RESUMO
OBJECTIVES: Psychological distress can occur following diagnosis and treatment for prostate cancer, compromising psychosocial wellbeing. Improved recognition and management of distress by healthcare professionals can enhance clinical practice and promote evidence-based prostate cancer care. This paper explores the effectiveness and feasibility of the online Distress Screening for Prostate Cancer course, designed to improve healthcare professionals' understanding of screening for prostate cancer-related distress. It aims to evaluate whether this e-learning course increases learners' knowledge of distress screening for prostate cancer. METHODS: Healthcare professionals were invited to enroll in the online course and complete optional evaluation questions. The pretest posttest design identified changes in learners' knowledge about distress screening for people with prostate cancer, including prevalence, risk factors, assessment and management strategies for distress (nâ¯=â¯149). Learners also rated satisfaction in a cross-sectional survey (nâ¯=â¯116). Most respondents were nurses, including Prostate Cancer Specialist Nurses. RESULTS: Learners' knowledge of distress screening was higher after course completion. Improvement between pre- and posttest results was statistically significant for four of ten items, including risk of prostate cancer-related distress, and suicidality, and the purpose of distress screening. Learners reported high satisfaction with course content, structure, engagement, relevance, and approach. They particularly valued the narrative-based approach and interactivity. Small numbers encountered technological problems and some offered suggestions to improve learner feedback. CONCLUSIONS: The course improved healthcare professionals' knowledge of distress among people affected by prostate cancer. Learners found the e-learning format feasible and acceptable. IMPLICATIONS FOR NURSING PRACTICE: Deeper understanding of the psychological implications of diagnosis and treatment of prostate cancer can help healthcare professionals respond to and manage distress among men and their families, and provide supportive care to improve health-related quality of life. Access to an online course can offer effective, feasible education on distress screening.
Assuntos
Pessoal de Saúde , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/psicologia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/enfermagem , Pessoa de Meia-Idade , Adulto , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Estudos Transversais , Estresse Psicológico , Angústia Psicológica , Programas de Rastreamento/métodos , Feminino , Educação a Distância/métodos , Conhecimentos, Atitudes e Prática em Saúde , Instrução por Computador/métodos , Inquéritos e Questionários , Enfermagem Oncológica/educação , Enfermagem Oncológica/métodosRESUMO
Introducción: El cáncer de próstata es el cáncer de mayor prevalencia en hombres. La enfermedad y el tratamiento generan síntomas urinarios, intestinales, sexuales, hormonales y emocionales que repercuten en el rendimiento funcional de los hombres quienes las padecen, el automanejo de los síntomas ha sido considerada desde la Organización Mundial de la Salud (OMS) como una estrategia para permitir que los hombres puedan conocer mejor su enfermedad y generar habilidades para manejarla desde un ámbito domiciliario. Objetivo: Determinar la efectividad de la Intervención Prostactive para el automanejo de síntomas y su repercusión en el rendimiento funcional, en personas con cáncer de próstata en tratamiento que asisten a la Unidad Oncológica de la Clínica Nogales entre 2022 y 2023. Materiales y métodos: Es un diseño experimental paralelo determinado por la conformación aleatoria de dos grupos con un tamaño de muestra de 100 participantes, 50 para el control (GC) que recibirá el cuidado habitual y 50 para el experimental (GI) al cual se implementó la intervención Prostactive que consta de 4 sesiones presenciales en las cuales se le explicará cómo manejar los síntomas que presenta debido al cáncer de próstata y el tratamiento. Posteriormente se realizó el seguimiento telefónico para conocer el estado de salud a la semana 8 después de las sesiones presenciales. Resultados: la Intervención Prostactive mejoró los niveles de autoeficacia en los participantes del GI, el rendimiento funcional (0,0001) además del automanejo de síntomas urinarios con diferencias estadísticamente significativas frente al GC. No se identificaron cambios en los síntomas obstructivos (valor P= 0.6), síntomas sexuales y síntomas hormonales. Conclusión: La Intervención Prostactive mejora el automanejo de síntomas en hombres con CP en tratamiento, además de la autoeficacia y el Rendimiento Funcional. (AU)
Introduction: Prostate cancer is more prevalent in men. The disease and treatment generate urinary, intestinal, sexual, hormonal and emotional symptoms that impact the functional performance of men who suffer from them. Self-management of symptoms has been considered since the World Health Organization (WHO) as a strategy to allow men to better understand their disease and generate skills to manage it from a home environment. Objective: Determine the effectiveness of the Prostactive Intervention for the selfmanagement of symptoms and its impact on functional performance, in people with prostate cancer undergoing treatment who attend the Oncology Unit of the Nogales Clinic between 2022 and 2023. Materials and methods: It is a parallel experimental design determined by the random formation of two groups with a sample size of 100 participants, 50 for the control (CG) who will receive the usual care and 50 for the experimental (GI) to which the Prostactive intervention was implemented, which It consists of 4 face-to-face sessions in which you will be explained how to manage the symptoms you present due to prostate cancer and the treatment. Subsequently, telephone follow-up was carried out to determine the health status at week 8 after the face-to-face sessions. Results: the Prostactive Intervention improved the levels of self-efficacy in the IG participants, functional performance (0.0001) in addition to the self-management of urinary symptoms with statistically significant differences compared to the CG. No changes were identified in obstructive symptoms (P value= 0.6), sexual symptoms, and hormonal symptoms. Conclusion: The Prostactive Intervention improves symptom self-management in men with CP undergoing treatment, in addition to self-efficacy and Functional Performance. (AU)
Assuntos
Humanos , Masculino , Neoplasias da Próstata/enfermagem , Ensaio Clínico , Avaliação de Eficácia-Efetividade de Intervenções , AutogestãoRESUMO
Kelly Kusinski, Urology Advanced Nurse Practitioner, The Royal Wolverhampton NHS Trust (kelly.kusinski@nhs.net), runner-up in the Urology Nurse of the Year category in the BJN Awards 2021.
Assuntos
Distinções e Prêmios , Profissionais de Enfermagem , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/enfermagemRESUMO
BACKGROUND: Presently, few studies have examined the impact of positive thinking on the HRQoL of prostate cancer patients who receive androgen deprivation therapy (ADT). OBJECTIVES: We explored the factors that affect health-related quality of life (HRQoL), particularly positive thinking, of prostate cancer patients who receive ADT. METHODS: A cross-sectional design was used. A total of 132 prostate cancer patients, drawn from outpatient clinics of 2 medical centers, who were receiving ADT were included. Structured questionnaires, including a basic information sheet, the Positive Thinking Scale, Social Support Scale, and Functional Assessment of Cancer Therapy-Prostate (FACT-P), were used for data collection. Statistical analysis was performed by using independent-sample t tests, one-way analysis of variance, Pearson correlation, and multiple regression. RESULTS: Prostate cancer patients who were receiving ADT were more likely to engage in positive thinking, which was correlated with better social/family well-being, emotional well-being, functional well-being, prostate cancer concern, and a higher score on the FACT-P. Improved self-reported health status was correlated better with all subdimensions of HRQoL and better scores on the FACT-P. Greater social support was correlated with high social/family well-being. CONCLUSIONS: Positive thinking, self-reported health status, and social support are important associated factors of HRQoL in prostate cancer patients who receive ADT. IMPLICATIONS FOR PRACTICE: Oncology nurses can improve HRQoL by improving positive thinking, self-reported health status, and social support of prostate cancer patients who receive ADT.
Assuntos
Antagonistas de Androgênios/uso terapêutico , Terapia de Reposição Hormonal , Neoplasias da Próstata/tratamento farmacológico , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Otimismo , Neoplasias da Próstata/enfermagem , Neoplasias da Próstata/psicologia , Apoio Social , Inquéritos e QuestionáriosRESUMO
Editor's note: The mission of Cochrane Nursing is to provide an international evidence base for nurses involved in delivering, leading, or researching nursing care. Cochrane Corner provides summaries of recent systematic reviews from the Cochrane Library. For more information, see https://nursing.cochrane.org.
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Antagonistas de Androgênios/uso terapêutico , Terapia de Reposição Hormonal/enfermagem , Neoplasias da Próstata/tratamento farmacológico , Progressão da Doença , Humanos , Masculino , Pesquisa em Educação em Enfermagem , Neoplasias da Próstata/enfermagemRESUMO
Hormone deprivation therapies play a key role in the treatment of prostate cancer. These treatments require standardized care and regular monitoring. The objective of this work was to review the different hormonal therapies available, their side effects and the role of a coordinating nurse in the management of these therapies. First generation hormone therapy is the standard treatment for metastatic prostate cancer. In the past years, second generation hormone therapies have been indicated in combination with first-generation hormone therapies at different stages of the disease. These molecules are responsible for several side effects that should be monitored and prevented. Thus, after an initial assessment, clinical and paraclinical follow-up are essential. Our center has set up monitoring by a coordinating nurse (IDEC) to optimize the education and follow-up of the patient, but also to provide psychosocial support adapted throughout the patient's care path under hormone therapy. This monitoring and information function by IDEC can be facilitated by new digital solutions.
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Antagonistas de Androgênios/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Papel do Profissional de Enfermagem , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/enfermagem , Humanos , MasculinoRESUMO
OBJECTIVE: To review the indications for and side effects of androgen deprivation therapy (ADT) in men affected by prostate cancer. DATA SOURCES: National guidelines, evidence-based summaries, peer-reviewed studies, and websites. CONCLUSION: Indications for ADT include men with (1) intermediate- to high-risk localised prostate cancer undergoing radiation therapy, (2) biochemical recurrence after radical prostatectomy treated with salvage radiation therapy, or (3) metastatic prostate cancer. Several forms of ADT are available. To support self-management, body weight, diet, physical activity, alcohol consumption, and smoking should be discussed during clinical consultations. Important side effects of ADT may include flare-up phenomena of GnRH analogues, local reactions at injection sites, cardiovascular events, bone loss/fractures, drug-drug interactions, urinary tract dysfunction, hot flashes, cognitive impairment, seizure falls, and liver impairment. IMPLICATIONS FOR NURSING PRACTICE: Nurses have a role in personalized cancer care and should be familiar with indications, side effects, and interventions to optimize quality of life for men affected by prostate cancer receiving ADT.
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Antagonistas de Androgênios/efeitos adversos , Neoplasias da Próstata/tratamento farmacológico , Antagonistas de Androgênios/administração & dosagem , Densidade Óssea , Fogachos , Humanos , Masculino , Enfermagem Oncológica/métodos , Neoplasias da Próstata/enfermagem , Neoplasias da Próstata/psicologia , Qualidade de VidaRESUMO
OBJECTIVE: Prostate cancer is one of the most common male cancers in the world and accounts for substantial morbidity, mortality, loss of disability-adjusted life-years, and financial burden to patients and to the community. Metastatic prostate cancer has been managed for over 70 years with androgen deprivation therapy, but further life-prolonging therapies were not available until 2004. Since then, drugs such as docetaxel, abiraterone, enzalutamide, cabazitaxel, radium-223 dichloride, and (not available in Australia) sipuleucel-T have all demonstrated efficacy in prolongation of survival in castrate-resistant prostate cancer, and improvement in cancer-related morbidity. DATA SOURCES: Peer-reviewed scientific publications, Australian Government agency reports, and expert opinion. CONCLUSION: More recently, several of these agents have been given earlier in the treatment course to the hormone-sensitive metastatic setting, with even greater benefits in survival. These treatments have come at a cost: a literal financial cost to the community, and often to the patients and their families; and financial costs to the community to supply the drugs to those who need them. They also carry non-financial costs, including side effects of treatment, exacerbation of other co-morbidities, metabolic and bone health challenges, and psychological and social stresses, including those associated with longer survival with metastatic cancer. IMPLICATIONS FOR NURSING PRACTICE: The role of the nurse in management of these issues has never been more important. Nurses are often uniquely placed to educate men with prostate cancer and their families, screen for and identify adverse effects of treatment, and provide education and support not otherwise available. Nurses are central to the streamline of care coordination within the multidisciplinary team and the holistic care journey for men and their partners through the health care system. This review discusses several of these aspects to inform practice.
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Enfermagem Oncológica/métodos , Neoplasias da Próstata/enfermagem , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Humanos , Masculino , Papel do Profissional de Enfermagem , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/psicologiaRESUMO
BACKGROUND: Prostate cancer is the second most commonly diagnosed cancer globally. Cancer prehabilitation is defined as a process on the continuum of care that occurs between the time of a cancer diagnosis and the beginning of acute treatment. This article will discuss the importance of prostate cancer prehabilitation interventions in optimising physical and psychological recovery to enhance person-centred care. DATA SOURCES: Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, professional websites, and grey literature were searched using Google Scholar. CONCLUSION: Prehabilitation in cancer care aims to enhance perioperative care and recovery. An emerging field of research suggests that the preoperative period may be physically and psychologically salient to introduce modifiable self-management behaviours to optimise overall recovery. IMPLICATIONS FOR NURSING PRACTICE: Prostate cancer specialist nurses provide the hub of person-centred care across the entire cancer care continuum embedded within the multidisciplinary team. Individually tailored interventions such as exercise and pelvic floor muscle training programmes, nutritional advice, anxiety and depression reduction, and sexual well-being interventions should be considered in the prehabilitation phase of the cancer care continuum.
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Enfermagem Oncológica/métodos , Exercício Pré-Operatório , Neoplasias da Próstata/enfermagem , Humanos , Masculino , Assistência Centrada no Paciente/métodos , Neoplasias da Próstata/psicologiaRESUMO
OBJECTIVE: A diagnosis of prostate cancer is a major life-changing event that brings social, psychological, physical, financial, and spiritual challenges. In both the United Kingdom (UK) and Australia, prostate cancer specialist nurses (PCSNs) have a unique role in the care of men and their families. Prostate cancer specialist nursing roles are described from the UK and Australian perspective. DATA SOURCES: Government regulations, peer-reviewed journal articles, nursing society and government websites. CONCLUSION: Specialist nursing roles have developed within different frameworks and in response to very different political drivers in the UK and in Australia. An evidence base has developed demonstrating that PCSNs offer positive outcomes for men and their families. Despite some differences in the scope of international roles, there are common aspects. Both health care settings have challenges in terms of education, role definition, and capacity. Yet both PCSN roles have delivered innovative models of specialist care in terms of service delivery and patient support and education. IMPLICATIONS FOR NURSING PRACTICE: PCSNs have the potential to significantly decrease the burden on the public health system and influence change. For men with prostate cancer and their families, PCSNs can improve care through holistic nursing models focussing on what is important to individuals: support, education, management of side effects, rehabilitation, and by delivering and improving access to high-quality care.
Assuntos
Papel do Profissional de Enfermagem , Enfermagem Oncológica/métodos , Neoplasias da Próstata/enfermagem , Austrália , Humanos , Masculino , Enfermeiros Clínicos/organização & administração , Reino UnidoRESUMO
OBJECTIVE: Prostate cancer continues to be one of the highest-incident cancers among men. Reducing serum testosterone with androgen deprivation therapy (ADT) is a common effective treatment. While well-demonstrated for cancer suppression, there are numerous adverse effects caused by ADT that can contribute to short- and long-term prognosis. Increased levels of physical activity (PA) during treatment may reduce these side effects. However, uptake of PA is low. The purpose of this review is to identify and evaluate the current literature on strategies to promote and increase the levels of PA in patients with prostate cancer undergoing ADT. DATA SOURCES: Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, and grey literature were searched using Google Scholar up until April 2020. CONCLUSION: At present the most appropriate modes and dosages of PA for specific ADT toxicities is not known. It is established that some PA in the form of exercise, whether aerobic or resistance, is better than being sedentary for improvements in physical health, but beyond this prescription specifics have not been established. Further research is required to understand the impact of PA on the mental and physical health of men with prostate cancer undergoing ADT. IMPLICATIONS FOR NURSING PRACTICE: Being physically active and avoiding sedentary behaviour is important for men with prostate cancer undergoing ADT, especially the implementation of strength training. PA in the form of exercise can assist in reducing the adverse physical side effects in the short- and long-term, with limited understanding of the effects on mental health. PA improves mental health outcomes across populations, which may also translate to men with prostate cancer, although further research is required. An important strategy to improve PA within the prostate cancer population is to provide an early referral to an exercise professional, such as an accredited exercise physiologist/clinical exercise physiologist or physical therapist/physiotherapist, and is supported by research as best practice for people affected by cancer undergoing active treatment.
Assuntos
Antagonistas de Androgênios/efeitos adversos , Terapia por Exercício/métodos , Orquiectomia/efeitos adversos , Neoplasias da Próstata/psicologia , Humanos , Masculino , Saúde Mental , Enfermagem Oncológica/métodos , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/enfermagem , Neoplasias da Próstata/cirurgia , Qualidade de VidaRESUMO
OBJECTIVES: To explore the four Rs of radiobiology (Repair, Reoxygenation, Reassortment, and Repopulation) as a means to understand the effects of ionising radiation on biological tissue and subsequently as the basis for conventional fractionated treatment schedules. These radiobiological principles will form a rationale for combined regimens in prostate cancer treatment involving androgen deprivation therapy and radiation therapy and the associated toxicities of this approach will be discussed. DATA SOURCES: Electronic databases including CINAHL, MEDLINE, Scopus, professional websites, books and grey literature were searched using Google Scholar. CONCLUSION: It is important for nurses to understand the four Rs of radiobiology to grasp the effects of ionising radiation on biological tissue as the basis for conventional fractionated treatment schedules in prostate cancer. Men can experience a sequalae of physical and psychological side effects of treatment that can negatively impact quality of life. IMPLICATIONS FOR NURSING PRACTICE: Men can experience a range of unmet supportive care needs particularly related to informational, sexual, and psychological needs. For men affected by prostate cancer opting for radiation therapy (+/-) androgen deprivation therapy, nurses should ask targeted questions based on the Common Terminology Criteria for Adverse Events related to urinary and bowel function, potency and fatigue, and sexual health. We also recommend the use of holistic needs assessments to tailor self-management care plans. Evidence-based self-management advice should be provided in response to each man's unique needs.
Assuntos
Neoplasias da Próstata/radioterapia , Antagonistas de Androgênios/efeitos adversos , Humanos , Masculino , Enfermagem Oncológica/métodos , Neoplasias da Próstata/enfermagem , Neoplasias da Próstata/fisiopatologia , Neoplasias da Próstata/psicologia , Qualidade de Vida/psicologia , RadiobiologiaRESUMO
OBJECTIVES: Staging of extra-prostatic prostate cancer has traditionally been assessed by computerised tomography (CT), bone scan, and where indicated, pelvic lymph node dissection at the time of surgery. The advent of the prostate-specific membrane antigen (PSMA) positron emission tomography (PET) scan shows promise in improving the accuracy of preoperative staging of this cancer. The role of pelvic lymph node dissection and its associated morbidity will be examined. This article will review current literature assessing the current role of PSMA PET and lymph node dissection in the staging and treatment of prostate cancer. DATA SOURCES: Peer-reviewed literature and databases, including Medline and PubMed. CONCLUSIONS: PSMA PET/CT appears to be a promising and superior staging investigation that may replace bone scan and CT scan in guiding treatment decision-making. It has high specificity and positive predictive value, thus in patients with low-risk prostate cancer, unnecessary extended pelvic lymph node dissection (ePLND) may be avoided. It would also help detect lymph nodes in patients with intermediate- or high-risk prostate cancer where ePLND may be required. ePLND remains the gold standard in staging high-risk patients because the PSMA PET/CT scan may under-stage the cancer. IMPLICATION FOR NURSING PRACTICE: Given the increased utilisation of PSMA PET/CT scan as a primary staging investigation in clinical practice for prostate cancer and as an alternative to bone scan and CT scan, it is timely for prostate cancer specialist nurses to understand and recognise the specificity and sensitivity of PSMA PET/CT scans in prostate cancer staging. Because ePLND is the gold standard for staging high-risk disease, prostate cancer specialist nurses should be aware of the complications associated with pelvic lymph node dissection to optimise supportive care for men affected by complications from ePLND.
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Excisão de Linfonodo/métodos , Metástase Linfática/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Neoplasias da Próstata/diagnóstico por imagem , Humanos , Masculino , Estadiamento de Neoplasias , Enfermagem Oncológica , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/efeitos adversos , Neoplasias da Próstata/enfermagem , Neoplasias da Próstata/cirurgia , Sensibilidade e EspecificidadeRESUMO
PURPOSE: To identify barriers and corresponding solutions for implementing a telephone-based, nurse-led supportive care intervention for men with advanced prostate cancer. PARTICIPANTS & SETTING: 21 healthcare professionals with an average 15.81 years of experience in diverse prostate cancer care settings. METHODOLOGIC APPROACH: Data from semistructured interviews were coded into the Theoretical Domains Framework and mapped to behavior change techniques (BCTs) to inform the development of an implementation schema. FINDINGS: Barriers included lack of knowledge about the effectiveness of survivorship interventions and how to deliver them, low referral rates to psychosocial oncology care, low help-seeking behavior among men with advanced prostate cancer, lack of care coordination skills, and inadequate service capacity. IMPLICATIONS FOR NURSING: Interprofessional support exists for a nurse-led supportive care intervention. Causes of low engagement with supportive care among men with advanced prostate cancer extend beyond gendered patterns of response.
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Terapia Comportamental/métodos , Pessoal de Saúde/psicologia , Relações Enfermeiro-Paciente , Enfermagem Oncológica/métodos , Neoplasias da Próstata/enfermagem , Neoplasias da Próstata/psicologia , Apoio Social , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Austrália , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa QualitativaRESUMO
BACKGROUND: There are multiple options for men diagnosed with localized prostate cancer. Patient decision aids (PtDAs) help empower individuals and reduce unwarranted practice variation, but few are used in clinical practice. OBJECTIVE: We compared 2 programs implementing PtDAs for men with localized prostate cancer. METHODS: This was a comparative case study. Case 1 was a hospital prostate pathway and case 2 was a provincial prostate pathway with 2 locations (2a, 2b). Nurses provided the men with PtDAs and answered questions. Data sources were as follows: (a) 2 years administrative data for men with localized prostate cancer, (b) clinicians survey and interviews, and (c) patients/spouses interviews. Analysis was within and across cases. RESULTS: The PtDA was used with 23% of men in case 1 (95% confidence interval, 19.8%-26.1%) and 98% of men in case 2a (95% confidence interval, 96.5%-99.8%). The pathway was not implemented in case 2b. Men given the PtDA had positive experiences. Many clinicians supported the use of PtDAs, some adapted their discussions with patients, and others did not support the use of PtDAs. To increase use in case 1, participants identified needing a Canadian PtDA available electronically and endorsed by all clinicians. In case 2b, the provincial prostate pathway needed to be implemented. CONCLUSIONS: There was variable uptake of the PtDAs between the cases. Men who received the PtDA had positive outcomes. Several strategies were identified to increase or sustain PtDA use. IMPLICATIONS FOR PRACTICE: Nurses have a key role in supporting men making decisions about prostate cancer treatment by providing PtDAs, answering questions, and advocating for men's preferences.
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Técnicas de Apoio para a Decisão , Educação de Pacientes como Assunto/métodos , Participação do Paciente/psicologia , Neoplasias da Próstata/enfermagem , Canadá , Estudos de Casos e Controles , Tomada de Decisões , Humanos , Masculino , Pessoa de Meia-Idade , Estudos de Casos Organizacionais , Avaliação de Resultados da Assistência ao Paciente , Participação do Paciente/métodos , Neoplasias da Próstata/psicologiaRESUMO
AIMS & OBJECTIVES: To describe the prostate cancer survivorship experience and priorities from the perspective of prostate cancer specialist nurses. BACKGROUND: Specialist nurses are providing long-term survivorship care to men and their partners however, few prostate cancer survivorship interventions are effective and priorities for nurse-led survivorship care are poorly understood. DESIGN: A three-round modified Delphi approach. METHODS: The study was conducted between 1 December 2018 and 28 February 2019 to develop a consensus view from an expert nurse cohort (43 prostate cancer specialist nurses: 90% response). First, participants described men's prostate cancer survivorship experience and priorities for improving care for men and partners. In subsequent rounds, participants identified key descriptors of the survivorship experience; rated priorities for importance and feasibility; and identified a top priority action for men and for partners. Thematic analysis and descriptive statistics were applied. Guidelines for Reporting Reliability and Agreement Studies informed the conduct of the study. RESULTS: Prostate cancer specialist nurses characterised the prostate cancer survivorship experience of men as under-resourced, disjointed and distressing. In all, 11 survivorship priorities for men and three for partners were identified within five broad areas: capacity building; care coordination; physical and psychosocial care; community awareness and early detection; and palliative care. However, feasibility for individual items was frequently described as low. CONCLUSION: Internationally, prostate cancer survivorship care for men and their partners requires urgent action to meet future need and address gaps in capacity and care coordination. Low feasibility of survivorship priorities may reflect translational challenges related to capacity. Prostate cancer survivorship care guidelines connected to practice priorities are urgently needed. RELEVANCE TO CLINICAL PRACTICE: These findings address key gaps in the evidence for developing national nurse-led prostate cancer survivorship priorities. These priorities can be used to inform survivorship guidelines including nursing care for men with prostate cancer and their partners.
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Enfermagem Oncológica/organização & administração , Neoplasias da Próstata/enfermagem , Sobrevivência , Consenso , Técnica Delphi , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/organização & administração , Neoplasias da Próstata/psicologia , Parceiros Sexuais/psicologiaRESUMO
This article outlines the role of the clinical nurse specialist in establishing a Scotland-wide national designated service for prostate cryotherapy for patients with radiation-recurrent prostate cancer. The service was established in 2009 and provides prostate cryotherapy across Scotland. This article reviews and discusses the challenges involved in setting up a new service for tertiary treatment as well as highlighting the key achievements of the service. The challenges have included introducing the cryotherapy procedure in a safe and quality assured manner, developing and refining the referral process, educating both primary and secondary care teams on salvage prostate cryotherapy as a treatment modality and surgical procedure, as well as managing of complications following salvage prostate cryotherapy. The article also outlines the achievements of both the service and the treatment as well as how the service has developed since 2009.
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Crioterapia/enfermagem , Administração de Serviços de Saúde , Enfermeiros Clínicos , Papel do Profissional de Enfermagem , Neoplasias da Próstata/terapia , Humanos , Masculino , Neoplasias da Próstata/enfermagem , EscóciaRESUMO
AIMS AND OBJECTIVES: To investigate whether a symposium aimed at healthcare professionals in the uro-oncological field changes knowledge, competence and general practice regarding sexual dysfunction after prostate cancer treatment. BACKGROUND: Sexual dysfunction is not frequently discussed by healthcare professionals; lack of knowledge and training are two of the most often reported barriers. Provision of additional training could improve knowledge, competence and general practice of healthcare professionals. DESIGN: Two questionnaires were used in this pre-post study to determine knowledge, competence and general practice at the time of the symposium and six months afterwards. METHODS: In order to perform repeated measures to analyse alterations among participating healthcare professionals (n = 55), the McNemar's test was used. A STROBE checklist was completed. RESULTS: Seventy-three per cent (n = 40) stated that not enough attention was paid to prostate cancer-related sexual dysfunction during their education. Nurses felt significantly less competent in discussing sexual function, advising on sexual dysfunction and actively inquiring sexual complaints compared to other healthcare professionals. After the symposium, sexual dysfunction was significantly more often discussed. No significant effects were found on knowledge on sexual dysfunction, knowledge on treatment of sexual dysfunction, competence in discussing sexual function, advising on sexual dysfunction, actively inquiring sexual complaints and rate of referral. Tools needed to address sexual dysfunction concerned written information materials (75.5%) and a website containing adequate information (56.6%). CONCLUSIONS: The symposium had no significant influence on knowledge, competence and rate of referral in men with sexual dysfunction after prostate cancer treatment. However, sexual dysfunction was more frequently discussed after the symposium, so increase of awareness of consequences of prostate cancer treatment was achieved. RELEVANCE TO CLINICAL PRACTICE: Consequences of prostate cancer treatment to sexual function should be taken in consideration in daily practice; written information materials and a website containing adequate information were indicated as valuable resources to address sexual dysfunction in routine consultations.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Relações Enfermeiro-Paciente , Neoplasias da Próstata/enfermagem , Disfunções Sexuais Fisiológicas/enfermagem , Adulto , Atitude do Pessoal de Saúde , Medicina de Família e Comunidade , Feminino , Pessoal de Saúde/educação , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Neoplasias da Próstata/complicações , Disfunções Sexuais Fisiológicas/etiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Develop and validate an instrument to assess family resilience and, more specifically, the family dynamics and resources, estimating the adaptation flexibility to cancer disease. Cohesion, communication, coping style and relational style were considered as critical functional areas in the construction of the instrument. DESIGN: Two cross-sectional studies. Study 1: identification of factorial structure of the questionnaire in two samples with different cancer sites. Study 2: validation of the questionnaire in patients with cancer in two different phases of their therapeutic pathway. PARTICIPANTS AND SETTING: A total of 213 patients with a histologically confirmed non-metastatic breast or prostate cancer and 209 caregivers were recruited for the two studies from an oncological hospital in Italy. OUTCOME MEASURES: The Resilience Scale for Adults and the Family Resilience (FaRE) Questionnaire, developed by the researchers, were administered to all patients and caregivers who gave consent. RESULTS: In study 1, the 60-item version of the FaRE Questionnaire underwent discriminant and construct validity, internal consistency and factorial analysis. Comparisons between patient and caregiver populations showed that patients perceived higher levels of family resources (p=0.048) and that patients with prostate cancer perceived less social support compared with patients with breast cancer (p=0.002). Factor analysis demonstrated four domains: communication and cohesion, perceived social support, perceived family coping, and religiousness and spirituality. In study 2, the validity and factorial structure of the final scale, composed of 24 items, were confirmed. The Cronbach alpha of all subscales was above 82. Normative values for patients with breast cancer can provide indications of family resilience levels. CONCLUSIONS: Preliminary findings showed acceptable psychometric properties for the FaRE Questionnaire to evaluate family resilience in oncological patients and their caregivers. Further research should test its sensibility to change to assess its use as a psychoemotional monitoring tool and its validity in other medical contexts.