Impact of the "Looking after my health after cancer" peer-led active patient education program on cancer survivors and their caregivers: A qualitative study.

BACKGROUND: Cancer survival has doubled and is likely to continue increasing in the near future. Cancer survivors experience long-term adverse effects, with associated psychological changes, and often they have needs that are yet to be met. Recognizing the lack of continuity-of-care initiatives for cancer survivors and caregivers, Osakidetza Basque Health Service has started to implement through primary care a peer-led active patient education program called "Looking after my health after cancer". This study explores how cancer survivors and their caregivers rate the experience of participating in the program, to what extent the program helps them understand and address their unmet felt needs, and helps them improve their activation for self-care and self-management. METHODS: A qualitative exploratory phenomenological study was conducted using five focus groups: four with cancer survivors (n = 29) and caregivers (n = 2), and one with peer leaders (n = 7). Narrative content analysis was performed using the constant comparison method, facilitated by Atlas-ti software. Descriptive analysis of sociodemographic and clinical data was performed. The study was developed according to the Consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS: Five main themes emerged from the content analysis: 1) satisfaction with the program as a positive learning experience; 2) peer sharing and learning ("if they can, so can I"); 3) fears prior to attending the program; 4) becoming more aware of unmet felt needs and feeling understood in the "new normal"; and 5) a more positive view of their experience, helping them become active in self-care and empowered in the self-management of their condition. CONCLUSIONS: The peer education program has shown to have a positive impact on cancer survivors and caregivers. It is necessary to design, implement and evaluate interventions of this type to address unmet felt needs during cancer survivorship and improve their quality of life.

Co-Design and Validation of a Family Nursing Educational Intervention in Long-Term Cancer Survivorship Using Expert Judgement.

The number of cancer survivors is increasing exponentially thanks to early screening, treatment, and cancer care. One of the main challenges for healthcare systems and professionals is the care of cancer survivors and their families, as they have specific needs that are often unmet. Nursing students, as future healthcare professionals, need education to face these new health demands. They will need to develop specific competencies to help them care for and empower this emerging population. The aim of the study was to co-design and validate an educational intervention on long-term cancer survivorship for nursing, through a multidisciplinary panel of experts. Group interviews were conducted with a panel of 11 experts, including eight professionals from different backgrounds (oncology, cancer nursing, pharmacology, and education), a long-term cancer survivor, a family member of a cancer survivor, and a nursing student. The experts validated a pioneer educational intervention to train nursing students in long-term cancer survival. The co-design and validation of the intervention from an interdisciplinary perspective and with the participation of long-term cancer survivors and their families was considered relevant as it included the vision of all the stakeholders involved in long-term cancer survivorship.

Differences in Quality of Life and Emotional Well-being in Breast, Colon, and Lung Cancer Patients During Outpatient Adjuvant Chemotherapy: A Longitudinal Study.

BACKGROUND: Adjuvant chemotherapy used at each cancer site may affect quality of life (QoL) and emotional well-being (affect) of cancer patients differently; however, these differences between groups have not been studied. OBJECTIVES: The aim of this study was to assess differences in QoL and affect by cancer site at the start of outpatient adjuvant chemotherapy, whether QoL and affect change during this treatment, and whether adverse effects influence these variables. METHODS: A multicenter longitudinal descriptive study was conducted with 247 participants with breast, colon, or lung cancer at the beginning (T1) and end of treatment (T2). We used the SF-12 Health Survey, Positive and Negative Affect Scale, and an "ad hoc" adverse effects questionnaire. RESULTS: At the start of chemotherapy, the lung group had poorer Physical Component Summary and poorer positive and negative affect ( P < .05) scores. In the end-of-treatment comparisons, breast and colon cancer patients' status had worsened, whereas lung cancer patients had tended to stabilize, although they remained the most vulnerable. Adverse effect severity was significant for Physical Component Summary ( r = -0.13, P = .035), with decreases in positive affect ( r = -0.17, ß = -.16) and increases in negative affect ( r = 0.15, ß = .14). CONCLUSIONS: Changes in QoL and emotional state differ between groups, implying a need for varying levels of follow-up and emotional support. Patients with lung cancer seem particularly vulnerable. IMPLICATIONS FOR PRACTICE: Cancer nurses could strengthen the assessment of patients undergoing chemotherapy using more sensitive instruments such as the Positive and Negative Affect Scale and considering differences by cancer site, to provide care tailored to individual patient needs and preferences.

Cambios en la calidad de vida de personas en tratamiento con quimioterapia adyuvante ambulatoria / Quaility of Life changes in persons with outpatient adjuvant chemotherapy

OBJETIVOS: conocer la evolución de la calidad de vida relacionada con la salud de pacientes con cáncer durante el tratamiento con quimioterapia sistémica adyuvante ambulatoria y compararla con la población general. MÉTODO: estudio longitudinal observacional multicéntrico aplicando el SF-12v2 sobre una muestra de 247 pacientes con cáncer entre 28 y 70 años (medición inicial en 2º ciclo de quimioterapia; segunda medición en el último ciclo). Se ha utilizado la prueba t de Student para datos independientes para comparación con la población general, y la prueba t de Student para datos relacionados para la comparación entre las dos mediciones. En todas las comparaciones se calculó el tamaño del efecto basado en estimación d de Cohen. RESULTADOS: concluyeron el estudio 234 personas. Hay un empeoramiento en todas las dimensiones del SF-12. Todas las diferencias fueron estadísticamente significativas, a excepción de vitalidad y dolor, resaltando un peor funcionamiento físico (t= 8,07;p< 0,001; d= 0,55). Cuando se comparó con la población general existieron diferencias estadísticamente significativas en todas las dimensiones, a excepción del dolor. El empeoramiento fue mayoral compararlo con los pacientes al final del tratamiento (en el componente sumario físico (t= 14,4; p< 0,001; d= 0,96) y en el componente sumario mental (t= 3,2; p< 0,002; d= 0,21).CONCLUSIONES: las personas con quimioterapia ambulatoria empeoran su percepción de calidad de vida del inicio al final del tratamiento y perciben peor calidad de vida que la población general en las dimensiones físicas y en menor medida en la calidad de vida de los aspectos emocionales

OBJECTIVES: to understand the evolution of quality of life associated with the health of cancer patients during treatment with outpatient adjuvant systemic chemotherapy, and to compare it with the overall population. METHOD: an observational multicentre longitudinal study applying the SF-12v2 survey on a sample of 247 patients with cancer between 28 and 70-years-of age (initial measurement on their 2nd chemotherapy cycle; second measurement at their last cycle). The Student's t test for independent data was used for comparison with the overall population, and the Student's t test for associated data was used for the comparison between both measurements. For all comparisons, the effect size was calculated based on Cohen's d measurement. RESULTS: 234 persons completed the study. There was a worsening in all SF-12 dimensions. All differences were statistically significant, except for vitality and pain; there was a noticeable worsening in physical function (t= 8.07; p< 0.001; d=0.55). When compared with the overall population, there were statistically significant differences in all dimensions, except for pain. Worsening was higher when compared with patients at the end of their treatment in the Physical Component Summary (t=14.4; p< 0.001; d= 0.96) and in the Mental Summary Component(t= 3.2; p< 0.002; d= 0.21).CONCLUSIONS: those persons with outpatient chemotherapy will have a worsening in their perception of quality of life at the end of their treatment, and they will perceive a worse quality of life than the overall population in physical dimensions, and to a lower extent in the quality of life of emotional aspects

Construyendo un aprendizaje cooperativo e integrador. Experiencia de innovación docente en el marco del EEES / Building cooperative and integrative learning. Teaching innovation experience within the European Higher Education Area (EHEA)

La Enfermería del siglo XXI se encuentra inmersa en el Espacio Europeode Educación Superior (EEES), que promueve un nuevo paradigmadocente centrado en el proceso de aprendizaje y en la integración de conocimientos.Este paradigma implica un cambio en los parámetros tradicionales en losque se concibió el aprendizaje para enfatizar en otras dimensiones formativas.Desde esta necesidad, como educadoras de futuras enfermeras,en el curso académico 2007/08 comenzamos a desarrollar una nuevametodología en una de las unidades temáticas de la asignaturaEnfermería Médico-Quirúrgica II, basada en la construcción de un aprendizajecooperativo e integrador mediante la combinación del análisis dirigidode casos clínicos en grupos pequeños de trabajo y el estudio yempleo autónomo del estudiante.En este artículo se describe el desarrollo de esta nueva experiencia y lavaloración que de la misma realizan todos los agentes implicados, estudiantesy profesores (AU)

21st century nursing is immersed in the European Higher Education Area(EHEA), which promotes a new teaching paradigm focused on the learningprocess and integration of knowledge.This paradigm entails a change in the traditional parameters in whichlearning was conceived, now emphasising other training/educationaldimensions. With this need in mind, as teachers of future nurses, in the2007/08 school year we started to develop a new methodology within oneof the thematic units of the 2nd Surgical-Medical Nursing course, basedon the construction of cooperative and integrative learning via the combinationof directed analysis of clinical cases in small working groupsand the student’s autonomous study and work.This article describes the development of this new experience and itsassessment by all agents involved, including both students and teachers (AU)