[Chat-based cancer counseling in Switzerland: A reflexive thematic analysis of chat protocols focused on cancer survivors' needs]. / Chat-basierte Krebsberatung in der Schweiz.

Chat-based cancer counseling in Switzerland: A reflexive thematic analysis of chat protocols focused on cancer survivors' needs Abstract: Background: The number of people diagnosed with cancer and continue to live as cancer survivors is growing. Together with their relatives, they have information and counseling needs during the illness trajectory. With Cancerline, the Swiss Cancer League offers a chat-based counseling service for cancer survivors. Research question/objective: For the first time, the qualitative study investigated which needs cancer survivors express in Cancerline to gain insights for the further development and quality assurance of chat-based cancer counseling. Methods: Based on the principles of Interpretive Description, 669 chat counseling transcripts were analyzed using Braun et al. (2018) reflexive thematic analysis in an iterative process in six analysis steps. Results: Cancer survivorship needs in Cancerline are multifaceted, and we have identified nine themes: need anonymous chat to communicate, get informed, weigh ethical dilemmas and make decisions, seek meaning and hope, find ways to manage burdensome emotions, resolve social conflict and not burden others, feel understood and give space to own needs, clarify role as significant other acting correctly and seeking security. Conclusions: Chat-based counseling may contribute to supporting cancer survivors with information needs about cancer in a flexible way that is close to everyday life. Professionals can sensitize survivors to chat-based counseling, which makes low-threshold counseling accessible.

Who to Talk to About my Pain? A Brief Qualitative Study on Perception of Pain and its Management in Swiss Nursing Home Residents.

BACKGROUND: The prevalence of pain in nursing home (NH) residents is high. Insufficiently treated pain reduces quality of life and often leads to negative health consequences. Pain experience in older people can be influenced by physical, psychosocial, emotional, and spiritual factors. AIMS: To inform development of NH pain management interventions, we studied residents' pain related perceptions and needs. DESIGN: This was a qualitative descriptive substudy (embedded in ProQuaS, a larger pain project). SETTINGS: Three Swiss NHs. PARTICIPANTS/SUBJECTS: A purposeful sample of eight NH residents with severe pain and no severe cognitive impairment, based on information from the Minimum Data Set. METHODS: Eight semistructured interviews were conducted between October and December 2016. The audio-recorded interviews were transcribed verbatim and analyzed inductively using thematic analysis. RESULTS: Three central themes were identified from the interview data: dealing with major life changes, managing pain, and using formal care. The interviews highlighted the multidimensionality of pain experience in NH residents. In complex pain situations, participants perceived that care workers did not respond adequately to their needs. They had learned to cope with their pain using self-developed strategies and direct consultations with their physicians. CONCLUSIONS: The perceived lack of responsiveness may prompt NH residents to bypass care workers with their pain management concerns. This study's findings will inform the development of an educational intervention for NH care workers.

Selbstmanagement bei Krebstherapien fördern: Das Symptom-Navi-Programm.

Support self-management of symptoms in cancer therapies:The Symptom-Navi-Program Abstract. Background: Cancer patients experience a variety of symptoms associated with their disease and treatment. Many patients express uncertainty how to self-manage these symptoms. We developed the Symptom-Navi-Program (SNP) to support cancer patients' symptom self-management. The SNP comprises concise information leaflets, Symptom-Navi-Flyers (SNF), with content tailored to the needs of patients and nurse-led semi-structured consultations. AIM: The aim of the study was to to explore if patients experienced with the SNP with a focus on the perceived usefulness. METHOD: In a qualitative study, we conducted ten semi-structured interviews with cancer patients undergoing treatment. The interviews conduct and data analysis was based on thematic analysis as defined by 1-2Braun and Clarke (2006). RESULTS: Overall, patients described the SNP as a helpful facilitator for their self-management of symptoms. They highlighted its usefulness in an emotionally challenging situation. Nurse-led education and SNF tailored to the individual situation were experienced as self-management empowering elements. Consequently, patients experienced to know and have more choices in their symptom management strategies. Patients also described to use SNF to inform their relatives. CONCLUSIONS: Patients experience the SNP as a promising tool to facilitate their symptom self-management. Its implementation in clinical practice will now be further evaluated.

Introducing the chronic disease self-management program in Switzerland and other German-speaking countries: findings of a cross-border adaptation using a multiple-methods approach.

BACKGROUND: Stanford's Chronic Disease Self-Management Program (CDSMP) stands out as having a large evidence-base and being broadly disseminated across various countries. To date, neither evidence nor practice exists of its systematic adaptation into a German-speaking context. The objective of this paper is to describe the systematic German adaptation and implementation process of the CDSMP (2010-2014), report the language-specific adaptation of Franco-Canadian CDSMP for the French-speaking part of Switzerland and report findings from the initial evaluation process. METHODS: Multiple research methods were integrated to explore the perspective of workshop attendees, combining a longitudinal quantitative survey with self-report questionnaires, qualitative focus groups, and interviews. The evaluation process was conducted in for both the German and French adapted versions to gain insights into participants' experiences in the program and to evaluate its impact. Perceived self-efficacy was measured using the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G). RESULTS: Two hundred seventy eight people attending 35 workshops in Switzerland and Austria participated in the study. The study participants were receptive to the program content, peer-led approach and found principal methods useful, yet the structured approach did not address all their needs or expectations. Both short and long-term impact on self-efficacy were observed following the workshop participation (albeit with a minor decrease at 6-months). Participants reported positive impacts on aspects of coping and self-care, but limited effects on healthcare service utilization. CONCLUSIONS: Our findings suggest that the process for cross-border adaptation was effective, and that the CDSMP can successfully be implemented in diverse healthcare and community settings. The adapted CDSMP can be considered an asset for supporting self-management in both German-and French-speaking central European countries. It could have meaningful, wide-ranging implications for chronic illness care and primary prevention and potentially tertiary prevention of chronic disease. Further investigations are needed to tailor the program for better access to vulnerable and disadvantaged groups who might benefit the most, in terms of facilitating their health literacy in chronic illness.

[Self-management support in chronic illness: history, concept and challenges]. / Selbstmanagementföderung bei chronischer Krankheit: Geschichte, Konzept und Herausforderungen.

Self-management in chronic illness has been discussed internationally for some time now. It has become increasingly important in German speaking countries as well. During the last years programs for self-management support have been developed with good progress. At the same time self-management has turned into a collective term. This article aims at clarifying terms and discussing aspects of definitions and concepts of self-management. Furthermore, it presents the tasks of self-management support and discusses needs for further discussion and action. The main focus of this article is on the importance of self-management support in dealing with chronic illness--one of the most important areas of its application.

[Acute postoperative confusion in heart surgery patients]. / Akute postoperative Verwirrtheit kardiochirurgischer Patienten.

Unlike other countries, Germany does not have data about the incidence of acute confusion following heart surgery. However, the occurrence of acute confusion does extend the hospitalization length by up to 13 days. Thus, this phenomenon is of high relevance for the health profession. This incidence study was performed with the goal to obtain exact information on the incidence rate of acute postoperative confusion after heart surgery (bypass and valve operations) through a multi-center evaluation. The data evaluation took place in the form of a convenient sample survey in three different German clinics specialized in heart surgery. The observation period lasted from the day of surgery up to the fifth postoperative day. In the context of this prospective cohort study, suitable study participants were all patients aged 18 or older who underwent heart surgery between February 1st and April 30th, 2000. At the end, 860 patients were included in the study. A total of 152 patients showed symptoms of acute confusion, meaning a total incidence of 17.4% (confidence interval 14-20%). The occurrence of this phenomenon was not symmetrical. A wide-spread occurrence could be observed particularly at night. Patients aged 81-91 were mainly affected, with an incidence of confusion of 43.5% in this group. The results confirm the clinical importance of this issue and require interdisciplinary approaches for solution.

Routines in medication management: the perspective of people with chronic conditions.

OBJECTIVE: To focus on the challenges and problems of medication management in everyday life experienced by people with chronic conditions, giving special attention to chronic illness trajectories. METHODS: Using a grounded theory approach, in-depth and follow-up interviews with 27 chronically ill people were conducted and analysed. RESULTS: From the perspective of people with chronic conditions, the main challenge in everyday medication management was to develop, maintain, and adjust routines. Routines were affected by the chronic illness trajectory and a variety of barriers. Developing and adjusting routines was further complicated by inadequate information and counselling, asymmetric relationships and communication with healthcare professionals, restrictive healthcare conditions, increasing complexities in medication regimens as well as healthcare professionals' lack of interest in the problems of chronically ill people balancing their chronic condition and medication regimen in everyday life. DISCUSSION: Chronically ill persons have to deal with numerous difficulties in everyday medication management on their own. They are often overwhelmed by problems related to both their medication regimen and their routines in medication (self-) management. Thus, they require individualized long-term self-management support. Future research should address the dynamic nature of chronic illness trajectories and focus on later phases of chronic conditions.