Information and counselling needs of patients with major low anterior resection syndrome: A qualitative study

Pape, Eva; Decoene, Elsie; Debrauwere, Mieke; Nieuwenhove, Yves Van; Pattyn, Piet; Feryn, T.; Pattyn, Paul; Verhaeghe, Sofie; Hecke, Ann Van

doi:10.1111/jocn.16277

Cited by 3 publications

(11 citation statements)

References 51 publications

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“…As part of a larger research project, the experiences and needs of patients with major LARS were also explored [15,16,31]. Patients described a contrast between information during their cancer trajectory and information about possible LARS.…”

Section: Discussion and Con Clus Ionmentioning

confidence: 99%

“…Our previous studies explored the experiences and needs of patients with major LARS [15,16] as part of a larger research project. This study showed that patients are confronted with fluctuating hope during their trajectory and loneliness, presenting in different forms and layers [15].…”

Section: Introductionmentioning

confidence: 99%

“…Second, when confronted with major LARS, a need for an explanation of the expected evolution of their symptoms and recognition of the impact of LARS on patients' lives by the HCP were deemed necessary. Additionally, patients preferred proactive counselling [16].…”

Section: Introductionmentioning

confidence: 99%

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Interprofessional perspectives on care for patients with low anterior resection syndrome: A qualitative study

et al. 2022

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Aim Many patients are confronted with low anterior resection syndrome after rectal surgery. The perspectives of both healthcare professionals and patients on the impact of bowel problems may differ. This study aimed to explore experiences of healthcare professionals on how to provide, organise and optimise care for patients with low anterior resection syndrome from an interprofessional perspective. Methods An explorative qualitative design was used. Healthcare professionals were recruited in October 2018 in one general teaching hospital and one university hospital. Twenty one healthcare professionals from different professions caring for patients with low anterior resection syndrome were included in three focus group interviews. Results Healthcare professionals confirmed a lack of focus on patients who are confronted with low anterior resection syndrome and stated a need for a standardised approach of care. Additionally, three levels for care optimization emerged from the data: information before surgery with strong emphasis on the timing of informing, counselling of patients when confronted with low anterior resection syndrome and organisation of care. Conclusions Healthcare professionals find it important to adopt the moment and amount of information to the coping mechanism and timing of the trajectory. Counselling and follow‐up of patients with LARS should be organised proactively and should not remain restricted to pharmacological and nutritional advice. A possible strategy is to develop and implement late effects nurse‐led clinics coordinated by the clinical nurse specialist.

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Section: Discussion and Con Clus Ionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Interprofessional perspectives on care for patients with low anterior resection syndrome: A qualitative study

et al. 2022

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“…Assessment combined with a thorough analysis of symptoms also helps define treatment [39]. Although detailed in only one paper another necessary step to improve symptoms is emotional counselling [30].…”

Section: Discussionmentioning

confidence: 99%

“…Patients also indicated that a clinical nurse specialist (CNS) adds value to their care and they feel more able to discuss issues with nurses than physicians. Not discussed in the pathways, but reported as important by patients, was being able to contact their CNS directly for practical and emotional support [30]. There is an increased need for advanced nursing roles as cancer survival rates improve, leading to more cancer survivors with potential bowel symptoms [31,32].…”

Section: Discussion and Con Clus Ionmentioning

confidence: 99%

Intervention pathways for low anterior resection syndrome after sphincter‐saving rectal cancer surgery: A systematic scoping review

et al. 2022

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Aim: Low anterior resection syndrome (LARS) has a large impact on patients' quality of life. Several heterogeneous intervention pathways are suggested in the literature. The steps and timing of the different steps in the pathways are unclear. This systematic scoping review aims to map the range of intervention pathways for LARS after sphinctersaving rectal cancer surgery. Methods:A search was undertaken on four databases (CINAHL, EMBASE, PubMed, and Web of Science). Any type of paper describing intervention pathways for patients with LARS following sphincter-saving surgery was included. Excluded were patients with a stoma, no full paper, no intervention pathway and not being written in English or Dutch.The review was registered with Open Science Framework (10.17605/OSF.IO/JB5H8).Narrative synthesis of the results was performed by charting and summarising key results.Results: A total of 373 records were screened and 12 papers were included. There was a high variability among the intervention pathways, including which patients should be included. The number of pathway steps ranged from 2-6. Most intervention pathways were treatment-led. Intervention options ranged from conservative measures to a permanent stoma. Pathway flow was highly variable and sometimes not well described, with different or no timings provided for the start, progression, or end of the pathways. Three studies discussed the use of a nurse to coordinate the pathway. Conclusion:This systematic scoping review shows that despite similarities in treatment options there are variations in which treatments are included, when treatments should be instigated, and even which patients should be treated.

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‘He's a surgeon, like I'm not going to waste his time’: interviews to determine healthcare needs of people with low anterior resection syndrome after rectal cancer surgery

et al. 2023

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Aim The aim of this study was to determine the views of people on their healthcare needs when managing their bowel symptoms following an anterior resection. Method One‐to‐one, semi‐structured interviews were undertaken, after consent and completion of three questionnaires. Results were analysed using a modified framework analysis and presented narratively. Results Twenty three participants aged 38–75 years were interviewed; 10 were men. Most had low anterior resection syndrome (LARS) scores indicating ‘major LARS’, Bowel Function Index scores ranged from 28 to 65. The two most bothersome symptoms were faecal incontinence and unpredictable bowel function. Data were grouped into three broad themes: ‘treatment consequences’, ‘strategies and compromises’ and ‘healthcare needs.’ Each theme had four subthemes, such as ‘bowel dysfunction’ in the theme ‘treatment consequences’. Bowel symptoms were common and persistent. Symptom management often required multiple interventions. Expressed healthcare needs included managing expectations through clinician‐led information. Participants needed knowledgeable clinicians to enquire about and assess symptoms, provide and reiterate information as well as making an onward referral to enable symptom management. Peers improved the adaptation process through support and advice. Our findings indicate that participants' needs are not being fully met. Conclusion People with LARS have unmet healthcare requirements needed to meet their individual goals. We propose these are addressed by using the acronym ‘LARS’: a Learned clinician who Asks and assesses bowel symptoms, Revisiting the topic to address new or persisting symptoms as well as Signposting, advising or referring onwards as needed.

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Information and counselling needs of patients with major low anterior resection syndrome: A qualitative study

Abstract: Trial registration number: Clinicaltrials.gov NCT04896879, https://clinicaltrials.gov/ct2/show/NCT04896879. †The members of the Belgian LARS collaborative group can be found in the acknowledgements.

Cited by 3 publications

References 51 publications

Interprofessional perspectives on care for patients with low anterior resection syndrome: A qualitative study

Interprofessional perspectives on care for patients with low anterior resection syndrome: A qualitative study

Intervention pathways for low anterior resection syndrome after sphincter‐saving rectal cancer surgery: A systematic scoping review

‘He's a surgeon, like I'm not going to waste his time’: interviews to determine healthcare needs of people with low anterior resection syndrome after rectal cancer surgery

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