Symptom Experience in Patients with Gynecological Cancers: The Development of Symptom Clusters through Patient Narratives

The vast majority of the increasing cancer literature on physical and psychological symptom clusters is quantitative, attempting either to model clusters through statistical techniques or to test priori clusters for their strength of relationship. Narrative symptom clusters can be particularly sensitive outcomes that can generate conceptually meaningful hypotheses for symptom cluster research. We conducted a study to explore the explanation of patients about the development and coexistence of symptoms and how patients attempted to self-manage them. We collected 12-month qualitative longitudinal data over four assessment points consisting of 39 interview data sets from 10 participants with gynecological cancer. Participants' experiences highlighted the presence of physical and psychological symptom clusters, complicating the patients' symptom experience that often lasted 1 year. While some complementary and self-management approaches were used to manage symptoms, few options and interventions were discussed. The cancer care team may be able to develop strategies for a more thorough patient assessment of symptoms reported as the most bothersome and patient-centered sensitive interventions that encompass the physiological, psychological, sociocultural, and behavioral components of the symptom experience essential for effective symptom management

Preparation for cancer care: perceptions of newly qualified health care professionals

The present paper is derived from a larger survey which examined the perceptions of recently qualified health care professionals’ experience on evidence-based practice, team working and cancer care. This study reports solely on the findings relating to cancer care. The perceptions of recently qualified professionals in relation to their initial educational input on issues such as confidence, anxiety, communication skills and practice in cancer care as well as adequacy of support, professional supervision and use of reflection were gathered using a cross-sectional postal survey design. A total of 50 graduates from each professional category in nursing, occupational therapy, physiotherapy, and social work were sampled yielding a total sample of 200. Eighty-five questionnaires were returned yielding a response rate of 43%. Twenty-eight (33%) respondents stated that they were currently involved in working with people with cancer. These were as follows: 5 nurses, 8 physiotherapists, 9 occupational therapists and 6 social workers. Despite the low response rate, the findings suggest that health care professionals’ educational input and experiences of working with people with cancer were overall positive; for example, in the respondents’ confidence, communication skills, decrease in anxiety and application of knowledge gained in classroom to professional practice. Moreover, most respondents learnt about caring for cancer patients through practice rather than classroom teaching. A high percentage (i.e. 64%;18) across all groups felt supported when caring for people with cancer and reported receiving professional supervision as well as being able to actively reflect on their practice. The implications for education and practice were discussed particularly as there have been few studies conducted in relation to the specific needs and collaborative learning of these health care professional groups

Male caregivers of patients with breast and gynecologic cancer: experiences from caring for their spouses and partners

Background: There is considerable evidence demonstrating the negative effects of caregiving particularly in the areas of psychological well-being and quality of life of family caregivers of patients with cancer. However, there is little work on male caregivers' subjective experience of caring for family members with cancer, and little is known on how caregivers experience the caring over time. Objective: The objective of the study was to explore male spouses'/partners' experience of caring for their wives/partners with breast and gynecologic cancer over a 1-year period. Method: An exploratory longitudinal qualitative descriptive design using face-to-face interviews of 15 spouses/partners was used in this study. Content analysis of the transcribed data was conducted to extract significant categories and themes. Results: Varying degrees of interrelated cognitive, physical, and psychological impact were experienced by caregivers that extended to 12 months. Gender-specific attitudes prevented male caregivers from supporting their own self. Male caregivers dealt with problems that arose in the caregiving congruent with their masculinity, such as minimizing disruptions, focusing on tasks, and keeping their own stress to themselves. Conclusion: Male caregivers as a separate group with their own needs have not received much attention in the cancer literature, and their concerns and challenges may differ from those of female caregivers. Implications for Practice: Male caregivers' concerns and challenges must be taken into consideration when planning appropriate interventions to support them in their caregiving role

Symptom experience in patients with gynaecological cancers: the development of symptom clusters through patient narratives

The aim of the study was to explore the interplay between the physical and psychological symptom experience in patients with gynaecological cancer undergoing radiotherapy and/or chemotherapy and strategies they used to self-manage these symptoms. The study collected qualitative longitudinal data over four assessment points. Thirty nine interview data sets from ten participants were analysed. Participants had a mean age of 62.8 years, and five had ovarian cancer. A key theme was the strong inter-relationship between the physical and psychological symptoms experienced by patients. Symptoms seemed to co-occur, highlighting the presence of symptom clusters, complicating the patients’ symptom experience. Complex physical and psychological links emerged particularly in relation to fatigue, hair loss, weight gain and peripheral neuropathies. While some complementary and self-management approaches were used to manage symptoms, few options and interventions were discussed. The findings provide evidence that patients with gynaecological cancer experience complex symptoms with little formal support to manage them, which highlights the need for a more thorough patient support and has implications for the physiological, psychological, sociocultural and behavioural components of the symptom experience essential for effective symptom management