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Background:Prostate cancer is for many men a chronic disease with a long life expectancy after treatment. The impact of prostate cancer therapy on men has been well defined, however, explanation of the consequences of cancer treatment has not been modelled against the wider variables of long-term health-care provision. The aim of this study was to explore the parameters of unmet supportive care needs in men with prostate cancer in relation to the experience of nursing care.Methods:A survey was conducted among a volunteer sample of 1001 men with prostate cancer living in seven European countries.Results:At the time of the survey, 81% of the men had some unmet supportive care needs including psychological, sexual and health system and information needs. Logistic regression indicated that lack of post-treatment nursing care significantly predicted unmet need. Critically, men's contact with nurses and/or receipt of advice and support from nurses, for several different aspects of nursing care significantly had an impact on men's outcomes.Conclusion:Unmet need is related not only to disease and treatment factors but is also associated with the supportive care men received. Imperative to improving men's treatment outcomes is to also consider the access to nursing and the components of supportive care provided, especially after therapy.

Objective: In the context of increasing prostate cancer survivorship, evidence of unmet supportive care needs and growing economic healthcare restraints, this review examined and evaluated best approaches for developing self-management programmes to meet men's survivorship needs.Methods: A search of international literature published in the last twelve years was conducted. Only randomised controlled trials were included in the analysis. Key components of the interventions were evaluated to determine what has been offered, and which elements are most beneficial in improving health outcomes. Methodological issues were also considered.Results: Targeting participant need and promoting motivation to participate and maintain programme adherence were the most important factors to emerge in ensuring positive health outcomes. Both need and motivation are multi-faceted, the components of which are identified and evaluated. Guidance was also identified in relation to delivery design, theoretical mechanisms for change, modes of delivery and facilitator issues.Conclusion: Self-management is a viable and appropriate way of providing health care solutions to ameliorate men's functional and emotional problems associated with increased prostate cancer survivorship. Integration into clinical practice will require training, resources and commitment and, in addition, economic viability will be difficult to assess since cost comparison with current provision is not straightforward. Nevertheless, from the psychosocial and behavioural studies reviewed there is convincing evidence that can be used to design, implement and evaluate future self-management programmes for men surviving prostate cancer.3

bladder retraining, patient education and problem solving and coping strategies RESULTS• Lower urinary tract symptoms, as measured by the IPSS, showed a significant improvement, with a median score change of 5 ( P < 0.005).• This was supported by objective changes in median bladder void volume of + 7.5 mL ( P < 0.05) and the median number of daily voids of − 1 ( P < 0.005).• In addition, decreases in emotional distress and problems associated with urinary function suggest that the intervention had a positive impact on health-related quality of life. CONCLUSIONS• The provision of such an intervention was feasible within the clinical setting and provided benefits for men.• Symptom change vs those of normative recovery values for IPSS showed an intervention effect.• This intervention could be applied in routine practice and further testing is required in a randomized controlled trial.

background Annually, across the world a substantial number of dependent children experience the death of a parent through lifelimiting illness. Without support, this has longterm implications for children's emotional, social and physical well-being, impacting on health and social care services globally. Limited information exists on how service providers are meeting family needs when a parent with dependent children is dying. Aim To determine the bereavement support provided to families with dependent children by UK hospices before and after a parent's death. Design A 23-item, cross-sectional, web-based survey of adult UK hospices. Closed and openended questions were asked about the features of support provided; open-ended response was sought to a question about the challenges faced by hospices in delivering support. Descriptive and non-parametric statistics and framework analysis were used to analyse the data. results 197 hospices were invited to participate. Response rate was 66% (130/197). More types of support were provided after, than before, parental death (mean 6.36/5.64, z=−5.767, p<0001). Twenty-two per cent of hospices reported no formal processes for asking or documenting the presence of dependent children. Volunteers were an underused resource before parental death. Four themes characterised challenges in delivering support for families: emotional difficulties for families; practical and social difficulties for families; funding/resources; and staff training/numbers. conclusions Family needs are not consistently being met when a parent is dying. Areas for development include: enhanced systems to record when patients have dependent children; flexible approaches to support vulnerable families; staff training to help communication with families and management of their own fears of making the situation worse. Effective educational interventions and service developments to better support staff, parents and children are needed.on July 10, 2020 by guest. Protected by copyright.