Clinicians' Perspectives on Managing Symptom Clusters in Advanced Cancer: A Semistructured Interview Study

Dong, Skye; Butow, Phyllis; Agar, Meera; Lovell, Melanie; Boyle, Frances; Stockler, Martin R.; Forster, Benjamin C; Tong, Allison

doi:10.1016/j.jpainsymman.2015.11.021

Cited by 16 publications

(13 citation statements)

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“…This finding complements, yet differs from, Dilworth et al’s finding [ 19 ] that the barrier to receiving psychosocial care most frequently reported by patients (38.77%) is their view that there is “no need for psychosocial services and support,” followed by a lack of information and not knowing that the service is available. Similar to the findings of [ 63 , 64 ], the present study shows that nurses frequently considered their core task to be medical management, and that both nurses and patients placed an emphasis on the physical care provided by the nurses. This suggests that a focus on the physical comfort of the patients could enhance the patients’ psychological well-being.…”

Section: Discussionsupporting

confidence: 86%

“…The interrelationship between physical needs and psychosocial management was demonstrated in the present study, which showed that the psychological state of the patients changed with the physical care that they received. The art of managing symptoms has been defined as the skill of coping with the distress arising from experiencing symptoms [ 63 ]. Studies have elaborated on how profoundly symptom management can affect the psychosocial aspects of a patient’s life.…”

Section: Discussionmentioning

confidence: 99%

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Patients' perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study

et al. 2018

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BackgroundThe nursing shortage and its impact on patient care are well-documented global issues. Patients living with cancer as a chronic illness have many psychosocial problems and often lack adequate support as a result of ineffective nurse-patient communication. A review of the literature on factors influencing the delivery of psychosocial care to cancer patients indicates that the delivery of psychosocial care in routine cancer nursing within a biomedical healthcare system has not been widely explored.ObjectiveTo explore patients’ perceptions of their experiences with nurse-patient communication in an oncological clinical environment.MethodA focused ethnographic study was undertaken in two oncology wards of a hospital in Hong Kong. Data were collected through observations of the ward environment, the activities and instances of nurse-patient communication, semi-structured interviews with patients, and a review of nursing documents.ResultsTwo main themes were identified: 1. Nurses’ workload and the environment and 2. Nurse-patient partnership and role expectations. Within these two themes were related subthemes on: Sympathy for the busy nurses; Prioritizing calls to the nurses; Partnership through relationship; Nurses’ role in psychosocial care; and Reduction of psychosocial concerns through physical care.ConclusionsMany cancer patients do not expect to receive psychosocial care in the form of emotional talks or counseling from busy nurses, but appreciate the attention paid by nurses to their physiological and physical needs. Nurse-patient partnerships in cancer care may reduce the potential workload of nurses. The psychosocial needs of cancer patients could be optimized by providing good physical care through effective communication within a time-constrained oncology setting.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Patients' perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study

et al. 2018

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“…However, data from the current study population indicates that supportive interventions to alleviate symptoms of prostate cancer treatment are currently not frequently used [49]. Moreover, research among clinicians indicates considerable uncertainty in how to manage concurrent symptoms in cancer patients and survivors [50], suggesting professional education initiatives may be needed.…”

Section: Discussionmentioning

confidence: 91%

Pain, fatigue and depression symptom cluster in survivors of prostate cancer

Baden

Drummond

et al. 2020

Support Care Cancer

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Purpose Pain, fatigue and depression are common sequelae of a cancer diagnosis. The extent to which these occur together in prostate cancer survivors is unknown. We (i) investigated prevalence of the pain-fatigue-depression symptom cluster and (ii) identified factors associated with experiencing the symptom cluster among prostate cancer survivors. Methods Men in Ireland diagnosed with prostate cancer 2-18 years previously were identified from population-based cancer registries and sent postal questionnaires. Cancer-related pain and fatigue were measured using the EORTC QLQ-C30 and depression using the DASS-21. Cut-offs to define 'caseness' were pain ≥ 25, fatigue ≥ 39 and depression ≥ 10. Associations between survivor-related factors, clinical variables and specific prostate cancer physical symptoms and the symptom cluster were assessed using multivariate logistic regression. Results A total of 3348 men participated (response rate = 54%). Twenty-four percent had clinically significant pain, 19.7% had clinically significant fatigue, and 14.4% had depression; 7.3% had all three symptoms. In multivariate analysis, factors significantly associated with the symptom cluster were living in Northern Ireland, experiencing back pain at diagnosis and being affected by incontinence, loss of sexual desire, bowel problems, gynecomastia and hot flashes post-treatment. There was a strong association between the cluster and health-related quality of life. Conclusions The pain-fatigue-depression symptom cluster is present in 1 in 13 prostate cancer survivors. Physical after-effects of prostate cancer treatment are associated with this cluster. More attention should be paid to identifying and supporting survivors who experience multiple symptoms; this may help health-related quality of life improve among the growing population of prostate cancer survivors.

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“…Dong et al (24) describieron las actitudes y estrategias del personal de salud en el manejo de múltiples síntomas en pacientes con cáncer avanzado; identifican que el manejo de los grupos de síntomas es un arte y una ciencia que está llena de incertidumbre en la toma de decisiones. Se requiere el fortalecimiento del trabajo interdisciplinario, la continuidad en la atención, planificación más pragmática de los ensayos clínicos para abordar más de un síntoma y el entrenamiento en el manejo de estos (25,26).…”

Section: Fundamentación Conceptual Y Atributos De Los Grupos De Síntounclassified

Los grupos de síntomas en personas con cáncer: una revisión integrativa

González¹

2017

Aquichan

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Objetivo: explorar el estado actual de desarrollo investigativo del área temática de grupos de síntomas en adultos con cáncer. Método: revisión integrativa de producción científica generada entre 2001 y 2016. Se incluyeron 61 artículos por su aporte en la comprensión del área temática. Resultados: el estudio de los grupos de síntomas en personas con cáncer se consolida como un área temática novedosa, pertinente y necesaria para la investigación y práctica de enfermería en oncología, con tendencias y retos que incluyen: (1) El desarrollo de marcos conceptuales que aporten a la fundamentación, atributos y efectos (2) La determinación de métodos y formas de crearlos y clasificarlos (3) La generación de estudios con poblaciones específicas por tipos de cáncer y tratamiento y la consolidación de intervenciones de enfermería. Conclusiones: los pacientes con cáncer experimentan múltiples síntomas de forma simultánea durante las distintas fases de la enfermedad. Es incipiente el estudio de este fenómeno, los retos para la enfermería se centran en la generación de respuestas que alivien la carga de los grupos de síntomas y mejoren la calidad de vida de estos pacientes. Es necesario validar escalas de carga del síntoma y explorar los grupos de síntomas incluyendo variables clínicas ligadas a los tratamientos oncológicos.

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Clinicians' Perspectives on Managing Symptom Clusters in Advanced Cancer: A Semistructured Interview Study

Cited by 16 publications

References 50 publications

Patients' perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study

Patients' perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study

Pain, fatigue and depression symptom cluster in survivors of prostate cancer

Los grupos de síntomas en personas con cáncer: una revisión integrativa

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