Patients' perceived challenges, competencies, and supportive care needs during acute clinical treatment of breast or gynecological cancer.

OBJECTIVE: This study aimed to examine challenges, competencies, and supportive care needs (SCN) of women with breast or gynecological cancer during acute cancer treatment and associations to other health-related variables. METHODS: We surveyed 120 patients with breast or gynecological cancer at the end of acute cancer treatment, either directly after surgery or during adjuvant chemotherapy. We assessed challenges, subjective competencies, and SCN using a self-developed measure comprising 25 items referring to coping tasks assigned to six domains. In addition, patients' competencies and health literacy (HL) were assessed. RESULTS: Most patients felt at least moderately challenged by coping tasks concerning psychological distress (e.g., dealing with fears and insecurities, 70.2%; coping with cancer diagnosis, 69.6%) and physical complaints (e.g., dealing with a reduced physical capacity, 56.6%). About 42.5%-71.4% of patients who evaluated coping tasks as highly challenging felt competent to deal with these challenges themselves. Less than half of patients reported SCN, mainly regarding psychological concerns. The extent of challenging coping tasks, patients' perceived ability to overcome challenges themselves, and SCN showed associations to patient competencies and HL. CONCLUSIONS: SCN regarding psychological concerns and health behavior should be addressed in acute cancer care and rehabilitation programs. In addition, promoting HL might be essential in strengthening patients' subjective competencies related to various coping tasks.

[Patient Competence for Coping with Disease - A Qualitative Analysis in Women with Breast and Gynaecological Cancer]. / Patientenkompetenz zur Krankheitsbewältigung ­ Eine qualitative Analyse bei Frauen mit Brustkrebs und gynäkologischen Tumoren.

OBJECTIVE: The study explores challenges, competencies, and helpful support in coping with the disease of patients with breast cancer and gynaecological cancer and how patient competence as an interaction of these factors might be promoted. METHODS: Semi-structured interviews were conducted with 19 patients in acute care, 20 patients undergoing rehabilitation, and 16 participants in a self-help group and evaluated using qualitative content analysis. RESULTS: The challenges are summarised in the main categories - diagnosis processing, treatment/recurrence fears, illness processing and adaptation, worries about relatives, reactions of the social environment, and worries about the workplace. The named personal competencies in dealing with these challenges were assigned to the following main categories: cognition-related coping, action-related coping, self-regulation illness processing, obtaining and accepting support, self-determined communication of the illness, identifying and applying helpful strategies, illness-related experience, favourable life circumstances, openness to offers of help. Helpful emotional, informational or instrumental support is perceived by relatives, friends, animals, colleagues/employers, treatment providers, rehabilitation, fellow patients, self-help, and counselling facilities. DISCUSSION: The women describe a variety of competencies, which corresponds to a needs-oriented, self-directed coping process. The individuality and complexity of the interaction of the components of patient competence underline the relevance of patient-oriented care. Empowerment and an active patient role are necessary to promote their coping skills according to their needs. Support from practitioners or the private environment can reduce challenges or promote competencies and application.

Patients' challenges, competencies, and perceived support in dealing with information needs - A qualitative analysis in patients with breast and gynecological cancer.

OBJECTIVES: This study aimed to investigate challenges, competencies, and support in breast and gynecological cancer patients when dealing with information needs and how health literacy as an interplay of these factors might be improved. METHODS: Semi-structured interviews were conducted with patients in acute care (n = 19), undergoing rehabilitation (n = 20) or attending self-help groups (n = 16). Interviews were analyzed using content analysis. RESULTS: Challenges: gain information according to own needs, internet as information source, information evaluation and decisions, doctor-patient communication, situationally limited information processing, difficult access to information. Competencies: self-regulation of information needs, media and social competencies, communication skills in the doctor-patient conversation, internet competencies, self-directed decisions according to own needs, interest/self-efficacy, previous knowledge, trust in the doctor. SUPPORT: by professionals (e.g., patient-centered communication), relatives (e.g., support during consultations), peers (e.g., exchange), facilities (e.g., clinics). CONCLUSIONS: Our findings provide insight into challenges and competencies relevant to patients' health literacy and the influence of support. The individuality of the interplay highlights the relevance of an active patient role and patient-centered care. PRACTICE IMPLICATIONS: Patients' health literacy should be improved in (psycho)oncological work by both reducing challenges (e.g., by communication skills training, involving relatives) and promoting competencies (e.g., by needs- and competence-oriented information offers).