ABSTRACT
BACKGROUND: Many efforts have been made to better integrate spiritual assessment into the care of patients with cancer, with varying degrees of success in different parts of the United States. Little work has been done to describe challenges that face those who seek to implement assessment in busy ambulatory settings, particularly in the northeastern section of the United States. OBJECTIVES: This study sought to test the feasibility of a screening process describing spirituality, distress, and spiritual transformation in cancer survivors after chemotherapy for lung or gastrointestinal cancer. METHODS: This descriptive pilot study took place in a rural National Cancer Institute- designated comprehensive cancer center, referral center, and outpatient medical oncology clinic. A web-based questionnaire was completed by 29 survivors, and 22 declined participation. FINDINGS: Respondents were primarily Christian, aged 60 years or older, and an average of 18 months post-diagnosis. The mean spiritual distress score was 1.38 (SD = 2.09), and the mean psychological distress score was 3.03 (SD = 2.73). Participants reported mean spiritual well-being, positive degree of spiritual growth, and little spiritual decline. The opportunity for spiritual growth among survivors creates a need for effective assessment and intervention to promote spiritual growth and mitigate spiritual decline and spiritual distress.
Subject(s)
Gastrointestinal Neoplasms/psychology , Lung Neoplasms/psychology , Spirituality , Survivors/psychology , Female , Gastrointestinal Neoplasms/therapy , Humans , Lung Neoplasms/therapy , Male , Middle Aged , Pilot Projects , Rural Population , Surveys and QuestionnairesABSTRACT
This pilot study describes the multidimensional (physical, psychological, social, and spiritual) needs of caregivers of cancer survivors. A regional comprehensive cancer center and nine community-based rural and urban cancer clinics in New Hampshire assembled a convenience sample. Patients with cancer completed an online survey, the cancer survivor Web-based needs assessment survey (CS-WEBS), to identify needs and desire for intervention. Patients then identified a caregiver who was recruited to complete a caregiver version of the CS-WEBS. Caregivers reported challenges within all four domains of the survivorship model. The highest reported physical symptoms were fatigue, insomnia, and weight gain. Social symptoms included financial issues. Although visiting nurse services were the most commonly used resource, many caregivers used no supportive services. The most common caregiver task was listening and talking. Caregivers frequently experienced fatigue, anxiety, and insomnia. Exploring effective ways to alleviate their symptom burden should be a priority. Local and national attention should be directed toward easing the financial burden of caring for a patient with cancer.
Subject(s)
Caregivers/psychology , Health Services Needs and Demand , Neoplasms/nursing , Cross-Sectional Studies , Female , Humans , Male , Pilot Projects , Surveys and QuestionnairesSubject(s)
Cancer Care Facilities/organization & administration , Group Practice/organization & administration , Nurse Practitioners , Oncology Nursing/organization & administration , Awards and Prizes , Education, Nursing, Continuing/organization & administration , Goals , Humans , Information Dissemination , Leadership , Nurse's Role , Nursing Research/organization & administration , Oncology Nursing/education , Peer Review , Triage/organization & administrationSubject(s)
Group Practice/organization & administration , Hematologic Diseases/nursing , Nurse Clinicians , Nurse Practitioners , Oncology Nursing , Practice Management , Health Plan Implementation , Humans , Interprofessional Relations , Leadership , Needs Assessment , Staff Development , United StatesABSTRACT
PURPOSE/OBJECTIVES: To obtain detailed information about the preferences of patients with cancer and their need for information about side effects of cancer treatment to design an interactive multimedia educational program. DESIGN: Qualitative. SETTING: Regional rural academic medical center. SAMPLE: 51 patients and 14 spouses of patients who either currently were undergoing or recently had completed chemotherapy or radiation therapy for cancer. METHODS: Focus groups. MAIN RESEARCH VARIABLES: Information needs and common and distressing symptoms. FINDINGS: Patients wanted information about the process of getting treatment, specific side effects that might occur, and the impact of treatment on their lives. Patients sought information from a variety of sources, but many found that other patients were the most helpful source. Although most patients wanted as much information as possible so they would be prepared for whatever happened, some patients preferred to avoid information about possible side effects. Several obstacles related to information were reported, including access to providers, communication difficulties with providers, informational overload, and problems with retention. CONCLUSIONS: Several aspects regarding information needs confirmed previous findings, and new aspects were illuminated. This led to a conclusion that multimedia technology offered many advantages to meet these informational needs. IMPLICATIONS FOR NURSING: New approaches to patient education that will meet the needs of patients as well as clinicians and educators need to be developed.
