- Email: [email protected]
P86 Life on interferon: a longitudinal, phenomenological study of people with kidney cancer
S50
Abstracts and learning outcomes / European Journal of Oncology Nursing 14S1 (2010) S1–S62
sample included men (n = 45) whose wives had been diagnosed with breast cancer no more than two years. Data were collected included socio-demographic characteristics, Hospital anxiety and Depression Scale, State-Trait Anger Expression Inventory. Results and Discussion: The average age was 53.8. It was established that most of the spouses of the patients (55.6%) were self-employed and 46.7% were primary school graduates. The average marriage length was 22.0 years. Income levels of 60% of the spouses were middle level. It was discovered that constant level of anger were high and they could control their anger and had not difficulty in expressing their anger. Anxiety score average of the spouses was 17.7; depression score average was 16.4. These values demonstrate that spouses have experienced high levels of anxiety and depression. After the correlation analysis between the scales, it was found a meaningful negative relation between the anxiety and expressing anger (p < 001). Spouses with high levels of anxiety have difficulty expressing their anger. Conclusion: The results of this study carried out within the context of the project emphasize the fact that spouses of the patients with breast cancer should be given psycho-social support. P86 Life on interferon: a longitudinal, phenomenological study of people with kidney cancer J. Moore1 , E. Ream1 , A. Richardson2 . 1 King’s College London, Florence Nightingale School of Nursing & Midwifery, London, United Kingdom; 2 Southampton University Hospitals NHS Trust and the University of Southampton, Cancer Nursing and End of Life Care, Southampton, United Kingdom Introduction: In the UK, cancers of the kidney account for approximately 3% of all cancers in men and <2% in women (CancerStats, 2009). The median age at diagnosis is 66 years. Until recently, standard treatment for advanced kidney cancer was interferon alpha. Administered by subcutaneous injection three times a week over an extended period of time, interferon is associated with multiple side-effects. Materials and Methods: The aim of the study was to elucidate patients’ experience of receiving interferon for kidney cancer and to determine its impact on patients’ lives over time. A longitudinal, phenomenological approach was selected. In-depth interviews were conducted pre-treatment, at weeks 2, 4 and 12, then 3 monthly as long as the participant remained on treatment. All interviews were audiotape-recorded. Demographic data were obtained from medical records and field notes were made. An adaptation of Moustakas’ modification of Van Kaam’s method was employed to reflect the longitudinal nature of the data. Results and Discussion: Ten men and three women, aged 46–78 years, took part in the study. Length of time on interferon ranged from three weeks to eight months. Eight participants discontinued treatment because of progressive disease and five because of interferon side-effects. Forty-seven interviews were available for analysis. Five key components of the interferon experience were identified: selfmanagement; chronicity of treatment; unrelenting side-effects; unpredictability and disruption of life; and uncertainty of outcome. It was possible to elucidate the essence of the experience of being treated with interferon for kidney cancer: being treated with interferon for kidney cancer means patients having to manage their own treatment over an unspecified and potentially extensive period of time whilst enduring unrelenting side-effects that disrupt usual life and make it feel unpredictable, while not knowing what the outcome of treatment will be. Conclusion: The findings suggest that support based on established self-management programmes is required. This should include: provision of treatment-related information; the design and delivery of treatment specific education related to skills such as injection technique; closer monitoring of patients throughout the course of
treatment; provision of ongoing support; and pertinent preparation and training of clinical staff. Findings may have implications for other groups of cancer patients receiving chronic treatments for disease palliation where effective self-management is necessary. P87 Perceptions of prostate cancer and prostate cancer risk in men of African Caribbean descent; a systematic review E. Ream, V.H. Pedersen, J. Armes. Florence Nightingale School of Nursing and Midwifery King’s College London, Department of Specialist Care, London, United Kingdom Introduction: Men from African Caribbean communities in the UK are at greater risk of developing prostate cancer (PC) and dying from the disease than White men. There is some evidence to suggest that Black men have less awareness of PC, are more embarrassed by their symptoms and are more reluctant to attend their doctor with PC symptoms than White men. However, research evidence regarding African Caribbean men’s perceptions of both PC and their risk of developing it has yet to be appraised and synthesised. We conducted a systematic review to appraise evidence from studies investigating perceptions of PC and PC risk in African Caribbean men. Materials and Methods: The following databases were searched: Medline, PsychINFO, CINAHL and Cochrane Database of Systematic Reviews. Studies were eligible for inclusion if they were written in English and investigated perceptions, knowledge of symptoms and risk of PC among African Caribbean men. Studies of any design were included. Data were extracted systematically using standardised forms developed by the research team. Data were extracted independently by two reviewers. No papers were excluded due to low quality; results from poor quality studies were given less weight in the discussion. Themes reported in qualitative studies were synthesised using comparative thematic analysis. Findings from quantitative or mixed method studies were incorporated into these themes. Results: The search identified 373 papers – 25 fulfilled the inclusion criteria. 12 were qualitative exploratory studies while 13 were cross-sectional surveys. All were conducted in the US. 603 people participated in the qualitative studies (sample sizes ranged from 9 to 104). 5267 people participated across the observational studies (sample sizes ranged from 27 to 1504). Ten themes were identified in the literature: perceptions of prostate anatomy & function; causes and symptoms of PC; PC risks; screening methods and treatment; barriers to PC screening and prevention; PC as a threat to masculine identity; fear of cancer; mistrust of the health care system; poor patient-provider communication; lack of access to health care; and factors promoting PC awareness including faith and community partnerships. Conclusion: African Caribbean men are at relatively high risk of PC. However, their perceptions of men’s health issues, risk of PC, treatments for PC and trust/mistrust of healthcare services are likely to impact greatly on early/late presentation with the disease. This in turn will impact on morbidity and mortality. Unfortunately, no research has been conducted to date in either the UK or Europe more widely. This clearly hampers our understanding and current ability to develop culturally sensitive interventions to enhance knowledge and understanding in this under served group. This review was funded by The Prostate Cancer Charity.
Abstracts and learning outcomes / European Journal of Oncology Nursing 14S1 (2010) S1–S62
sample included men (n = 45) whose wives had been diagnosed with breast cancer no more than two years. Data were collected included socio-demographic characteristics, Hospital anxiety and Depression Scale, State-Trait Anger Expression Inventory. Results and Discussion: The average age was 53.8. It was established that most of the spouses of the patients (55.6%) were self-employed and 46.7% were primary school graduates. The average marriage length was 22.0 years. Income levels of 60% of the spouses were middle level. It was discovered that constant level of anger were high and they could control their anger and had not difficulty in expressing their anger. Anxiety score average of the spouses was 17.7; depression score average was 16.4. These values demonstrate that spouses have experienced high levels of anxiety and depression. After the correlation analysis between the scales, it was found a meaningful negative relation between the anxiety and expressing anger (p < 001). Spouses with high levels of anxiety have difficulty expressing their anger. Conclusion: The results of this study carried out within the context of the project emphasize the fact that spouses of the patients with breast cancer should be given psycho-social support. P86 Life on interferon: a longitudinal, phenomenological study of people with kidney cancer J. Moore1 , E. Ream1 , A. Richardson2 . 1 King’s College London, Florence Nightingale School of Nursing & Midwifery, London, United Kingdom; 2 Southampton University Hospitals NHS Trust and the University of Southampton, Cancer Nursing and End of Life Care, Southampton, United Kingdom Introduction: In the UK, cancers of the kidney account for approximately 3% of all cancers in men and <2% in women (CancerStats, 2009). The median age at diagnosis is 66 years. Until recently, standard treatment for advanced kidney cancer was interferon alpha. Administered by subcutaneous injection three times a week over an extended period of time, interferon is associated with multiple side-effects. Materials and Methods: The aim of the study was to elucidate patients’ experience of receiving interferon for kidney cancer and to determine its impact on patients’ lives over time. A longitudinal, phenomenological approach was selected. In-depth interviews were conducted pre-treatment, at weeks 2, 4 and 12, then 3 monthly as long as the participant remained on treatment. All interviews were audiotape-recorded. Demographic data were obtained from medical records and field notes were made. An adaptation of Moustakas’ modification of Van Kaam’s method was employed to reflect the longitudinal nature of the data. Results and Discussion: Ten men and three women, aged 46–78 years, took part in the study. Length of time on interferon ranged from three weeks to eight months. Eight participants discontinued treatment because of progressive disease and five because of interferon side-effects. Forty-seven interviews were available for analysis. Five key components of the interferon experience were identified: selfmanagement; chronicity of treatment; unrelenting side-effects; unpredictability and disruption of life; and uncertainty of outcome. It was possible to elucidate the essence of the experience of being treated with interferon for kidney cancer: being treated with interferon for kidney cancer means patients having to manage their own treatment over an unspecified and potentially extensive period of time whilst enduring unrelenting side-effects that disrupt usual life and make it feel unpredictable, while not knowing what the outcome of treatment will be. Conclusion: The findings suggest that support based on established self-management programmes is required. This should include: provision of treatment-related information; the design and delivery of treatment specific education related to skills such as injection technique; closer monitoring of patients throughout the course of
treatment; provision of ongoing support; and pertinent preparation and training of clinical staff. Findings may have implications for other groups of cancer patients receiving chronic treatments for disease palliation where effective self-management is necessary. P87 Perceptions of prostate cancer and prostate cancer risk in men of African Caribbean descent; a systematic review E. Ream, V.H. Pedersen, J. Armes. Florence Nightingale School of Nursing and Midwifery King’s College London, Department of Specialist Care, London, United Kingdom Introduction: Men from African Caribbean communities in the UK are at greater risk of developing prostate cancer (PC) and dying from the disease than White men. There is some evidence to suggest that Black men have less awareness of PC, are more embarrassed by their symptoms and are more reluctant to attend their doctor with PC symptoms than White men. However, research evidence regarding African Caribbean men’s perceptions of both PC and their risk of developing it has yet to be appraised and synthesised. We conducted a systematic review to appraise evidence from studies investigating perceptions of PC and PC risk in African Caribbean men. Materials and Methods: The following databases were searched: Medline, PsychINFO, CINAHL and Cochrane Database of Systematic Reviews. Studies were eligible for inclusion if they were written in English and investigated perceptions, knowledge of symptoms and risk of PC among African Caribbean men. Studies of any design were included. Data were extracted systematically using standardised forms developed by the research team. Data were extracted independently by two reviewers. No papers were excluded due to low quality; results from poor quality studies were given less weight in the discussion. Themes reported in qualitative studies were synthesised using comparative thematic analysis. Findings from quantitative or mixed method studies were incorporated into these themes. Results: The search identified 373 papers – 25 fulfilled the inclusion criteria. 12 were qualitative exploratory studies while 13 were cross-sectional surveys. All were conducted in the US. 603 people participated in the qualitative studies (sample sizes ranged from 9 to 104). 5267 people participated across the observational studies (sample sizes ranged from 27 to 1504). Ten themes were identified in the literature: perceptions of prostate anatomy & function; causes and symptoms of PC; PC risks; screening methods and treatment; barriers to PC screening and prevention; PC as a threat to masculine identity; fear of cancer; mistrust of the health care system; poor patient-provider communication; lack of access to health care; and factors promoting PC awareness including faith and community partnerships. Conclusion: African Caribbean men are at relatively high risk of PC. However, their perceptions of men’s health issues, risk of PC, treatments for PC and trust/mistrust of healthcare services are likely to impact greatly on early/late presentation with the disease. This in turn will impact on morbidity and mortality. Unfortunately, no research has been conducted to date in either the UK or Europe more widely. This clearly hampers our understanding and current ability to develop culturally sensitive interventions to enhance knowledge and understanding in this under served group. This review was funded by The Prostate Cancer Charity.