Long-term Recovery After Colorectal Cancer Surgery Among the Old: A Qualitative Study.

BACKGROUND: Colorectal cancer is the third most frequently diagnosed cancer worldwide, disproportionally affecting older people. With modern treatment, older people are surviving cancer treatment and recovery. However, only a limited number of studies on the older person's experience of recovery exist. Knowledge of the experience of recovery among people 80 years or older is essential to optimize recovery and follow-up care. OBJECTIVE: The aim of this study was to explore the experiences of persons 80 years or older during recovery up to 2 years after curative colorectal cancer surgery. METHODS: This exploratory inductive qualitative study was conducted through 18 individual in-depth interviews between July 2020 and June 2021. Content analysis was used to analyze the data. RESULTS: The main theme identified was Recovery among the old is a complex process. It indicated that older people operated on for colorectal cancer may have intricate health challenges that affect recovery in addition to their cancer and treatment. The main theme is built upon the subthemes Individual factors affect colorectal cancer recovery and External support systems facilitate and impede colorectal recovery. CONCLUSION: Important resources for recovery among old patients included their own coping ability and support from social networks and healthcare services. The identified barriers to recovery included other health problems and issues with healthcare services delivery. IMPLICATIONS FOR PRACTICE: It is essential for healthcare personnel in contact with older patients to be aware of factors that influence their recovery to identify and preserve the older person's resources and implement health-promoting initiatives to optimize recovery when needed.

Exploring variables affecting sense of coherence and social support in recovery after colorectal cancer surgery among the oldest old.

OBJECTIVE: To explore the associations between sense of coherence, perceived social support, and demographic and clinical characteristics among survivors ≥80 years treated for curable colorectal cancer. METHODS: This exploratory, cross-sectional survey investigates 56 individuals surgically treated for stage I-III colorectal cancer between one and five years prior. Statistical analysis permitted exploration of associations between sense of coherence, perceived social support, and demographic- and clinical variables. RESULTS: Lower sense of coherence was associated with higher age, limitations in physical function, and the need for homecare nursing. Lower perceived social support was associated with re-admission, higher age at time of surgery, and male gender. No correlations were found between sense of coherence and perceived social support. CONCLUSION: The results are important for healthcare professionals to consider when dealing with older people who underwent surgery for colorectal cancer, especially in the discharge process to facilitate optimal follow-up care and recovery.

The patient experience with treatment and self-management (PETS) questionnaire: translation and cultural adaption of the Norwegian version.

BACKGROUND: Noncommunicable diseases represents long term medical conditions, which often puts the patients under enormous demands when following treatment, exposing them to experiencing treatment burden. The Patient Experience with Treatment and Self-Management (PETS) questionnaire was developed as a patient-reported measure to identify treatment burden of chronic illness, using modern measurement theory and tested in a variety of settings. Developed in English, this set of measures had not been previously translated into Norwegian. The objective of this study was to develop a Norwegian version of the PETS and to pretest the translated measures through a cognitive debriefing methodology. METHODS: A rigorous translation approach was applied, guided by Functional Assessment of Chronic Illness Therapy methodology. Bilingual teams from Norway and the United States reviewed the translation to develop a provisional version, which was evaluated for test content validity with cognitive interviews by probing 12 native Norwegian patients with noncommunicable diseases. The interviews applied both concurrent and retrospective verbal probing techniques, guided by a question route. Audio-recorded interviews were transcribed verbatim and analysed using systematic text condensation. RESULTS: Assessment of translatability identified the need for cultural adaptation on several core words, balanced with the need to keep close to the original literal meaning. Seven patients with colorectal cancer and five patients with heart failure participated in cognitive testing of the Norwegian version of the PETS. The analytical process of the cognitive interviews identified two emergent main themes, 'comprehension and readability' and 'relevance of the PETS', with seven corresponding subthemes. Most items, response options and instructions were well understood by the patients. Revisions were made concerning cultural relevance. CONCLUSIONS: PETS items were semantically equivalent to the original. The patients with colorectal cancer and heart failure were able to comprehend the PETS and found it to express their experience with treatment burden in chronic illness. Future work will focus on psychometric construct validation and reliability testing of the PETS.