The trajectory of hope and loneliness in rectal cancer survivors with major low anterior resection syndrome: A qualitative study

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

doi:10.1016/j.ejon.2021.102088

Cited by 9 publications

(11 citation statements)

References 38 publications

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“…However, bowel function was significantly affected after TME. Patients experience loneliness due to being toilet‐bound, and as a result of changes in their lives and activities outside their homes and the impact on their family life 15 . The prevalence of LARS and its risk factors are awareness of deficiency noted by a significant number of colorectal surgeons 16 .…”

Section: Discussionmentioning

confidence: 99%

“…Patients experience loneliness due to being toilet-bound, and as a result of changes in their lives and activities outside their homes and the impact on their family life. 15 The prevalence of LARS and its risk factors are awareness of deficiency noted by a significant number of colorectal surgeons. 16 We found that the incidence of LARS following rectal cancer resection was 69.3% (28.6% with minor LARS and 40.7% with major LARS), which is similar to previous findings.…”

Section: Discussionmentioning

confidence: 99%

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A predictive nomogram model for low anterior resection syndrome after rectal cancer resection

Yan

Lin

et al. 2022

ANZ Journal of Surgery

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Background: The aim of this study was to identify risk factors associated with the low anterior resection syndrome (LARS) and to construct a nomogram capable of predicting the risk of LARS in patients who undergo rectal cancer resection. Methods: About 538 patients who had undergone anterior resection were recruited as a development set. In addition, 114 patients with rectal cancer were analysed as a validation set to test the new nomogram. Patients in the development set were grouped into two separate cohorts: those with major LARS and those with minor or no LARS. Multiple logistic regression was conducted to detect risk factors for major LARS. Results: The prevalence of major LARS was 40.7%, of minor LARS was 28.6% and the proportion with no LARS was 30.7% in the development set. In multivariate analysis, female gender, preoperative chemoradiation, low tumour height, diverting ileostomy, postoperative anastomotic leakage were shown to be independently associated with major LARS occurring in patients after rectal cancer resection. The area under the curve (AUC) values of the nomogram were 0.726 (95% CI: 0.682-0.769) and 0.750 (95% CI: 0.655-0.845) in the development and validation sets, respectively. The calibration curves and Hosmer-Lemeshow goodness of fit tests showed that the model was acceptably accurate. Conclusion: A nomogram model based on risk factors could be valuable as a predictor of the probability of major LARS after rectal cancer surgery, and provides a guide that clinical staff can use to take preventive measures for high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A predictive nomogram model for low anterior resection syndrome after rectal cancer resection

Yan

Lin

et al. 2022

ANZ Journal of Surgery

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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%

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: Introductionmentioning

confidence: 99%

“…To manage their bowel function, patients search for strategies and solutions [2] often using trial and error [4]. They look for self-care strategies informed by healthcare professionals (HCP) or tips and tricks from family, friends and peers [4]. Although bowel symptoms are common, a large individual variation in the LARS experience makes a standardised approach difficult [5,6].…”

Section: Introductionmentioning

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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The trajectory of hope and loneliness in rectal cancer survivors with major low anterior resection syndrome: A qualitative study

Cited by 9 publications

References 38 publications

A predictive nomogram model for low anterior resection syndrome after rectal cancer resection

A predictive nomogram model for low anterior resection syndrome after rectal cancer resection

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

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