Preparedness for colorectal cancer surgery and recovery through a person-centred information and communication intervention – A quasi-experimental longitudinal design


Autoři: Joakim Öhlén aff001;  Richard Sawatzky aff001;  Monica Pettersson aff001;  Elisabeth Kenne Sarenmalm aff001;  Cecilia Larsdotter aff007;  Frida Smith aff008;  Catarina Wallengren aff001;  Febe Friberg aff010;  Karl Kodeda aff011;  Eva Carlsson aff001
Působiště autorů: Institute of Health and Care Sciences and University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden aff001;  Palliative Centre, Sahlgrenska University Hospital Västra Götaland Region, Gothenburg, Sweden aff002;  School of Nursing, Trinity Western University, Langley, BC, Canada aff003;  Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada aff004;  Vascular Department, Sahlgrenska University Hospital, Gothenburg, Sweden aff005;  Research & Development Unit, Skaraborg Hospital, Skövde, Sweden aff006;  Department of Nursing science, Sophiahemmet University, Stockholm, Sweden aff007;  Center for Health Care Improvement, Department of Technology Management and Economics, Division of Service Management and Logistics, Chalmers University of Technology, Gothenburg, Sweden aff008;  Regional Cancer Center West, Sahlgrenska University Hospital, Gothenburg, Sweden aff009;  Faculty of Health Sciences, University of Stavanger, Stavanger, Norway aff010;  Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden aff011;  Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden aff012
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225816

Souhrn

To meet patients’ information and communication needs over time in order to improve their recovery is particularly challenging for patients undergoing cancer surgery. The aim of the study was to evaluate whether an intervention with a person-centred approach to information and communication for patients diagnosed with colorectal cancer undergoing surgery can improve the patients’ preparedness for surgery, discharge and recovery during six months following diagnosis and initial treatment. The intervention components involving a novel written interactive patient education material and person-centred communication was based on critical analysis of conventional information and communication for these patients. During 2014–2016, 488 consecutive patients undergoing elective surgery for colorectal cancer were enrolled in a quasi-experimental longitudinal study. In three hospitals, first a conventional care group (n = 250) was recruited, then the intervention was introduced, and finally the intervention group was recruited (n = 238). Patients’ trajectories of preparedness for surgery and recovery (Preparedness for Colorectal Cancer Surgery Questionnaire—PCSQ) health related quality of life (EORTC QLQ-C30) and distress (NCCS Distress Thermometer) were evaluated based on self-reported data at five time points, from pre-surgery to 6 months. Length of hospital stay and patients’ behavior in seeking health care pre- and post-surgery were extracted from patient records. Longitudinal structural equation models were used to test the hypothesized effects over time. Statistically significant positive effects were detected for two of the four PCSQ domains (patients searching for and making use of information, and making sense of the recovery) and for the role functioning domain of the EORTC QLQ-C30. Patients in the intervention group were also more likely to contact their assigned cancer “contact nurse” (a.k.a. nurse navigator) instead of contacting a nurse on duty at the ward or visiting the emergency department. In conclusion, the overall hypothesis was not confirmed. Further research is recommended on written and oral support tools to facilitate person-centred communication.

Klíčová slova:

Cancer detection and diagnosis – Colorectal cancer – Communications – Critical care and emergency medicine – Nurses – Patients – Surgical and invasive medical procedures – Surgical oncology


Zdroje

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