Lived experiences and quality of life after gynaecological cancer—An integrative review

Abstract

Aim and objectives To review the literature on Nordic women's lived experiences and quality of life (QoL) after gynaecological cancer treatment. Background While incidence and survival are increasing in all groups of gynaecological cancers in the Nordic countries, inpatient hospitalisation has become shorter in relation to treatment. This has increased the need for follow‐up and rehabilitation. Design Integrative literature review using the Equator PRISMA guidelines. Methods The review was selected, allowing inclusion of both experimental and nonexperimental research. The search included peer‐reviewed articles published 1995–2017. To frame the search strategy, we applied the concept of rehabilitation, which holds a holistic perspective on health. Results Fifty‐five articles were included and were contextualised within three themes. Physical well-being in a changed body encompasses bodily changes comprising menopausal symptoms, a changed sexual life, complications in bowels, urinary tract, lymphoedema and pain, bodily‐based preparedness and fear of recurrence. Mental well-being as a woman deals with questioned womanliness, the experience of revitalised values in life, and challenges of how to come to terms with oneself after cancer treatment. Psychosocial well-being and interaction deals with the importance of having a partner or close person in the process of coming to terms with oneself after cancer. Furthermore, the women needed conversations with health professionals around the process of coping with changes and late effects, including intimate and sensitive issues. Conclusion Years after gynaecological cancer, women have to deal with fundamental changes and challenges concerning their physical, mental and psychosocial well‐being. Future research should focus on how follow‐up programmes can be organised to target the multidimensional aspects of women's QoL. Research collaboration across Nordic countries on rehabilitation needs and intervention is timely and welcomed. Relevance to clinical practice To ensure that all aspects of cancer rehabilitation are being addressed, we suggest that the individual woman is offered an active role in her follow‐up.

Perceptions of care after end-of-treatment among younger women with different gynecologic cancer diagnoses – a qualitative analysis of written responses submitted via a survey

“…Some also reported the period after end-of-treatment as particularly challenging. These findings correspond with previous studies of supportive care needs, where women described needs for distress screening and support [ 29 , 30 ] and a desire to be offered appropriate supportive care services and follow-up after treatment [ 29 – 33 ]. A key barrier to psychosocial care perceived by patients is the perception by health care providers that psychosocial care is not needed [ 34 ].…”

Meaning Making for Psychological Adjustment and Quality of Life in Older Long-Term Breast Cancer Survivors

“…From 1989 to 2006, the breast cancer mortality rate among middle aged and older women decreased with more than 20% across many European countries, including Norway ( Autier et al, 2010 ). Struggles with somatic and mental late effects after treatment are well documented ( Bower et al, 2005 ; Koch et al, 2013 ; Fielding and Lam, 2014 ; Kenne Sarenmalm et al, 2014 ; Sekse et al, 2019 ). Accordingly, a large proportion of women will enter retirement with complex health care needs.…”

Acceptability of quality indicators for the management of endometrial, cervical and ovarian cancer: results of an online survey

“…The physical changes comprise menopausal symptoms, a changed sexual life, bowel and/or urinary tract problems etc. An important part of the rehabilitation and follow-up of these patients needs to focus on conversations with health professionals around these challenges [19,20]. In the study of Vitale et al it is stated that not only young women, but also the elderly are entitled to a standard treatment.…”