowel disease

    2007-01-01

    AIM: To characterize the bifidobacterial microbiota of the colonic mucosa in patients with colon cancer,inflammatory bowel disease or diverticulitis.METHODS: A sample of the distal colonic mucosa was taken during surgery from a total of 34 patients,twenty-one with diagnosed colorectal cancer, nine with diverticulitis and four with inflammatory bowel disease, requiring surgery for their condition. Bacterial DNA was extracted from the resected mucosal samples and bifidobacterial mucosa-associated microbiota was qualitatively and quantitatively determined by means of qualitative and quantitative PCR.RESULTS: Bifidobacteria were found in 100% of the samples from patients with diverticulitis or IBD and a 76% of those suffering colon cancer. The species B. longum and B. bifidum were the most widely found, followed by B. animalis, B. catenulatum and B.adolescentis. B. breve, B. dentium and B. angulatum were not detected in any sample. A significantly higher occurrence of B. longum was observed in patients with diverticulitis than in those with colon cancer or IBD (100%, 62% and 75%, respectively, P < 0.05).Similar results were obtained for B. animalis (56%, 0%and 25%, P < 0.05), while B. adolescentis was only found in the mucosa from patients with colon cancer (5 out of 21, 24%). At the quantitative level, patients with colon cancer or IBD showed lower counts of total Bifidobacterium (4.94 and 5.91 vs 6.96 log Cells/sample,respectively, P < 0.05) and of the species B.longum (4.05 and 4.79 vs 6.76, P < 0.05) than those with diverticulitis.CONCLUSION: Aberrancies in mucosa associated microbiota are present in different intestinal diseases.This may indicate a role of the microbiota in the pathogenesis of these diseases.

  15. Perceptions of Breast Cancer Survivors on the Supporting Practices of Their Supervisors in the Return-to-Work Process: A Qualitative Descriptive Study.

    Caron, Maryse; Durand, Marie-José; Tremblay, Dominique

    2018-03-01

    Purpose Supervisors are known to be key actors in ensuring the success of absent employees in their return-to-work process. However, to date, little is known about the perceptions of breast cancer survivors on the practices put in place by their supervisors to support them during this process. The objective of this study was to describe the perceptions of breast cancer survivors on the practices put in place by their supervisors to support them during their return-to-work process. Method A qualitative descriptive study was conducted. Semi-structured interviews were carried out with breast cancer survivors (n = 10) who had returned to work after treatment and were still at work more than 18 months later. Each interview was audio recorded and then transcribed verbatim for qualitative thematic content analysis using a semi-open codification framework. Results Participants identified three main practices put in place by their supervisors to support them and which they perceived as particularly helpful during the return-to-work process: (1) maintaining communication during their period of absence; (2) working with them to structure their return-to-work process before their actual return; and (3) allowing them flexibility in their schedule for a certain period, particularly at the beginning of the return-to-work process. Breast cancer survivors also identified an omission in the practice of employers: lack of follow-up over time. Conclusion Knowledge about the practices perceived as helpful by breast cancer survivors during their return-to-work process lays the groundwork for the eventual development of services to help breast cancer survivors in their return to work.

  16. Barriers to early diagnosis of symptomatic breast cancer: a qualitative study of Black African, Black Caribbean and White British women living in the UK

    Jones, Claire E L; Maben, Jill; Lucas, Grace; Davies, Elizabeth A; Jack, Ruth H; Ream, Emma

    2015-01-01

    Objectives Understanding barriers to early diagnosis of symptomatic breast cancer among Black African, Black Caribbean and White British women in the UK. Design In-depth qualitative interviews using grounded theory methods to identify themes. Findings validated through focus groups. Participants 94 women aged 33–91 years; 20 Black African, 20 Black Caribbean and 20 White British women diagnosed with symptomatic breast cancer were interviewed. Fourteen Black African and 20 Black Caribbean women with (n=19) and without (n=15) breast cancer participated in six focus groups. Setting Eight cancer centres/hospital trusts in London (n=5), Somerset (n=1), West Midlands (n=1) and Greater Manchester (n=1) during 2012–2013. Results There are important differences and similarities in barriers to early diagnosis of breast cancer between Black African, Black Caribbean and White British women in the UK. Differences were influenced by country of birth, time spent in UK and age. First generation Black African women experienced most barriers and longest delays. Second generation Black Caribbean and White British women were similar and experienced fewest barriers. Absence of pain was a barrier for Black African and Black Caribbean women. Older White British women (≥70 years) and first generation Black African and Black Caribbean women shared conservative attitudes and taboos about breast awareness. All women viewed themselves at low risk of the disease, and voiced uncertainty over breast awareness and appraising non-lump symptoms. Focus group findings validated and expanded themes identified in interviews. Conclusions Findings challenged reporting of Black women homogenously in breast cancer research. This can mask distinctions within and between ethnic groups. Current media and health promotion messages need reframing to promote early presentation with breast symptoms. Working with communities and developing culturally appropriate materials may lessen taboos and stigma

  17. Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

    Lewis, Frances

    2003-01-01

    .... The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening...

  18. Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

    Lewis, Frances

    2002-01-01

    The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening...

  19. Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

    Lewis, Frances

    2004-01-01

    .... The purpose of the current study was to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening...

  20. Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

    Lewis, Frances

    2001-01-01

    .... The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening...

  1. Are Qualitative Assessments of Background Parenchymal Enhancement, Amount of Fibroglandular Tissue on MR Images, and Mammographic Density Associated with Breast Cancer Risk?

    Dontchos, Brian N.; Partridge, Savannah C.; Korde, Larissa A.; Lam, Diana L.; Scheel, John R.; Peacock, Sue; Lehman, Constance D.

    2015-01-01

    Purpose To investigate whether qualitative magnetic resonance (MR) imaging assessments of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT), and mammographic density are associated with risk of developing breast cancer in women who are at high risk. Materials and Methods In this institutional review board–approved HIPAA-compliant retrospective study, all screening breast MR images obtained from January 2006 to December 2011 in women aged 18 years or older and at high risk for but without a history of breast cancer were identified. Women in whom breast cancer was diagnosed after index MR imaging comprised the cancer cohort, and one-to-one matching (age and BRCA status) of each woman with breast cancer to a control subject was performed by using MR images obtained in women who did not develop breast cancer with follow-up time maximized. Amount of BPE, BPE pattern (peripheral vs central), amount of FGT at MR imaging, and mammographic density were assessed on index images. Imaging features were compared between cancer and control cohorts by using conditional logistic regression. Results Twenty-three women at high risk (mean age, 47 years ± 10 [standard deviation]; six women had BRCA mutations) with no history of breast cancer underwent screening breast MR imaging; in these women, a diagnosis of breast cancer (invasive, n = 12; in situ, n = 11) was made during the follow-up interval. Women with mild, moderate, or marked BPE were nine times more likely to receive a diagnosis of breast cancer during the follow-up interval than were those with minimal BPE (P = .007; odds ratio = 9.0; 95% confidence interval: 1.1, 71.0). BPE pattern, MR imaging amount of FGT, and mammographic density were not significantly different between the cohorts (P = .5, P = .5, and P = .4, respectively). Conclusion Greater BPE was associated with a higher probability of developing breast cancer in women at high risk for cancer and warrants further study. © RSNA

  2. Cancer-related information needs and treatment decision-making experiences of people with dementia in England: a multiple perspective qualitative study.

    McWilliams, Lorna; Farrell, Carole; Keady, John; Swarbrick, Caroline; Burgess, Lorraine; Grande, Gunn; Bellhouse, Sarah; Yorke, Janelle

    2018-04-12

    Little is known about the cancer experience and support needs of people with dementia. In particular, no evidence currently exists to demonstrate the likely complex decision-making processes for this patient group and the oncology healthcare professionals (HCP) involved in their care. The aim of this study was to explore the cancer-related information needs and decision-making experiences of patients with cancer and comorbid dementia, their informal caregivers and oncology HCPs. Cross-sectional qualitative study. Semistructured interviews were conducted face to face with participants. Interviews were audio recorded and transcribed prior to thematic analysis. Patients with a diagnosis of cancer and dementia, their informal caregivers and oncology HCPs involved in their care, all recruited from a regional treatment cancer centre. Purposeful sample of 10 patients with a diagnosis of cancer-dementia, informal caregivers (n=9) and oncology HCPs (n=12). Four themes were identified: (1) leading to the initial consultation-HCPs require more detailed information on the functional impact of dementia and how it may influence cancer treatment options prior to meeting the patient; (2) communicating clinically relevant information-informal caregivers are relied on to provide patient information, advocate for the patient and support decision-making; (3) adjustments to cancer care-patients with dementia get through treatment with the help of their family and (4) following completion of cancer treatment-there are continuing information needs. Oncology HCPs discussed their need to consult specialists in dementia care to support treatment decision-making. Although patients with cancer-dementia are involved in their treatment decision-making, informal caregivers are generally crucial in supporting this process. Individual patient needs and circumstances related to their cancer must be considered in the context of dementia prognosis highlighting complexities of decision-making in this

  3. The experiences of health-related quality of life in patients with nonspecific symptoms who undergo a diagnostic evaluation for cancer: a qualitative interview study.

    Moseholm, Ellen; Lindhardt, Bjarne Oerskov; Rydahl-Hansen, Susan

    2017-09-01

    The diagnostic phase of cancer can affect health-related quality of life (HRQoL). The aim of this study was to investigate how patients with nonspecific symptoms experience HRQoL while undergoing diagnostic evaluations for cancer. Twenty-one participants who had completed a fast-track evaluation for possible cancer at one of three hospitals in the Capital Region, Denmark were interviewed 2-4 weeks after completing diagnostic evaluations. The interviews were semi-structured and were supported by an interview guide based on the same themes as in The European Organisation for Research and Treatment of Cancer Quality of Life questionnaire (EORCT-QLQ-C30). Data analysis was based on qualitative content analysis by Krippendorff. The analysis generated six categories: symptoms, physical-, role-, emotional-, cognitive- and social functioning, and the diagnostic fast-track experience. From these categories, a main theme was identified: Health-related quality of life is not solely affected by the diagnostic process. The results provide a comprehensive understanding of HRQoL in the diagnostic phase of possible cancer, which can be used not only to enhance evidence-based care, but also in the interpretation of the EORTC-QLQ-C30 scores. Psycho-social support with a focus on individual informational needs during the diagnostic phase may be warranted. © 2016 Nordic College of Caring Science.

  4. The role of complementary and alternative medicine (CAM) routines and rituals in men with cancer and their significant others (SOs): a qualitative investigation.

    Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

    2014-05-01

    Complementary and alternative medicine (CAM) is frequently used in cancer patients, often with contribution of the significant others (SOs), but without consultation of healthcare professionals. This research explored how cancer patients integrate and maintain CAM use in their everyday life, and how SOs are involved in it. In this qualitative study, male participants were selected from a preceding Australian survey on CAM use in men with cancer (94 % response rate and 86 % consent rate for follow-up interview). Semistructured interviews were conducted with 26 men and 24 SOs until data saturation was reached. Interview transcripts were coded and analyzed thematically, thereby paying close attention to participants' language in use. A major theme associated with high CAM use was "CAM routines and rituals," as it was identified that men with cancer practiced CAM as (1) functional routines, (2) meaningful rituals, and (3) mental/spiritual routines or/and rituals. Regular CAM use was associated with intrapersonal and interpersonal benefits: CAM routines provided men with certainty and control, and CAM rituals functioned for cancer patients and their SOs as a means to create meaning, thereby working to counter fear and uncertainty consequent upon a diagnosis of cancer. SOs contributed most to men's uptake and maintenance of dietary-based CAM in ritualistic form resulting in interpersonal bonding and enhanced closeness. CAM routines and rituals constitute key elements in cancer patients' regular and satisfied CAM use, and they promote familial strengthening. Clinicians and physicians can convey these benefits to patient consultations, further promoting the safe and effective use of CAM.

  5. Multi-mutational model for cancer based on age-time patterns of radiation effects: 2. Biological aspects

    Mendelsohn, M.L.; Pierce, P.A.

    1997-09-04

    Biological properties of relevance when modeling cancers induced in the atom bomb survivors include the wide distribution of the induced cancers across all organs, their biological indistinguishability from background cancers, their rates being proportional to background cancer rates, their rates steadily increasing over at least 50 years as the survivors age, and their radiation dose response being linear. We have successfully described this array of properties with a modified Armitage-Doll model using 5 to 6 somatic mutations, no intermediate growth, and the dose-related replacement of any one of these time-driven mutations by a radiation-induced mutation. Such a model is contrasted to prevailing models that use fewer mutations combined with intervening growth. While the rationale and effectiveness of our model is compelling for carcinogenesis in the atom bomb survivors, the lack of a promotional component may limit the generality of the model for other types of human carcinogenesis.

  6. Studies on certain exons in the P53 gene in Egyptian patients suffering from laryngeal cancer concerning some biochemical aspects

    Hagag, S.A.

    2010-01-01

    Human head and neck cancer disease is the most common respiratory cancer that population suffering from its symptoms all over the world. This type of malignancy is connected with drinking alcohol and smoking tobacco beside other factors concerning the type of nutrition, age, gender as well as environmental factors such as ionizing radiation and toxic chemicals. These factors can lead to genetic changes in one or more tissue cells which begin to proliferate due to the inflammatory stimulus. The immune inflammatory state serves as a key mediator of the middle stages of tumor development. Cancer begins with a series of genetic changes that prompt group of cells which begin to over replicate and then invade surrounding tissues (metastases) and lately the malignancy spread to the blood and lymph nodes. Genetic changes which cause cancer can be considered as the match that lights the fire and the inflammation is the fuel that feed it. The antiinflammatory cancer therapy will prevent the premalignant cells from turning fully to cancerous or it will impede an existing tumor from spreading to other sites in the body. Chronic inflammation can play an important role in the progression of some types of tumors. So there is a close link between tumor and inflammation

  7. Using Qualitative Comparative Analysis (QCA) of Key Informant Interviews in Health Services Research: Enhancing a Study of Adjuvant Therapy Use in Breast Cancer Care

    McAlearney, Ann Scheck; Walker, Daniel; Moss, Alexandra DeNardis; Bickell, Nina A.

    2015-01-01

    Background Qualitative Comparative Analysis (QCA) is a methodology created to address causal complexity in social sciences research by preserving the objectivity of quantitative data analysis without losing detail inherent in qualitative research. However, its use in health services research (HSR) is limited, and questions remain about its application in this context. Objective To explore the strengths and weaknesses of using QCA for HSR. Research Design Using data from semi-structured interviews conducted as part of a multiple case study about adjuvant treatment underuse among underserved breast cancer patients, findings were compared using qualitative approaches with and without QCA to identify strengths, challenges, and opportunities presented by QCA. Subjects Ninety administrative and clinical key informants interviewed across ten NYC area safety net hospitals. Measures Transcribed interviews were coded by three investigators using an iterative and interactive approach. Codes were calibrated for QCA, as well as examined using qualitative analysis without QCA. Results Relative to traditional qualitative analysis, QCA strengths include: (1) addressing causal complexity, (2) results presentation as pathways as opposed to a list, (3) identification of necessary conditions, (4) the option of fuzzy-set calibrations, and (5) QCA-specific parameters of fit that allow researchers to compare outcome pathways. Weaknesses include: (1) few guidelines and examples exist for calibrating interview data, (2) not designed to create predictive models, and (3) unidirectionality. Conclusions Through its presentation of results as pathways, QCA can highlight factors most important for production of an outcome. This strength can yield unique benefits for HSR not available through other methods. PMID:26908085

  8. A qualitative study of patient and provider perspectives on using web-based pain coping skills training to treat persistent cancer pain.

    Rini, Christine; Vu, Maihan B; Lerner, Hannah; Bloom, Catherine; Carda-Auten, Jessica; Wood, William A; Basch, Ethan M; Voorhees, Peter M; Reeder-Hayes, Katherine E; Keefe, Francis J

    2018-04-01

    Persistent pain is common and inadequately treated in cancer patients. Behavioral pain interventions are a recommended part of multimodal pain treatments, but they are underused in clinical care due to barriers such as a lack of the resources needed to deliver them in person and difficulties coordinating their use with clinical care. Pain coping skills training (PCST) is an evidence-based behavioral pain intervention traditionally delivered in person. Delivering this training via the web would increase access to it by addressing barriers that currently limit its use. We conducted a patient pilot study of an 8-week web-based PCST program to determine the acceptability of this approach to patients and the program features needed to meet their needs. Focus groups with healthcare providers identified strategies for coordinating the use of web-based PCST in clinical care. Participants included 7 adults with bone pain due to multiple myeloma or metastasized breast or prostate cancer and 12 healthcare providers (4 physicians and 8 advanced practice providers) who treat cancer-related bone pain. Patients completed web-based PCST at home and then took part in an in-depth qualitative interview. Providers attended focus groups led by a trained moderator. Qualitative analyses identified themes in the patient and provider data. Patients reported strongly favorable responses to web-based PCST and described emotional and physical benefits. They offered suggestions for adapting the approach to better fit their needs and to overcome barriers to completion. Focus groups indicated a need to familiarize healthcare providers with PCST and to address concerns about overburdening patients. Providers would recommend the program to patients they felt could benefit. They suggested applying a broad definition of cancer pain and having various types of providers help coordinate program its use with clinical care. Web-based PCST was acceptable to patients and providers. Our findings suggest

  9. Positive aspects of menopause: a qualitative study

    Hvas, L

    2001-01-01

    As a part of a larger study, "Menopause described from the woman's perspective", it has been the aim to explore whether women have any positive experiences in relation to menopause, and if so, the nature of these experiences.......As a part of a larger study, "Menopause described from the woman's perspective", it has been the aim to explore whether women have any positive experiences in relation to menopause, and if so, the nature of these experiences....

  10. Can you un-ring the bell? A qualitative study of how affect influences cancer screening decisions.

    Driedger, S Michelle; Annable, Gary; Brouwers, Melissa; Turner, Donna; Maier, Ryan

    2017-09-13

    The belief that early detection is the best protection against cancer underlies cancer screening. Emerging research now suggests harms associated with early detection may sometimes outweigh the benefits. Governments, cancer agencies, and organizations that publish screening guidelines have found it is difficult to "un-ring the bell" on the message that "early detection is your best protection" because of its widespread communication and enduring resonance. This study explores affective factors-and their interplay with relevant analytical factors-in public/laypersons' decision making about cancer screening. A total of 93 people (47 men, 46 women) attended focus groups about, respectively, prostate cancer screening and breast cancer screening in two Canadian cities. Affective factors were a major influence on many focus group participants' decision making about cancer screening, including fear of cancer and a generalized enthusiasm for prevention/screening, and they were often inspired by anecdotes about the cancer experiences of family and friends. Affect also existed alongside more analytical factors including assessments of reduced risk in the management of any cancer diagnosis if caught early, and, for men, the belief that an unreliable test is "better than nothing," and that men deserve prostate cancer screening because women have breast and cervical cancer screening. Affective factors were particularly noticeable in the sub-groups most supportive of screening and the "early detection" message: older women who felt that mammogram screening should begin at age 40 rather than 50, and older men who felt that prostate cancer screening should be expanded beyond its current unorganized, opportunistic usage. In contrast, younger participants displayed less affective attachments to "early detection" messages and had greater concerns about harms of screening and were more receptive to nuanced messages informed by evidence. Policymakers attempting to communicate more

  11. “We both just trusted and leaned on the Lord”: A qualitative study of religiousness and spirituality among African American breast cancer survivors and their caregivers

    Sterba, Katherine Regan; Burris, Jessica L.; Heiney, Sue P.; Ruppel, Megan Baker; Ford, Marvella E.; Zapka, Jane

    2014-01-01

    Purpose Most breast cancer survivorship research focuses on the general population of survivors. Scant research investigates the potentially unique experiences of minorities, especially during and after the difficult transition from primary treatment to post-treatment. This qualitative study explored African American breast cancer survivors’ and caregivers’ quality-of-life in the post-treatment period with a focus on social and spiritual well-being. Methods Participants included a convenience sample of African American women with stage I-III breast cancer (N=23) who completed treatment 6–24 months before enrollment. Primary caregivers (N=22) included friends, spouses and other family members (21 complete dyads). Participants completed separate semi-structured telephone interviews. Template analysis was used to evaluate themes related to religiousness and spirituality, both across and within dyads. Results After treatment, religiousness and spirituality played a major role in both survivors’ and caregivers’ lives by: 1) providing global guidance, 2) guiding illness management efforts and 3) facilitating recovery. Participants described a spiritual connectedness with God and others in their social networks. Dyad members shared the goal of keeping a positive attitude and described positive growth from cancer. Few future concerns were expressed due to the belief that survivors were healed and “done” with cancer. Beyond practical and emotional support, provision of spiritual assistance was common. Conclusions Results highlight the principal, positive role of religiousness and spirituality for African American breast cancer survivors and caregivers after treatment. Findings emphasize the need to assess the importance of religious and spiritual beliefs and practices, and if appropriate, to provide resources that promote spiritual well-being. PMID:24578149

  12. Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countries

    Rietjens, Judith; Bruinsma, Sophie; Deliens, Luc; Sterckx, Sigrid; Mortier, Freddy; Brown, Jayne; Mathers, Nigel; van der Heide, Agnes

    2015-01-01

    Background: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. Methods: Qualitative case studies using interviews. Setting: Hospitals, the domestic home and hospices or palliative care units. Participants: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer patients. Results: UK respondents reported a continuum of practice from the provision of low doses of sedatives to control terminal restlessness to rarely encountered deep sedation. In contrast, Belgian respondents predominantly described the use of deep sedation, emphasizing the importance of responding to the patient’s request. Dutch respondents emphasized making an official medical decision informed by the patient’s wish and establishing that a refractory symptom was present. Respondents employed rationales that showed different stances towards four key issues: the preservation of consciousness, concerns about the potential hastening of death, whether they perceived continuous sedation until death as an ‘alternative’ to euthanasia and whether they sought to follow guidelines or frameworks for practice. Conclusion: This qualitative analysis suggests that there is systematic variation in end-of-life care sedation practice and its conceptualization in the United Kingdom, Belgium and the Netherlands. PMID:25062816

  13. The experience of cancer survivors in community-based psycho-social support activities in Shanghai, China: a qualitative study.

    Wang, Ji-Wei; Zhang, Tian-Rui; Shen, Qian; Yang, Zhi-Qi; Liu, Cong; Chen, Si-Jia; Li, Jiang; Luo, Zheng-Nian; Yuan, Zheng-Ping; Yu, Jin-Ming

    2015-12-01

    Cancer survivors are often embroiled in various physical and psycho-social issues as a consequence of cancer diagnosis and treatment. Psycho-social support activities in the phase of rehabilitation were provided to enhance their quality of life. This study seeks to explore and understand their experience of engagement in Shanghai Cancer Rehabilitation Club (SCRC). Sixty-eight participants attended eight semi-structured focus group interviews. Data were transcribed verbatim, and thematic analysis framework was adopted for data analysis. The participants reported benefits such as psychological support, informational provision and tangible support in the activities. Public services were reported to have restored their dignity and enabled them to rediscover their own meaning of life. Participants also pointed out challenges on functioning and opportunity for development of SCRC. The psycho-social support activities of SCRC had influenced cancer survivor's life. Public health resources and supportive policies should be in place to support local self-help cancer rehabilitation groups.

  14. A Qualitative Evaluation of Web-Based Cancer Care Quality Improvement Toolkit Use in the Veterans Health Administration.

    Bowman, Candice; Luck, Jeff; Gale, Randall C; Smith, Nina; York, Laura S; Asch, Steven

    2015-01-01

    Disease severity, complexity, and patient burden highlight cancer care as a target for quality improvement (QI) interventions. The Veterans Health Administration (VHA) implemented a series of disease-specific online cancer care QI toolkits. To describe characteristics of the toolkits, target users, and VHA cancer care facilities that influenced toolkit access and use and assess whether such resources were beneficial for users. Deductive content analysis of detailed notes from 94 telephone interviews with individuals from 48 VHA facilities. We evaluated toolkit access and use across cancer types, participation in learning collaboratives, and affiliation with VHA cancer care facilities. The presence of champions was identified as a strong facilitator of toolkit use, and learning collaboratives were important for spreading information about toolkit availability. Identified barriers included lack of personnel and financial resources and complicated approval processes to support tool use. Online cancer care toolkits are well received across cancer specialties and provider types. Clinicians, administrators, and QI staff may benefit from the availability of toolkits as they become more reliant on rapid access to strategies that support comprehensive delivery of evidence-based care. Toolkits should be considered as a complement to other QI approaches.

  15. Chronic disease management perspectives of colorectal cancer survivors using the Veterans Affairs healthcare system: a qualitative analysis.

    Zullig, Leah L; Goldstein, Karen M; Bosworth, Hayden B; Andrews, Sara M; Danus, Susanne; Jackson, George L; Provenzale, Dawn; Weinberger, Morris; Kelley, Michael J; Voils, Corrine I

    2018-03-09

    Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the US. CRC survivors may have complex healthcare needs requiring care from both specialists and primary care. Our objective was to understand how CRC survivors perceive their survivorship care, especially management of their cardiovascular-related chronic diseases. We identified patients diagnosed with non-metastatic CRC between 10/1/2007 and 12/31/2015 at Veterans Affairs Medical Centers in North Carolina or Virginia. In 2016, we conducted telephone-based, semi-structured interviews to assess survivors' experiences with cancer survivorship and changes in health priorities. Interviews were conducted until thematic saturation was reached. Interviews were audio-recorded, transcribed, and coded. The 25 participants were, on average, 64 years old and approximately 4 years post-CRC diagnosis at the time of interview; most were white (60%), male (92%), and diagnosed with colon cancer (64%) as opposed to rectal cancer. CRC survivors reported: (1) a shift in focus from surviving cancer to reducing cardiovascular disease risk (e.g., by managing weight); (2) challenges with taking medications for CVD-related conditions; (3) new recognition of the importance of engaging with primary care providers. Experiences with cancer shapes how survivors view their health. Management of cardiovascular-related chronic disease is important to veteran CRC survivors. There is a need to deliver cardiovascular disease risk reduction programs tailored for CRC survivors.

  16. Food connections: a qualitative exploratory study of weight- and eating-related distress in families affected by advanced cancer

    Hopkinson, Jane B.

    2016-01-01

    Purpose\\ud \\ud Weight loss and eating problems are common in cancer and have a profound effect on quality of life. They are symptoms of cancer cachexia syndrome.\\ud \\ud This paper examines interdependency between advanced cancer patient and family carer experience of weight- and eating-related problems, leading to proposition of how weight- and eating-related distress might be alleviated in both patients and their family members.\\ud \\ud Methods\\ud \\ud The study was of cross-sectional design. ...

  17. Barriers to early diagnosis of symptomatic breast cancer: a qualitative study of Black African, Black Caribbean and White British women living in the UK.

    Jones, Claire E L; Maben, Jill; Lucas, Grace; Davies, Elizabeth A; Jack, Ruth H; Ream, Emma

    2015-03-13

    Understanding barriers to early diagnosis of symptomatic breast cancer among Black African, Black Caribbean and White British women in the UK. In-depth qualitative interviews using grounded theory methods to identify themes. Findings validated through focus groups. 94 women aged 33-91 years; 20 Black African, 20 Black Caribbean and 20 White British women diagnosed with symptomatic breast cancer were interviewed. Fourteen Black African and 20 Black Caribbean women with (n=19) and without (n=15) breast cancer participated in six focus groups. Eight cancer centres/hospital trusts in London (n=5), Somerset (n=1), West Midlands (n=1) and Greater Manchester (n=1) during 2012-2013. There are important differences and similarities in barriers to early diagnosis of breast cancer between Black African, Black Caribbean and White British women in the UK. Differences were influenced by country of birth, time spent in UK and age. First generation Black African women experienced most barriers and longest delays. Second generation Black Caribbean and White British women were similar and experienced fewest barriers. Absence of pain was a barrier for Black African and Black Caribbean women. Older White British women (≥70 years) and first generation Black African and Black Caribbean women shared conservative attitudes and taboos about breast awareness. All women viewed themselves at low risk of the disease, and voiced uncertainty over breast awareness and appraising non-lump symptoms. Focus group findings validated and expanded themes identified in interviews. Findings challenged reporting of Black women homogenously in breast cancer research. This can mask distinctions within and between ethnic groups. Current media and health promotion messages need reframing to promote early presentation with breast symptoms. Working with communities and developing culturally appropriate materials may lessen taboos and stigma, raise awareness, increase discussion of breast cancer and promote

  18. Consequences, control and appraisal: cues and barriers to engaging in self-management among people affected by colorectal cancer - a secondary analysis of qualitative data.

    Kidd, Lisa A

    2014-08-01

    Little is known about peoples' self-management experiences and their desires or expectations to engage in self-management. As such, there is little understanding about individuals' perceived cues and barriers to engagement in self-management, particularly in people affected by cancer. To understand cues and barriers to people's engagement in self-management during chemotherapy treatment for colorectal cancer. Secondary analysis of qualitative data from mixed methods, longitudinal study. Eleven participants undergoing treatment for colorectal cancer. Semi-structured interviews were conducted twice with each participant, at the start and end of a 6-month course of chemotherapy treatment in a Scottish cancer centre. Cues and barriers to engagement in self-management appeared to stem from perceptions of the impact and associated severity of side effects experiences as well as the perceptions about the efficacy of chosen self-management activities and perceptions of control in minimizing the consequences of cancer treatment. Severe, episodic or unexpected side effects coupled with perceptions of uncertainty, lack of control and lack of adequate preparation to engage in self-management were identified as key barriers to engagement. Participants' reflection on, or appraisal of, their treatment-related experiences and personal abilities, confidence and preferences to manage the impact of these shaped their subsequent engagement in self-management. The findings highlight the importance of understanding individual's self-management experiences, perceptions, preferences, priorities and needs to help support, prepare and enable them to feel capable and confident to engage actively and effectively in self-management. © 2012 John Wiley & Sons Ltd.

  19. Contrast-enhanced ultrasonography in qualitative diagnosis of sentinel lymph node metastasis in breast cancer: A meta-analysis

    Yi-Xia Zhang

    2015-01-01

    Conclusions: Our meta-analysis suggests that CEUS may have high a diagnostic accuracy in testing for metastatic SLN in breast cancer. Thus, CEUS may be a good tool for differential diagnosis between metastatic and non-metastatic SLN.

  20. Responses to provision of personalised cancer risk information: a qualitative interview study with members of the public.

    Usher-Smith, Juliet A; Silarova, Barbora; Lophatananon, Artitaya; Duschinsky, Robbie; Campbell, Jackie; Warcaba, Joanne; Muir, Kenneth

    2017-12-22

    It is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the past five years if people had healthier lifestyles. A number of theories of behaviour change suggest that before people will change health behaviours, they must accept that a risk applies to them. This study aimed to explore the views of the public on receiving personalised cancer risk information and the potential for that information to motivate behaviour change. We conducted 27 interviews with members of the public (mean age 49 ± 23 years). Each participant completed a questionnaire to allow calculation of their risk of developing the most common cancers (10 for women, 8 for men). During the interviews we presented their risk using a web-based tool developed for the study and discussions covered their views on receiving that information. Each interview was audio-recorded and then analysed using thematic analysis. Participants generally viewed the concept of personalised cancer risk positively. The first reaction of almost all when presented with their 10-year risk of an individual cancer without any further context was that it was low and not concerning. Views on what constituted a high risk ranged widely, from 0.5 to 60%. All felt seeing the impact of changes in lifestyle was helpful. For some this led to intentions to change behaviour, but reductions in risk were not always motivating as the risks were considered low and differences small. Provision of personalised cancer risk was well received and may be a useful addition to other cancer prevention initiatives. Further work is needed in particular to develop ways to present cancer risk that reflect the general perception of what constitutes a risk high enough to motivate behaviour change and help patients contextualise a less well known health risk by providing a frame of reference.

  1. Fatalism or Destiny? A Qualitative Study and Interpretative Framework on Dominican Women’s Breast Cancer Beliefs

    Flórez, Karen R.; Aguirre, Alejandra N.; Viladrich, Anahí; Céspedes, Amarilis; De La Cruz, Ana Alicia

    2008-01-01

    Background A growing literature on Latino’s beliefs about cancer focuses on the concept of fatalismo (fatalism), despite numerous conceptual ambiguities concerning its meaning, definition, and measurement. This study explored Latina women’s views on breast cancer and screening within a cultural framework of destino (“destiny”), or the notion that both personal agency and external forces can influence health and life events Methods Semi-structured interviews were conducted with 25 Latinas from the Dominican Republic aged 40 or over. Results Respondents reported complex notions of health locus of control that encompassed both internal (e.g., individual action) and external (e.g., the will of God) forces shaping breast cancer prevention efforts. Furthermore, women actively participated in screening because they believed that cancer could become a death sentence if diagnosed late or left untreated. Discussion In contrast to simplistic notions of “fatalism”, our analysis suggests complex strategies and beliefs regarding breast cancer and cancer screening that speak of resiliency rather than hopelessness. PMID:18253833

  2. A qualitative study of an internet-based support group for women with sexual distress due to gynecologic cancer.

    Wiljer, David; Urowitz, Sara; Barbera, Lisa; Chivers, Meredith L; Quartey, Naa Kwarley; Ferguson, Sarah E; To, Matthew; Classen, Catherine C

    2011-09-01

    Internet-based support groups for cancer patients have been studied extensively; very few have focused on gynecologic cancer. We pilot-tested a web-based support group for gynecologic cancer patients and assessed women's perceptions of the intervention. Twenty-seven gynecologic cancer patients were randomized to an immediate intervention or a waitlist control group. Women participated in a 12-week, web-based support group focusing on sexuality-related topics. Semi-structured interviews were conducted to investigate the feasibility and efficacy of the intervention. Women reported benefits to participating in the intervention, including receiving support from group members and moderators, increased emotional well-being, improved feelings of body image and sexuality, and comfort in discussing sexuality online. Web-based support groups are both feasible and accepted by gynecologic cancer patients with psychosexual distress. The online format provided women with easy access to the support group and anonymity in discussing psychosexual concerns. Women with gynecologic cancer may benefit from participating in online support groups which provide an environment of relative anonymity to discuss psychosexual concerns.

  3. Struggling with cancer and treatment: young athletes recapture body control and identity through exercise: qualitative findings from a supervised group exercise program in cancer patients of mixed gender undergoing chemotherapy

    Adamsen, L.; Andersen, C.; Midtgaard, J.

    2009-01-01

    patients (median age 28 years). The young athletes experienced a change from a high level of physical activity, body satisfaction and a positive self-identity to a low level of physical activity, body denial and a negative self-identity. In the program, the patients experienced increased physical strength...... and recapture of certain aspects of their former positive body perception. Deterioation of muscle functions caused by chemotherapy was particularly painful to these patients, independent of gender and age. Young physically active patients are heavily dependent on their physical capacity, body satisfaction......Cancer and treatment can negatively affect the body's performance and appearance. Exercise has been tested in a few studies for altered body image among middle-aged women with breast cancer. The aim of the study was to explore how young pre-cancer athletes of both genders experience disease...

  4. A qualitative evaluation of a group phone-based weight loss intervention for rural breast cancer survivors: Themes and mechanisms of success.

    Fazzino, Tera L; Sporn, Nora J; Befort, Christie A

    2016-07-01

    Obesity is prevalent in breast cancer survivors and is a significant risk factor for recurrence and mortality. Weight management interventions for survivors have been diverse in design (in-person vs. phone-based, group vs. individual) and yielded varying weight loss results. Given these issues, participants themselves may provide insight into treatment-based factors that contributed to their weight loss outcomes. Here, we report qualitative results from interviews with survivors in a group phone-based weight loss intervention, with the objective of identifying mechanisms that facilitated or hindered adherence and weight loss. We explored interest in paying for continued treatment as an indicator of dissemination potential. Individual interviews were conducted with 186 rural, obese breast cancer survivors upon completion of a 6-month weight loss intervention that produced clinically meaningful weight loss (>5 %) in 91 % of participants. A thematic analysis of the interview data was performed. Five themes were identified as impacting adherence and success: (1) accountability; (2) importance of the group, with varying levels of connectedness; (3) dietary convenience; (4) difficulty maintaining intervention components that required more effort; and (5) importance of internal motivation to attributions of physical activity success or failure. Most were interested in paying to continue the program if it were extended beyond the study. Key intervention components that participants attributed to their success included supportive group processes and convenience. Results highlight the group phone-based approach as a potential venue for disseminating an effective weight loss program for breast cancer survivors. NCT01441011.

  5. Exploring and comparing the experience and coping behaviour of men and women with colorectal cancer after chemotherapy treatment: a qualitative longitudinal study.

    McCaughan, Eilis; Prue, Gillian; Parahoo, Kader; McIlfatrick, Sonja; McKenna, Hugh

    2012-01-01

    Men have higher incidence and mortality rates for nearly all cancers. They are less likely than women to utilise cancer information services and other social support services. The aim of this study was to explore and compare the experience and coping behaviour of men and women after treatment for colorectal cancer (CRC). A longitudinal qualitative study was conducted involving 38 individuals (24 men and 14 women) with CRC. Data were generated using semi-structured interviews at four time points over an 18-month period, post-diagnosis. Interviews focused on participant's experience of CRC and on how gender affected their coping. This paper reports the findings of interviews 3 and 4 which examined the participant's experience after chemotherapy. Three themes emerged from the interviews ('new normal', living with uncertainty and support needs). Many men and women reacted similarly; however, there was some variation evident between and within sexes. The main difference was with regard to the long-term physical side effects of the illness. Many women admitted to still experiencing side effects, whereas many men indicated that they had no problems. These men engaged in practices that aligned with their gender identity and view of masculinity. It must be noted that some men and women were still experiencing an impact. Recovery from the physical and psychological effects of CRC does not occur simultaneously. Healthcare professionals should be aware that not all men (or women) conform to the social stereotypes of masculinity (or femininity). Copyright © 2010 John Wiley & Sons, Ltd.

  6. Decision-making Processes among Prostate Cancer Survivors with Rising PSA Levels: Results from a Qualitative Analysis.

    Shen, Megan Johnson; Nelson, Christian J; Peters, Ellen; Slovin, Susan F; Hall, Simon J; Hall, Matt; Herrera, Phapichaya Chaoprang; Leventhal, Elaine A; Leventhal, Howard; Diefenbach, Michael A

    2015-05-01

    Prostate cancer survivors with a rising prostate-specific antigen (PSA) level have few treatment options, experience a heightened state of uncertainty about their disease trajectory that might include the possibility of cancer metastasis and death, and often experience elevated levels of distress as they have to deal with a disease they thought they had conquered. Guided by self-regulation theory, the present study examined the cognitive and affective processes involved in shared decision making between physicians and patients who experience a rising PSA after definitive treatment for prostate cancer. In-depth interviews were conducted with 34 prostate cancer survivors who had been diagnosed with a rising PSA (i.e., biochemical failure) within the past 12 months. Survivors were asked about their experiences and affective responses after being diagnosed with a rising PSA and while weighing potential treatment options. In addition, patients were asked about their decision-making process for the initial prostate cancer treatment. Compared with the initial diagnosis, survivors with a rising PSA reported increased negative affect following their diagnosis, concern about the treatability of their disease, increased planning and health behavior change, heightened levels of worry preceding doctor appointments (especially prior to the discussion of PSA testing results), and a strong reliance on physicians' treatment recommendations. Prostate cancer survivors' decision-making processes for the treatment of a rising PSA are markedly different from those of the initial diagnosis of prostate cancer. Because patients experience heightened distress and rely more heavily on their physicians' recommendations with a rising PSA, interactions with the health care provider provide an excellent opportunity to address and assist patients with managing the uncertainty and distress inherent with rising PSA levels. © The Author(s) 2014.

  7. A qualitative evaluation of breast cancer survivors' acceptance of and preferences for consumer wearable technology activity trackers.

    Nguyen, Nga H; Hadgraft, Nyssa T; Moore, Melissa M; Rosenberg, Dori E; Lynch, Chris; Reeves, Marina M; Lynch, Brigid M

    2017-11-01

    Physical inactivity and sedentary behaviour are common amongst breast cancer survivors. These behaviours are associated with an increased risk of comorbidities such as heart disease, diabetes and other cancers. Commercially available, wearable activity trackers (WATs) have potential utility as behavioural interventions to increase physical activity and reduce sedentary behaviour within this population. The purpose of the study is to explore the acceptability and usability of consumer WAT amongst postmenopausal breast cancer survivors. Fourteen participants tested two to three randomly assigned trackers from six available models (Fitbit One, Jawbone Up 24, Garmin Vivofit 2, Garmin Vivosmart, Garmin Vivoactive and Polar A300). Participants wore each device for 2 weeks, followed by a 1-week washout period before wearing the next device. Four focus groups employing a semi-structured interview guide explored user perceptions and experiences. We used a thematic analysis approach to analyse focus group transcripts. Five themes emerged from our data: (1) trackers' increased self-awareness and motivation, (2) breast cancer survivors' confidence and comfort with wearable technology, (3) preferred and disliked features of WAT, (4) concerns related to the disease and (5) peer support and doctor monitoring were possible strategies for WAT application. WATs are perceived as useful and acceptable interventions by postmenopausal breast cancer survivors. Effective WAT interventions may benefit from taking advantage of the simple features of the trackers paired with other behavioural change techniques, such as specialist counselling, doctor monitoring and peer support, along with simple manual instructions.

  8. Understanding low colorectal cancer screening uptake in South Asian faith communities in England--a qualitative study.

    Palmer, Cecily K; Thomas, Mary C; McGregor, Lesley M; von Wagner, Christian; Raine, Rosalind

    2015-10-01

    Colorectal cancer screening uptake within the South Asian population in England is approximately half that of the general population (33 % vs 61 %), and varies by Muslim (31.9 %), Sikh (34.6 %) and Hindu (43.7 %) faith background. This study sought to explore reasons for low uptake of CRC screening in South Asian communities and for the variability of low uptake between three faith communities; and to identify strategies by which uptake might be improved. We interviewed 16 'key informants' representing communities from the three largest South Asian faith backgrounds (Islam, Hinduism and Sikhism) in London, England. Reasons for low colorectal cancer screening uptake were overwhelmingly shared across South Asian faith groups. These were: limitations posed by written English; limitations posed by any written language; reliance on younger family members; low awareness of colorectal cancer and screening; and difficulties associated with faeces. Non-written information delivered verbally and interactively within faith or community settings was preferred across faith communities. Efforts to increase accessibility to colorectal cancer screening in South Asian communities should use local language broadcasts on ethnic media and face-to-face approaches within community and faith settings to increase awareness of colorectal cancer and screening, and address challenges posed by written materials.

  9. Understanding the information needs of people with haematological cancers. A meta-ethnography of quantitative and qualitative research.

    Atherton, K; Young, B; Salmon, P

    2017-11-01

    Clinical practice in haematological oncology often involves difficult diagnostic and treatment decisions. In this context, understanding patients' information needs and the functions that information serves for them is particularly important. We systematically reviewed qualitative and quantitative evidence on haematological oncology patients' information needs to inform how these needs can best be addressed in clinical practice. PsycINFO, Medline and CINAHL Plus electronic databases were searched for relevant empirical papers published from January 2003 to July 2016. Synthesis of the findings drew on meta-ethnography and meta-study. Most quantitative studies used a survey design and indicated that patients are largely content with the information they receive from physicians, however much or little they actually receive, although a minority of patients are not content with information. Qualitative studies suggest that a sense of being in a caring relationship with a physician allows patients to feel content with the information they have been given, whereas patients who lack such a relationship want more information. The qualitative evidence can help explain the lack of association between the amount of information received and contentment with it in the quantitative research. Trusting relationships are integral to helping patients feel that their information needs have been met. © 2017 John Wiley & Sons Ltd.

  10. Mind-body interactions in breast cancer : neuroendocrine and immune aspects of acute psychological stress and psychosocial intervention in breast cancer patients

    G. van der Pompe (Grietje)

    1997-01-01

    textabstractThe proposition that stress plays a role in the progression of breast cancer has been a source of inspiration for researchers to study the associations between psychological, neuroendocrine and immune parameters. Until now a number of shldies attempted to provide insight in the link

  11. Medical-oncological aspects in the treatment of pancreatic cancer; Internistisch-onkologische Aspekte bei der Behandlung des Pankreaskarzinoms

    Heinemann, V. [Klinikum Grosshadern, Ludwig-Maximilians-Universitaet Muenchen (Germany). Medizinische Klinik und Poliklinik III

    2009-02-15

    Pancreatic cancer is a highly malignant disease and despite progress in systemic therapy survival is still short. For patients with R0/R1 resected disease, adjuvant chemotherapy with gemcitabine has been established as the standard treatment. More controversy exists with regard to optimal treatment of locally advanced non-metastatic pancreatic cancer. However, there is evidence to suggest that patients who respond to an initial phase of chemotherapy may be those who benefit most from sequential chemoradiotherapy. Specifically, in the treatment of advanced and metastatic disease chemotherapy or radiotherapy cannot stand alone but must be accompanied by multidisciplinary treatment approaches involving pain management, weight control, psychooncological care and palliative care. Monotherapy with gemcitabine and the combined use of gemcitabine with erlotinib are established standards for treatment of metastatic pancreatic cancer. Patients in a good general condition but where the gemcitabine-based therapy failed should be offered second-line treatment. (orig.) [German] Das Pankreaskarzinom ist eine hochmaligne Erkrankung, die trotz nachweisbarer klinischer Fortschritte weiterhin mit einem meist kurzen Ueberleben verbunden ist. Bei R0/R1-resezierten Patienten gilt eine adjuvante Behandlung mit Gemcitabin gegenwaertig als etablierter Behandlungsstandard. Weniger eindeutig ist die optimale Therapie des lokal fortgeschrittenen, nichtmetastasierten Pankreaskarzinoms (LAPC). Es gibt aber Hinweise dafuer, dass Patienten, die auf eine initiale Chemotherapiephase ansprachen, von einer nachgeschalteten Radiochemotherapie profitieren koennen. Gerade zur Behandlung des metastasierten Pankreaskarzinoms sollten die Chemo- oder die Radiochemotherapie nicht allein stehen, sondern durch multidisziplinaere Behandlungsansaetze unterstuetzt werden. Dazu gehoeren die Schmerz- und Ernaehrungstherapie, Psychoonkologie und Palliativmedizin. Bei der Behandlung des metastasierten

  12. Qualitative research.

    Gelling, Leslie

    2015-03-25

    Qualitative research has an important role in helping nurses and other healthcare professionals understand patient experiences of health and illness. Qualitative researchers have a large number of methodological options and therefore should take care in planning and conducting their research. This article offers a brief overview of some of the key issues qualitative researchers should consider.