Roles of the urologist and nurse from the perspective of patients with prostate cancer receiving luteinizing hormone-releasing hormone analogue therapy.

OBJECTIVES: To establish the roles of the urologist, general practitioner (GP) and nurse from the perspective of the patient with prostate cancer receiving hormone therapy, and to assess patient satisfaction, in particular with management and information needs. PATIENTS AND METHODS: Patients with prostate cancer receiving luteinizing hormone-releasing hormone analogue (LHRH-a) therapy were recruited by a representative sample of 58 French urologists (March to April 2007) and invited to complete a 42-item questionnaire. RESULTS: In all, 350 representative patients participated in the study; >90% were totally or quite satisfied with the information given by their urologist at diagnosis and the start of treatment. Their main contact during treatment was with the nurse who gave the injection (84% of patients). The nurse's main role was to provide clarity (60% of patients), guidance (35%) and support to the family (28%). Fewer patients discussed disease stage and progression with their nurse (29%) than with a doctor (urologist, 63%; or GP, 61%). Fewer also discussed treatment (24% vs 32%) but as many patients discussed the impact of their disease and treatment with their nurse as with their doctor (e.g. 33% discussed general health and fatigue with the nurse, vs 26% with the urologist). The need for contact with a health professional was greater during the early stages of treatment. Patients treated for <12 months with 3-monthly injections were less likely to be in favour of spacing injections than patients treated for >or=3 years. CONCLUSION: The patient consults the urologist for reliable information on disease and treatment, and to the GP for further support, if needed, but the nurse has the pivotal role. A 3-monthly injection schedule enables regular face-to-face contact between the nurse and the patient and their family, and contributes towards the patient's coping strategies and quality of life.

Telling the Truth With Kindness: Retrospective Evaluation of 12 Years of Activity of a Support Group for Children and Their Parents With Cancer.

BACKGROUND: Cancer in a parent can have harmful effects on a child's ability to cope with the situation, in particular if communication about the disease is limited. OBJECTIVE: The aim was to evaluate whether the parent-child group run by a psychoanalyst and a doctor at the hospital helps facilitate communication about the disease with a child and helps to sooth the child and his/her symptoms. METHODS: This qualitative retrospective study conducted among 61 families (71 adults, 19 children) using semidirected interviews made it possible to identify the expectations and benefits perceived by the parents and children. RESULTS: The main expectations of the parents were to meet professionals who would help them to speak about the disease and to help the children understand it better in order to reduce their symptoms. The parents' expectations were largely satisfied. As far as the children are concerned, they expressed more benefits (better understanding of the disease, reduction of symptoms, meeting similar others) than expectations. CONCLUSIONS: The group is a resource that helps both parents and children. Meeting similar others made it possible to justify each participant's own experiences and promote better communication during the continued course of the disease. IMPLICATIONS FOR PRACTICE: The benefits brought about by this group testify to the need to offer such support to a greater number of parents with cancer. Improvements to the way in which the group is organized are discussed.