Searching for a harmonious survival: the experience of quality of life of urological cancer survivors.

PURPOSE: This study aimed to analyze the experience of quality of life for urological cancer survivors. METHODS: This is a qualitative narrative research based on the experience-centered approach. Twenty-one semi-structured face-to-face interviews were conducted with 12 survivors of urological cancer at different survival seasons. Participants were recruited from the convenience sampling. The thematic analysis approach was used to analyze the data. The findings are presented as narrative syntheses. The standards for reporting qualitative research (SPQR) were used in this study. RESULTS: Two narrative syntheses were constructed: (1) Rupture in the different dimensions of QoL; and (2) QoL: Searching for a harmonious survival, each presenting their respective sub-themes. After the rupture in the different dimensions of QoL, the survivors resigned themselves and searched for a harmonious survival despite the physical, social, and psychological changes imposed by cancer treatments. Survivors achieved a new meaning of QoL with the support of family, hope, and spirituality. CONCLUSIONS: The results highlight the changes experienced by survivors in different dimensions of QoL and the search for harmonious survival. Based on QoL experience reported in this study, health professionals can plan survival care and interventions that mitigate the consequences of treatment on QoL.

The experience of health-related quality of life in extended and permanent cancer survivors: A qualitative systematic review.

OBJECTIVE: This qualitative systematic review aims to synthesize qualitative evidence from primary studies on experiencing health-related quality of life (HRQoL) in extended and permanent cancer survivors. METHODS: A systematic literature search was performed in PubMed, CINAHL, LILACS, PsycINFO, Scopus, and Web of Science. It followed guidelines from the statement in the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). A quality appraisal of each study was undertaken using the Critical Appraisal Skills Programme. Data synthesis was conducted according to the thematic synthesis approach. Confidence in each review finding was assessed using the Confidence in the Evidence from Reviews of Qualitative research (Grade-CERQual). RESULTS: Twenty-four studies from nine countries were selected for the final sample. Analysis of the studies' results allowed for the construction of nine descriptive themes that were interpreted into three analytical themes: "The body as a representation of HRQoL," "Living through and beyond cancer: the re-signification of HRQoL," and "Employing resources to improve HRQoL." According to the CERQual approach, moderate confidence estimations were achieved for the results. CONCLUSIONS: The themes reflect that the HRQoL experience is re-signified by survivors from the privilege of being alive. This process happens with the support of social resources, family, hope, and spirituality. Based on the findings, it is suggested that health staff should be able to recognize the impact that cancer survival has on HRQoL and develop a care plan that addresses needs to sustain health in these survivors.

Concept analysis of cancer survivorship and contributions to oncological nursing.

AIM: This study aims to analyse the concept of cancer survivorship using Rodgers' evolutionary concept analysis model. BACKGROUND: The lack of a consensus definition as well as the confusion and debate concerning the definitions of "survivor" and "cancer survivorship" hinder an understanding of the intrinsic needs associated with the latter. DESIGN: Concept analysis. METHOD: A systematic literature search was performed using the following databases: PubMed, CINAHL, Web of Science, LILACS, and PsycINFO with studies published between 2000 and 2014. The final sample contained 39 studies that were analysed on the basis of Rodgers' model and inductive thematic analysis, discussed through the lens of the medical anthropology concept of culture. FINDINGS: Cancer survivorship is a broad concept that can be understood using 8 themes: changes in life plans, positive and negative aspect dualities, life reflections, identity change, individual experiences, symptom control, the need for support, and quality of care. These themes are summarized using 2 attributes: liminality process and culturally congruent care. CONCLUSIONS: This article contributes to understanding of cancer survivorship and the processes that are intrinsic to this concept. It calls for future investigations to enhance cancer survivorship across its 2 domains at the personal (patient's life) and clinical (nursing practice) levels.

Paradox of life among survivors of bladder cancer and treatments.

OBJECTIVE: To interpret the meanings attributed to the experience of bladder cancer among survivors in therapeutic follow-up. METHOD: Qualitative methodological approach, based on medical anthropology and narrative methodology. After approval by the research ethics committee of a public university hospital, data were collected from January 2014 to February 2015, by means of recorded semi-structured interviews, direct observation and field journal entries on daily immersion with a group of six men and six women, aged between 57 and 82 years, in therapeutic follow-up. Narratives were analyzed by means of inductive thematic analysis. RESULTS: The meanings revealed difficulties with the processes of disease and treatment, such as breakdown of normal life, uncertainty about the future due to possible recurrence of the disease, difficulty with continuity of care and emotional control, relating it to conflicting ways of understanding the present life. Thus, the meaning of this narrative synthesis is paradox. CONCLUSION: Interpretation of the meaning of experience with bladder cancer among patients provides nurses with a comprehensive view of care, which encompasses biological, psychological and social dimensions, and thereby systematizes humanized care. OBJETIVO: Interpretar o significado atribuído à experiência do câncer de bexiga entre sobreviventes em seguimento terapêutico. MÉTODO: Empregou-se a abordagem metodológica qualitativa, embasado pela antropologia médica e método narrativo. Após aprovação do Comitê de Ética, os dados foram coletados de janeiro 2014 a fevereiro de 2015, por meio de entrevistas semiestruturadas gravadas, observação direta e registros no diário de imersão com grupo de seis homens e seis mulheres, entre 57 e 82 anos, em seguimento terapêutico em um hospital público universitário. As narrativas foram analisadas por meio da análise temática indutiva. RESULTADOS: Os sentidos revelam as dificuldades com o processo da doença e do tratamento, como rupturas na vida, futuro incerto pela possibilidade de recidiva da doença, continuidade do tratamento e controle emocional, relacionando-se com as ponderações contraditórias da vida atual. Assim, o significado desta síntese narrativa é de paradoxo. CONCLUSÃO: A interpretação do significado da experiência com câncer de bexiga entre os adoecidos permite ao enfermeiro um olhar integralizado do cuidado que perpasse as dimensões biopsicossociais dos adoecidos e, com isso, sistematize a assistência de maneira humanizada.

Use of alcohol and other drugs among male university students and its meanings.

OBJECTIVE: To understand the meanings that male university students assign to the condition of users of alcohol and other drugs. METHOD: An exploratory study using a qualitative approach, with inductive analysis of the content of semi-structured interviews applied to 20 male university students from a public university in the southeast region of Brazil, grounded on the theoretical-methodological referential of interpretive anthropology and ethnographic method. RESULTS: Data were construed using content inductive analysis for two topics: use of alcohol and/or drugs as an outlet; and use of alcohol and/or other drugs: an alternative for belonging and identity. CONCLUSION: Male university students share the rules of their sociocultural environment that values the use of alcohol and/or other drugs as a way of dealing with the demands and stress ensuing from the everyday university life, and to build identity and belong to this social context, reinforcing the influence of culture. OBJETIVO: Compreender os significados atribuídos pelos universitários do sexo masculino à condição de usuários de álcool e outras drogas. MÉTODO: Estudo exploratório de abordagem qualitativa, com análise de conteúdo indutiva de entrevistas semiestruturadas de 20 universitários do sexo masculino, matriculados em uma universidade pública da região sudeste do Brasil, fundamentado no referencial teórico-metodológico da Antropologia Interpretativa e do método etnográfico. RESULTADOS: Os dados foram interpretados com a análise de conteúdo indutiva em dois temas: O uso do álcool e/ou drogas como válvula de escape; O uso do álcool e/ou outras drogas: alternativa para o pertencimento e para a identidade. CONCLUSÃO: Os universitários do sexo masculino compartilham normas de seu meio sociocultural, que valorizam o uso de álcool e/ou outras drogas, como uma forma de lidar com as exigências e o estresse da vida universitária, criar uma identidade e ter pertencimento neste contexto social, reforçando a influência da cultura.

[Chemotherapy-induced peripheral neuropathies: an integrative review of the literature]. / Neuropatia periférica induzida pela quimioterapia: revisão integrativa da literature.

OBJECTIVE: To identify scientific studies and to deepen the knowledge of peripheral neuropathies induced by chemotherapy antineoplastic, seeking evidence for assistance to cancer patients. METHOD: Integrative review of the literature conducted in the databases Latin American and Caribbean Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), Medical Literature Analysis (PubMed/MEDLINE), the Cochrane Library and the Spanish Bibliographic Index Health Sciences (IBECS). RESULTS: The sample consisted of 15 studies published between 2005-2014 that met the inclusion criteria. Studies showed aspects related to advanced age, main symptoms of neuropathy and chemotherapy agents as important adverse effect of neuropathy. CONCLUSION: We identified a small number of studies that addressed the topic, as well as low production of evidence related to interventions with positive results. It is considered important to develop new studies proposed for the prevention and/or treatment, enabling adjustment of the patient's cancer chemotherapy and consequently better service.

Photoeducation and photoprotection among liver transplant candidates: a cross-sectional study.

The incidence of skin cancer after liver transplant ranges from 3% to 16%, considerably higher than that observed in the general population. Skin cancer causes 25% of deaths in patients who have survived more than 3 years after liver transplant. The objective of this study was to identify differences regarding the level of sun exposure, knowledge of potential risk factors, and photoprotection measures among liver transplant candidates and recipients. We carried out a prospective cross-sectional study with 100 patients enrolled at a liver transplant program in a Brazilian center. The patients were interviewed and received oral information regarding skin care and sun exposure. Results reveal that measures of photoprotection and photoeducation are more prevalent among recipients than among candidates. High degrees of solar exposure were observed more frequently among candidates, although recipients showed better knowledge about the risks of sun exposure. Educational actions concerning skin cancer prevention should be part of the guidelines given by the multidisciplinary team to the liver transplant patients, in particular, by the nursing team.

Depression, fatigue, and health-related quality of life in head and neck cancer patients: a prospective pilot study.

PURPOSE: To assess the prevalence of depression and fatigue symptoms in head and neck cancer patients during radiotherapy treatment and relate them symptoms with these patients' quality of life. METHOD: This is a prospective study. The Beck Depression Inventory (BDI), Piper Fatigue Scale-revised and Functional Assessment Cancer Therapy Head and Neck (FACT-H&N) were applied to 41 head and neck cancer patients at three times: at the start of treatment (T1), approximately 15 days after the start of treatment (T2) and at the end of treatment (T3), approximately 30 days after the start of the radiotherapy. RESULTS: The mean BDI and PIPER increased during the radiotherapy treatment. BDI scores did not demonstrate the presence of depression, although the number of symptoms increased, and the presence of fatigue rose as treatment advanced. The mean FACT H&N decreased in the middle and at the end of treatment, indicating worsening in these patients' Quality of Life. CONCLUSIONS: Depression and fatigue symptoms increased during radiotherapy treatment, while QoL levels decreased. This demonstrates that these symptoms are strongly correlated and that their presence negatively influenced QoL. At the start of treatment, nurses need to advise patients and plan care, offering interventions to decrease these symptoms and improve QoL.

[Cancer patients' knowledge about their legal rights]. / O conhecimento dos pacientes com câncer sobre seus direitos legais.

The study objectives were: to survey the knowledge that oncology patients have about their legal rights, to identify the most known rights, and verify their knowledge about the procedure for requesting it. A survey was performed applying a checklist instrument during an interview. Participants were 42 oncology patients who were undergoing chemotherapy and their relatives. Of all participants, 57% were female; 28% were between 61 and 70 years old; 62% had completed only primary education; 72% were married; 50% had a family income of 2.6 minimum salaries. 45% were unaware of the benefits; among the existing benefits, retirement was recognized by 23%; 33% stated the medical record as the most important document; 38% had access to the information through the media; 23% had not requested any benefits and 31% reported obtaining some kind of benefit. In conclusion, nurses should work effectively to disseminate the patients' rights, so that benefits are guaranteed and their condition as citizens is respected.

"What I was and what I am": A qualitative study of survivors' experience of urological cancer.

PURPOSE: Most qualitative studies do not explore experience throughout the urologic cancer survival trajectory. Moreover, the evidence of the experience of cancer survivors that focuses on the contextual aspects of culture is scarce in oncology literature. This study aimed to analyze the survival experience of urological cancer from the perspective of men. METHOD: This was a narrative research based on the concepts of culture derived from the interpretative medical anthropologic approach. Semi-structured interviews were conducted with 10 male survivors of urological cancer at different survival seasons. Seven participants agreed to a second interview, which resulted in 17 interviews. The data were analyzed using a five-phase thematic analysis approach. The findings are presented as narrative syntheses. The standards for reporting qualitative research (SPQR) was used in this study. RESULTS: Two narrative syntheses were constructed: "The journey of urological cancer: discovering oneself as a survivor" and "What I was and what I am today": the disruption on the body and life. The narrative synthesis shows that survivors undergo transitions of identity from being healthy men to wrecked men. The survivors tried to present themselves as normal men to keep their masculinity intact. However, the experience of survival constituted a process of liminality and biographical disruption. CONCLUSION: The experience of surviving urological cancer has highlighted the physical, emotional, and social challenges experienced by these male survivors. It is recommended to oncology nurses that nursing care should be planned along survival seasons considering the survivors' individual and subjective experiences.

Explanatory models of families of children with type 1 diabetes mellitus.

OBJECTIVES: to analyze how children with type 1 diabetes mellitus and their families explain the pathology, based on their understanding of the factors related to the discovery of diabetes, the etiology, treatment, and prognosis of the disease. METHODS: qualitative methodological approach, based on medical anthropology and the narrative method. In-depth interviews were conducted with 12 families of children with type 1 diabetes mellitus attending follow-up consultations at a specialized center. The statements were subjected to inductive thematic analysis. RESULTS: the explanatory models identified describe the families search for the clarification of the signs and symptoms that the child had. Faced with the disease, families reorganized themselves to meet new health care needs of children, such as adequate nutrition, physical exercise, and blood glucose monitoring. Final Considerations: knowing the explanatory models allows the understanding of how families give meaning to the child's illness, favoring daily nursing care and an effective control of the disease.

The meaning of being a man with intestinal stoma due to colorectal cancer: an anthropological approach to masculinities.

This study analyzes the meanings that men with intestinal stoma attribute to their colorectal cancer experience and its treatment. The medical anthropology framework, gender identity and the ethnographic methods were used. A total of 16 men from 40 to 79 years of age, residents in Ribeirão Preto and neighboring cities, SP, Brazil participated in the study. Data collection was carried out through participant observation and semi-structured interviews. Two groups of meanings were selected through inductive data analysis: acknowledging the severity of the disease and the distress of having cancer, and being submitted to surgery and suffering from a stoma. These meanings revealed the tension that develops between traditional patterns of masculinity and the new identities resulting from the experience. The understanding of these meanings from a cultural perspective favors nurse-patient communication and enables planning of care appropriate to these patients' needs.

Quality of sleep in postoperative surgical oncologic patients.

This study aimed to evaluate surgical-oncologic patients' quality of sleep through the Pittsburgh Sleep Quality Index (PSQI) questionnaire. It is an exploratory study with transversal-observational design, in 46 postoperative head & neck and urology cancer patients. The PSQI questionnaire was used to evaluate the subjective quality of sleep and the occurrence of sleep disorders. Six PSQI components were statistically significant and 78.3% of the interviewees had impaired subjective quality of sleep. Among factors leading to sleep disorders we point out: taking too long to fall asleep; waking up in the middle of the night; getting up to go to the bathroom and napping during the day. This study is expected to sensitize the nursing team regarding the need to investigate quality of sleep and causes of its disorders in cancer survivors for an effective course of action.

[Quality of life evaluation in cancer patients to submitted to chemotherapy]. / Avaliação da qualidade de vida de pacientes com câncer submetidos à quimioterapia.

This descriptive and cross-sectional study aimed to assess the Quality of Life (QoL) of cancer patients who were receiving chemotherapy. The instrument European Organization for Research and Treatment of Cancer--Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) was used for data collection. The sample consisted of 30 patients who signed the informed consent term. Data were analyzed in SPSS software. The QLQ-C30 showed that, for physical, cognitive and social functions, and role performance mean scores ranged from 71.26 to 75.12, demonstrating a satisfactory level. In the emotional function, the mean score was low (55.46). On the symptoms scales, there were a predominance of insomnia, with a mean score of 34.44, followed by pain 23.33 and fatigue 22.31. The QoL was satisfactory in all domains except for the emotional function, which scored low demonstrating that the collateral effects of chemotherapy exert a negative influence on patients' quality of life.

Masculinities of prostate cancer survivors: a qualitative metasynthesis.

OBJECTIVE: To identify the production of knowledge in the health literature about masculinities in the context of prostate cancer survivors and to analyze the implications of this relationship for the maintenance of health care. METHOD: Metasynthesis of 21 qualitative studies, performed in the LILACS, MEDLINE and CINAHL databases, with the scientific descriptors of DeCS and MeSH terms masculinity, prostate neoplasms. RESULTS: Illness due to prostate cancer imposes numerous changes in male relationships, especially the non-dominance of the body and vulnerability to treatments and their consequences. The cultural values surrounding the disease and the hegemonic behaviors have implications for the health care of men. CONCLUSION: It has been shown that this relationship makes it difficult to communicate about the disease, marital relationships and family support, mainly influencing neglect of health. The knowledge produced is useful to promote the engagement of men in strengthening care.

Embodied hegemonies: moral dilemmas in the onset of prostate cancer. / Hegemonias corporificadas: dilemas morais no adoecimento pelo câncer de próstata.

OBJECTIVE: To interpret the meaning attributed to men's experience regarding their body during the development of prostate cancer. METHOD: Ethnographic study carried out with men and guided by the narrative method and the theoretical frameworks of medical anthropology and the anthropology of masculinities. Information was obtained through recorded interviews, direct observation, and logs from a field journal, which were examined using inductive thematic analysis. RESULTS: Seventeen men participated in the study. During the process of falling ill with prostate cancer, the male bodies were ruled by moral experiences that influenced the way men conducted their relationship with their health and multifaceted masculinity, standing for hegemonic cultural principles and identity affirmation moral dilemmas, which were interpreted with the meaning of embodiment. CONCLUSION: During the development of the disease, men experience bodily, social, and moral dilemmas that threaten the hegemonic masculinity. Understanding them can help professionals deal with this population.

Transitory masculinities in the context of being sick with prostate cancer.

OBJECTIVE: to interpret the meanings attributed by men with prostate cancer to the experience regarding their bodies and masculinities during illness. METHOD: ethnographic research with 17 men, guided by the narrative method and theoretical framework of medical anthropology and masculinities. The information was collected through recorded interviews, direct observation and field diary records, which were analyzed by inductive thematic analysis. RESULTS: men undergo body and identity transformations when they get sick with prostate cancer, transiting through multiple masculinities, resigning their actions, and occupying subordinate positions in relation to other healthy bodies, which are marginalized in their social relationships and allied with regard to establishing their affective relationships. CONCLUSION: this evidence enhances and deepens the knowledge disclosed in the literature and contributes to the strengthening of nursing care actions when dealing with the sick.

The oncologic radiotherapy experience for patients: a poison-drug.

The study aimed at understanding the patients' experience with oncologic radiotherapy. The anthropological interpretative approach and the ethnographic method guided the investigation. Ten patients took part in the study. They were of both genders, within the age range from 34 to 80 years old and monitored during radiotherapy treatment. Data were collected through semi-structured interviews, participative observation and medical records. The analysis of the respondents' statements allowed for the identification of the units of meaning: The encounter with radiotherapy, the body as a vehicle for radiotherapy action and alternative healthcare practices that relieved the effects of the treatment. We understand that the oncologic radiotherapy experience meant the need to submit to a therapy with a characteristic of a poison-drug, which causes fear, but was necessary, whether the goal was cure or even cancer survival.

Patient, cured, victim or survivor of urological cancer? A qualitative study.

PURPOSE: to describe the meanings that patients attribute to the term cancer survivor and to analyze the identities assumed by them according to their experience with the disease. METHODS: qualitative study with a narrative method, theoretical framework of the medical anthropology and identity concept. The study included 14 participants, men and women, diagnosed with urologic cancer. The semi-structured interviews were performed at the individual's home, after confirming participation. RESULTS: eight participants assumed to be survivors, but five also assumed at least one other identity, in addition to cancer survivor. In contrast, among the six who defined themselves as cured, only one indicated another identity. Four considered themselves as victims and only two as cancer patients. However, the latter - cancer patient and victim - assumed at least one other associated identity. CONCLUSIONS: allowing patients to reflect on themselves and their experience with the disease, as well as attributing themselves a new identity, will be directly related to the wellbeing and momentum the survivor is going through. Therefore, it can direct care in the cancer survivorship phase according to each survivor's individual context.

Care provided by the father to the child with cancer under the influence of masculinities: qualitative meta-synthesis.

OBJECTIVE: To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. METHOD: Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. RESULTS: Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. FINAL CONSIDERATIONS: The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.