Male caregivers of patients with breast and gynecologic cancer: experiences from caring for their spouses and partners.

BACKGROUND: There is considerable evidence demonstrating the negative effects of caregiving particularly in the areas of psychological well-being and quality of life of family caregivers of patients with cancer. However, there is little work on male caregivers' subjective experience of caring for family members with cancer, and little is known on how caregivers experience the caring over time. OBJECTIVE: The objective of the study was to explore male spouses'/partners' experience of caring for their wives/partners with breast and gynecologic cancer over a 1-year period. METHOD: An exploratory longitudinal qualitative descriptive design using face-to-face interviews of 15 spouses/partners was used in this study. Content analysis of the transcribed data was conducted to extract significant categories and themes. RESULTS: Varying degrees of interrelated cognitive, physical, and psychological impact were experienced by caregivers that extended to 12 months. Gender-specific attitudes prevented male caregivers from supporting their own self. Male caregivers dealt with problems that arose in the caregiving congruent with their masculinity, such as minimizing disruptions, focusing on tasks, and keeping their own stress to themselves. CONCLUSION: Male caregivers as a separate group with their own needs have not received much attention in the cancer literature, and their concerns and challenges may differ from those of female caregivers. IMPLICATIONS FOR PRACTICE: Male caregivers' concerns and challenges must be taken into consideration when planning appropriate interventions to support them in their caregiving role.

Symptom experience in patients with gynecological cancers: the development of symptom cIusters through patient narratives.

The vast majority of the increasing cancer literature on physical and psychological symptom clusters is quantitative, attempting either to model clusters through statistical techniques or to test priori clusters for their strength of relationship. Narrative symptom clusters can be particularly sensitive outcomes that can generate conceptually meaningful hypotheses for symptom cluster research. We conducted a study to explore the explanation of patients about the development and coexistence of symptoms and how patients at tempted to self-manage them. We collected 2-month qualitative longitudinal data over four assessment points consisting of 39 interview data sets from 10 participants with gynecological cancer. Participants' experiences highlighted the presence of physical and psychological symptom clusters, complicating the patients 'symptom experience that often lasted 1 year. While some complementary and self-management approaches were used to manage symptoms, few options and interventions were discussed. The cancer care team maybe able to develop strategies for a more thorough patient assessment of symptoms reported as the most bother so mean and patient-centered sensitive interventions that encompass the physiological, psychological, sociocultural, and behavioral components of the symptom experience essential for effectives symptom management.

Preparation for cancer care: perceptions of newly qualified health care professionals.

The present paper is derived from a larger survey which examined the perceptions of recently qualified health care professionals' experience on evidence-based practice, team working and cancer care. This study reports solely on the findings relating to cancer care. The perceptions of recently qualified professionals in relation to their initial educational input on issues such as confidence, anxiety, communication skills and practice in cancer care as well as adequacy of support, professional supervision and use of reflection were gathered using a cross-sectional postal survey design. A total of 50 graduates from each professional category in nursing, occupational therapy, physiotherapy, and social work were sampled yielding a total sample of 200. Eighty-five questionnaires were returned yielding a response rate of 43%. Twenty-eight (33%) respondents stated that they were currently involved in working with people with cancer. These were as follows: 5 nurses, 8 physiotherapists, 9 occupational therapists and 6 social workers. Despite the low response rate, the findings suggest that health care professionals' educational input and experiences of working with people with cancer were overall positive; for example, in the respondents' confidence, communication skills, decrease in anxiety and application of knowledge gained in classroom to professional practice. Moreover, most respondents learnt about caring for cancer patients through practice rather than classroom teaching. A high percentage (i.e. 64%;18) across all groups felt supported when caring for people with cancer and reported receiving professional supervision as well as being able to actively reflect on their practice. The implications for education and practice were discussed particularly as there have been few studies conducted in relation to the specific needs and collaborative learning of these health care professional groups.

Preparing for professional practice: how well does professional training equip health and social care practitioners to engage in evidence-based practice?

This paper reports on the findings of a study that aimed to explore how relevant initial training is in relation to evidence-based practice, and explore the perceptions of recently qualified practitioners about their confidence to engage in evidence-based practice. A cross-sectional postal survey was used to ascertain the views of nurses, social workers, occupational therapists and physiotherapists who had been qualified no longer than two years prior to the survey, and had qualified at one of three London Universities. Fifty questionnaires were sent out to each professional group (a sample of 200 overall) and there was a 43% response rate achieved. The results show a clear discrepancy between what are generally positive attitudes towards evidence-based practice and the value of research evidence and the infrequency with which they actually do make use of research resources and engage in evidence-based practice. A number of constraints to engagement in accessing and utilising evidence were identified.

Pre-registration nursing students' experience of caring for cancer patients.

The preparation of nurses caring for cancer patients remains a topical subject. The recent emphasis on the preparation of an effective and informed workforce for cancer care at all nursing levels is significant, particularly as the majority of previous studies have traditionally focused on post-registration preparation of qualified nurses. Currently, there is limited information on the preparation of pre-registered nursing students and little is known about the experiences of these students, especially during their initial exposure to cancer patients. Recently, changes have also been made to the pre-registration nursing programmes in the UK in line with national recommendations leading to much earlier exposures to patient care in practice. This study provides information about nursing students' experiences of caring for cancer patients. Using self-report questionnaires each comprising of 21 Likert scale items, a survey was conducted on a total of 134 students (response rate: 88%) enrolled on the common foundation programme at the end of the first year of their undergraduate nursing programme. Data collected included information about the types of clinical settings where students were exposed to cancer patients, perceptions of their experiences with cancer patients and aspects of educational and clinical inputs perceived as helpful in preparing them to care for cancer patients. Additional insight into the students' experience was further obtained from semi-structured interviews conducted from a total of nine students drawn from the three categories of experiences they identified: positive, non-positive and mixed. The findings and implications for the preparation of pre-registration nursing students in caring for cancer patients were discussed in relation to the theoretical input, clinical support and the use of reflection in practice.

Preparing for practice: how well are practitioners prepared for teamwork.

This article reports on the findings of a study that aimed to explore how relevant initial training is in relation to teamwork, and to explore the perceptions of newly qualified practitioners about their confidence to work as a member of a team. A cross-sectional postal survey was used to ascertain the views of nurses, social workers, occupational therapists and physiotherapists who had been qualified between six months and two years prior to the survey, and had qualified at one of three London universities. Fifty questionnaires were sent out to each professional group (a sample of 200 overall) and there was a 43% response rate. Findings revealed that respondents reported positive experiences of team working, with only one area--equality of status within teams--being highlighted as problematic. While no other area generated this level of disagreement, there were two other areas in which respondents felt unsure: cooperation within the team and conflict resolution within the team.

Supportive care: experiences of cancer patients.

The aim of this study was to explore how cancer patients with progressive disease perceived and experienced supportive care at the different stages of their cancer journey and to compare this to the perceptions of health care professionals. It was a single centre study using qualitative data obtained from two focus group interviews in an independent centre for specialist palliative care. Eight patients attending the centre were interviewed in two focus groups to ascertain their views on the supportive care that they had experienced during the course of their illness, focusing on: time of diagnosis, acute treatment phase and palliative care phase. Themes that emerged from the analysis of the interview transcripts using the QSR NUD*IST (version 4) software package included the following: manner in which diagnosis was revealed, information made available to family and friends, patients' acceptance of cancer; service provision such as a named contact person, choices in treatment and care, problems of limited resources; feelings of being unsupported, and ways in which supportive care could be improved.