Purpose/Objectives: To assess the psychological, physical, and social situations and needs of patients with colorectal cancer (CRC) diagnosed at an advanced stage of the disease.
Design: Quantitative, descriptive.
Setting: An urban comprehensive cancer center in northeastern Poland.
Sample: 50 patients undergoing first-line palliative chemotherapy.
Methods: Participants were asked to fill out an institution-developed questionnaire assessing personal, emotional, physical, and social data.
Main Research Variables: Psychological, physical, and social characteristics.
Findings: The most frequently reported side effects of chemotherapy were asthenia, loss of taste, and nausea and vomiting. In addition, about 54% of patients were unable to work during treatment. Chemotherapy administration resulted in severe or moderate impediment of activities of daily living in 74% of the patients and negatively influenced their financial situation. About 25% of the patients were reluctant to share the news of their disease with their coworkers; however, most revealed their diagnosis to friends and family. The majority (62%) of patients expected help from family members. Nurses provided emotional support to a much lesser extent than patients' immediate relatives. The majority of patients (80%) needed to express their feelings by talking, but only about 30% considered a nurse to be the preferred person with whom to discuss their disease.
Conclusions: Patients with CRC diagnosed at an advanced stage require considerably more emotional, informative, and instrumental support from nurses, doctors, family, other patients, and priests than was anticipated by the authors.
Implications for Nursing: Extending routine history taking via the addition of questions to the proposed questionnaire may help to better recognize a particular patient's situation and unique needs. An increasingly patient-focused approach could improve the individual nursing care in this region of Europe. Ultimately, a multidisciplinary team would be required to meet the needs of patients with CRC undergoing chemotherapy.
References
Campora, E., Naso, C., Vitullo, M., Giudici, S., Camoirano, A., & Rosso, L. (1992). The impact of chemotherapy on quality of life of breast cancer patients. Journal of Chemotherapy, 4, 59-63.
Coleman, M.P., Gatta, G., Verdecchia, A., Esteve, J., Sant, M., Storm, H., … Berrino, F. (2003). EUROCARE-3 summary: Cancer survival in Europe at the end of the 20th century. Annals of Oncology, 14, v128-v149. doi:10.1093/annonc/mdg756
Foot, G., & Sanson-Fischer, R. (1995). Measuring the unmet needs of people living with cancer. Cancer Forum, 19, 131-135.
Glajchen, M. (2004). The emerging role and needs of family caregivers in cancer care. Journal of Supportive Oncology, 2, 145-155.
Goldberg, R.M., Rothenberg, M.L., van Cutsem, E., Benson, A.B., 3rd, Blanke, C.D., Diasio, R.B., … Viele, C. (2007). The continuum of care: A paradigm for the management of metastatic colorectal cancer. Oncologist, 12, 38-50. doi:10.1634/theoncologist.12-1
Honea, N.J., Brintnall, R., Given, B., Sherwood, P., Colao, D.B., Somers, S.C., & Northouse, L.L. (2008). Putting Evidence Into Practice: Nursing assessment and interventions to reduce family caregiver strain and burden. Clinical Journal of Oncology Nursing, 12, 507-516. doi:10.1188/08.CJON.507-516
Jocham, H.R., Dassen, T., Widdershoven, G., & Halfens, R. (2006). Quality of life in palliative care cancer patients: A literature review. Journal of Clinical Nursing, 15, 1188-1195. doi:10.1111/j.1365-2702.2006.01274.x
Langenbach, M.R., Sauerland, S., Krobel, K.W., & Zirngibl, H. (2010). Why so late? Delay in treatment of colorectal cancer is socially determined. Langenbeck's Archive in Surgery, 395, 1017-1024. doi:10.1007/s00423-010-0664-8
Lin, H.R., & Bauer-Wu, S.M. (2003). Psychospiritual well-being in patients with advanced cancer: An integrative review of the literature. Journal of Advanced Nursing, 44, 69-80. doi:10.1046/j.1365-2648.2003.02768.x
Loomis, B. (2009). End-of-life issues: Difficult decisions and dealing with grief. Nursing Clinics of North America, 44, 223-231. doi:10.1016/j.cnur.2009.02.001
Madden, J. (2006). The problem of distress in patients with cancer: More effective assessment. Clinical Journal of Oncology Nursing, 10, 615-619. doi:10.1188/06.CJON.615-619
Malone, M., Harris, A.L., & Luscombe, D.K. (1994). Assessment of the impact of cancer on work, recreation, home management, and sleep using general health status measure. Journal of the Royal Society of Medicine, 87, 386-389.
Mattioli, J.L., Repinski, R., & Chappy, S.L. (2008). The meaning of hope and social support in patients receiving chemotherapy. Oncology Nursing Forum, 35, 822-829. doi:10.1188/08.ONF.822-829
McDowell, M.E., Occhipinti, S., Ferguson, M., Dunn, J., & Chambers, S.K. (2010). Predictors of change in unmet supportive care needs in cancer. Psycho-Oncology, 19, 508-516. doi:10.1002/pon.1604
Moore, C.D. (2005). Communication issues and advance planning. Seminars in Oncology Nursing, 21, 11-19. doi:10.1053/j.soncn.2004.10.003
Mystakidou, K., Tsilika, E., Prpa, E., Galanos, A., & Vlahos, L. (2007). Caregivers of advanced cancer patients: Feelings of hopelessness and depression. Cancer Nursing, 30, 412-418. doi:10.1097/01.NCC.0000290807.84076.73
Papastavrou, E., Charalambous, A., & Tsangari, H. (2009). Exploring the other side of cancer care: The informal caregiver. European Journal of Oncology Nursing, 13, 128-136. doi:10.1016/j.ejon.2009.02.003
Podmore, E.J., Bingham, L.C., Roberts, K.M., Selby P.J., Wright, P., & Velikova, G. (2009). Routine assessment of social difficulties in cancer patients: Are we opening Pandora's box? Supportive Care in Cancer, 17, 1425-1432. doi:10.1007/s00520-009-0690-7
Sanson-Fisher, R., Girgis, A., Boyes, A., Bonevsky, B., Burton, L., & Cook, P. (2000). The unmet supportive care needs of patients with cancer. Supportive Care Review Group. Cancer, 88, 226-237. doi:10.1002/(SICI)1097-0142(20000101)88:1<226::AID-CNCR30>3.0.CO;2-P
Spiegel, D. (1994). Health carrying: Psychosocial support for patients with cancer. Cancer, 74, 1453-1457. doi:10.1002/1097-0142(19940815)74:4+<1453::AID CNCR2820741609>3.0.CO;2-1
Surbone, A., Baider, L., Weitzman, T.S., Brames, M.J., Rittenberg, C.N., & Johnson, J. (2010). Psychosocial care for patients and their families is integral to supportive care in cancer: MASCC position statement. Supportive Care in Cancer, 18, 255-263.
Thorne, S.E., Hislop, T.G., Stajduhar, K., & Oglov, V. (2009). Time-related communication skills from the cancer patient perspective. Psycho-Oncology, 18, 500-507. doi:10.1002/pon.1418
Ward, W.L., Hahn, E.A., Mo, F., Hernandez, L., Tulsky, D.S., & Cella, D. (1999). Reliability and validity of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) quality-of-life instrument. Quality of Life Research, 8, 181-195. doi:10.1023/A:1008821826499
World Health Organization Quality of Life Group. (1998). Development of the World Health Organization WHOQOL-BREF quality-of-life assessment. The WHOQOL Group. Psychological Medicine, 28, 551-558.
