Year: 2018
Type: dissertation
Study design: Observational Study
Abstract: As a basis for nursing support for survivors and partners following CRC treatment, the\noverall aim of the present thesis was to explore the first year of subjective recovery following\nsuch treatment. First, the focus was on illness perceptions and self-reorientation\nin cancer care settings from the survivors’ perspective as well as on cancer care settings\nand illness perceptions from the partners’ perspective. Second, the focus was on investigating\nrelations between fatigue, mental health, gastrointestinal health, illness perceptions\nand self-efficacy in relation to maintaining everyday activities, where health-related\nquality of life (HRQoL) was the outcome measure.\nPersons treated for CRC at a county hospital in western Sweden and their partners\nwere the participants. In Study I (n=17), III (n=46) and IV (n=39) the participants\nwere survivors, and in Study II (n =18) the participants were survivors and partners. In\nStudy I and II, data were collected through interviews and analyzed using Grounded\nTheory methodology. In Study III and IV, data were collected through questionnaires\nand statistically analyzed. The following questionnaires were used: European Organization\nfor Research and Treatment of Cancer’s (EORTC) cancer-specific Quality of Life\nQuestionnaire (QLQ-C30); the Hospital Anxiety and Depression Scale (HADS); the\nIllness Perception Questionnaire-Revised (IPQ-R); and the Maintain Function Scale.\nIn Study I, the theoretical model explained self-reorientation as the individual trying\nto achieve congruence in self-perception. The core of self-reorientation was questions\nthat did not have clear answers. Not knowing the cause of cancer, or not being able to\nunderstand bodily reactions, meant losing one’s former sense of self. In Study II, the\ntheoretical model illustrated illness perceptions of survivors and partners in relation to\nthe experienced contemporary cancer care environment. Information and non-continuity\nwas experienced as troublesome if there was no specific healthcare professional to\ncontact if needed, and the time after discharge was characterized by loneliness. Survivors’\nand partners’ illness perceptions were incompatible: Survivors tended to minimize the\nseriousness, while partners were more focused on seeing cancer as a life-changing event.\nIn Study III, fatigue and diarrhea were identified as negative predictors of HRQoL,\nwhile self-efficacy in relation to maintaining everyday activities was identified as a positive\npredictor. The Maintain Function Scale was suitable for assessing self-efficacy in\nrelation to maintaining everyday activities. Study IV showed a significant decrease in\nlevel of self-efficacy at 12 months. Emotional representations and fatigue, respectively,\nfunctioned as mediators between self-efficacy and HRQoL.\nIn conclusion, nurse-led follow up consultations after discharge need to be prioritized\nafter treatment for CRC. Because illness perceptions not only influence self-reorientation\nbut also function as a mediator between self-efficacy in relation to maintaining\neveryday activities and HRQoL, illness perceptions and self-efficacy need to be in focus\nwhen addressing symptoms. In addition to prioritizing nursing care after discharge,\nthe informational burden, lack of continuity and strain on partners found in the results\nshould be addressed during treatment.
Author: Ann‐Caroline Johansson
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2793546679