Patients’ Expectations of Physiotherapeutic Treatment for Long-Term Side Effects After Cancer: A Qualitative Study

Objective This study aims to explore the expectations of physiotherapeutic treatment of long-term side effects (LTSEs) after cancer among patients treated in physiotherapy clinics. Methods This a qualitative interview study based on a phenomenological approach. Adult patients with LTSEs after cancer were recruited through The Danish Cancer Society and a private physiotherapy clinic in Denmark. Individual semi-structured interviews were carried out using Microsoft Teams based on an interview guide piloted before the interviews. Interviews were audiotaped and transcribed verbatim. Sampling was conducted with a focus on variation in LTSE. The data were analyzed using Malterud’s principles of systematic text condensation and coded in NVivo 12. Results 2 males and 8 females with an average age of 55.8 years were interviewed for between 40 and 60 minutes from October to November 2020. Four main themes emerged from the interviews 1 : The importance of the physiotherapist’s approach, 2 the benefits of meeting patients with similar symptoms, 3 the importance of receiving knowledge, and 4 patients seeking to maintain their current state more often than aiming to improve their condition. Conclusions Patients consulting a physiotherapy clinic with LTSE after cancer prefer the physiotherapist to have knowledge about cancer and to be emphatic. Furthermore, patients prefer to meet like-minded people and expect support to maintain their current condition rather than improve their condition.

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Information needs of hematologic cancer survivors

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.18547 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 18547-18547 ◽

Cited By ~ 1

Author(s):

C. Soloe ◽

K. Bandel ◽

M. Jarblum ◽

E. Willacy ◽

S. Squire ◽

...

Keyword(s):

Side Effects ◽

Diagnostic Tests ◽

Information Needs ◽

Treatment Options ◽

Structured Interviews ◽

Cancer Centers ◽

Cancer Types ◽

Cancer Experience ◽

Financial Issues

18547 Background: Little is known about how information needs of cancer survivors/patients (S/P), caregivers (CG), and non-caregiver relatives (NCG) evolve during the cancer experience. Methods: We conducted structured interviews of 21 leukemia, lymphoma, and multiple myeloma S/P, 13 CG, and 19 NCG, and asked them to prioritize information needs during the 4 cancer experience phases from a list of 13 topics. This research was supported by the Division of Cancer Prevention and Control of the Centers for Disease Control and Prevention. Results: Information preferences varied (Friedman’s test, P < 0.0001) by phase of the cancer experience. Topics ranked highest (median rank in parentheses) before treatment, during treatment, after treatment, and at relapse, respectively, were diagnostic tests (2), cancer/ cancer types (2.5), treatment options (3.4), hospitals/cancer centers (3.5), and insurance/financial issues (4); coping with treatment side effects (3), insurance/financial issues (4.5), treatment options (5), hospitals/cancer centers (5), and long term side effects (5); long term side effects (2), tests to detect recurrence (2), risk factors (3), diagnostic tests (4), and support groups (5); and tests to detect recurrence (3), insurance/financial issues (3), cancer/cancer types (4), diagnostic tests (5), and treatment options (5). Across the cancer experience, the highest priority topics for S/P, CG, and NCG, were cancer/ cancer types (4), treatment options (4), long term side effects (5), and risk factors (5); diagnostic tests (4.5), coping with side effects of treatment (5), and treatment options (5); and treatment options (3), diagnostic tests (4), and 5 other topics tied for 3rd place (6). In-depth, semi-structured interviews conducted with the surveys provided additional detail regarding responses collected in the prioritization exercise. Conclusions: Clinicians can help S/P, CG, and NCG by offering role- and cancer continuum-targeted information. No significant financial relationships to disclose.

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GPs’ insights about discontinuing long-term antidepressant use: a qualitative study

British Journal of General Practice ◽

10.3399/bjgp.2020.0913 ◽

2021 ◽

pp. BJGP.2020.0913

Author(s):

Maria Donald ◽

Riitta Partanen ◽

Leah Sharman ◽

Johanna Lynch ◽

Genevieve A Dingle ◽

...

Keyword(s):

Decision Making ◽

Prescribing Practices ◽

Structured Interviews ◽

Relational Context ◽

Qualitative Interview Study ◽

Complex Decision Making ◽

Complex Decision ◽

Antidepressant Use ◽

Set Up

Background: There is considerable concern about increasing antidepressant use, with Australians among the highest users in the world. Evidence suggests this is driven by patients on long-term rather than new prescriptions. Most antidepressant prescriptions are generated in general practice and it is likely that attempts to discontinue are either not occurring or are proving unsuccessful. Aim: To explore GPs’ insights about long-term antidepressant prescribing. Design and Setting: A qualitative interview study with Australian GPs. Method: Semi-structured interviews explored GPs’ discontinuation experiences, decision-making, perceived risks and benefits, and support for patients. Data were analysed using reflexive thematic analysis. Results: Three overarching themes were identified from interviews with 22 GPs. The first, ‘Not a simple deprescribing decision’, speaks to the complex decision-making GPs undertake in determining whether a patient is ready to discontinue. The second, ‘A journey taken together’ captures a set of steps GPs take together with their patients to initiate and set-up adequate support before, during and after discontinuation. The third: ‘Supporting change in GPs’ prescribing practices’ describes what GPs would like to see change to better support them and their patients to discontinue antidepressants. Conclusions: GPs see discontinuation of long-term antidepressant use as more than a simple deprescribing decision. It begins with considering a patients’ social and relational context and is a journey involving careful preparation, tailored care and regular review. These insights suggest interventions to redress long-term use will need to take these considerations into account and be placed in a wider discussion about the use of antidepressants.

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Hopes and fears before opioid tapering: a quantitative and qualitative study of patients with chronic pain and long-term opioids

British Journal of Pain ◽

10.1177/2049463720974053 ◽

2020 ◽

pp. 204946372097405

Author(s):

Jane Quinlan ◽

Heather Willson ◽

Katheryn Grange

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Side Effects ◽

Phenomenological Approach ◽

Free Text ◽

Significant Depression ◽

Opioid Tapering ◽

The Uk

Background: It is clear that the risks of opioids in chronic pain outweigh the benefits, creating a drive for clinicians to support patients taper and stop long-term opioids. However, it is not known how patients who have been taking these medicines for months or years feel about reducing them. Using quantitative and qualitative data, this study describes the psychological complexity of these patients and examines their hopes and fears before opioid reduction. Methods: Sixty patients attending the opioid clinic completed psychological and pain questionnaires, providing quantitative data, just before they commenced opioid tapering. They scored the severity of opioid side effects and completed a free text framework to express their beliefs about stopping or continuing opioids. A phenomenological approach was used to identify common qualitative themes. Results: Most patients were taking opioid doses above the UK recommended maximum dose and reported severe pain with high pain interference. Over 80% of patients described significant depression and 60% significant anxiety. Negative themes around stopping opioids were more common than positive ones, with 63% patients fearing increased pain. A quarter of patients referred to addiction and 16% feared withdrawal. Five patients hoped for a better quality of life; seven feared a worse one. Opioid side effects were common and severe. Conclusion: Patients with chronic pain taking long-term opioids demonstrate high psychological distress and low self-efficacy. Their concerns around opioid tapering relate to pain, quality of life and withdrawal. Identifying and addressing patients’ individual concerns should increase the likelihood of successful opioid tapering.

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Radiotherapy side effects: integrating survivorship clinical lens to better serve patients

Current Oncology ◽

10.3747/co.27.6233 ◽

2019 ◽

Vol 27 (2) ◽

Author(s):

Vanessa Di Lalla ◽

G. Chaput ◽

Tristan Williams ◽

Khalil Sultanem

Keyword(s):

Side Effects ◽

Advanced Disease ◽

Early Stage ◽

Locally Advanced ◽

Primary Care Providers ◽

Care Providers ◽

Cancer Society ◽

Locally Advanced Tumors ◽

After Cancer ◽

Anxiety Depression

The Canadian Cancer Society estimated 220,400 new cases of cancer would be diagnosed in 2019. Of these, over 60% will survive for 5 years or more after cancer diagnosis1. Furthermore, nearly 40% of cancer patients receive at least one course of radiotherapy (RT)2. RT is utilized for both curative and palliative intents, to treat early stage or locally advanced tumors and for symptom management in advanced disease, respectively. RT can be delivered systemically, referred to as external-beam RT, or internally via brachytherapy3. Although technique improvements have drastically reduced RT-related toxicity3, most patients still experience burdensome RT side effects (SE)4. RT SE are local or loco-regional, and manifest in tissues or organs that were radiated. SE manifesting during within weeks following RT completion are defined as early SE, whereas those occurring after months or years are defined as late SE4. In addition to radiation oncologists, general practitioners in oncology and primary care providers are involved in survivorship care and management of RT SE5. This article presents an overview of common SE and respective management: anxiety, depression, fatigue, and SE related to these treatment sites: head and neck, thoracic, and pelvic.

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Why do people with long-term health needs see more than one GP?: a qualitative study

Australian Journal of Primary Health ◽

10.1071/py20179 ◽

2020 ◽

Vol 26 (6) ◽

pp. 514

Author(s):

David Cosgriff ◽

Jenny Reath ◽

Penelope Abbott

Keyword(s):

Continuity Of Care ◽

Waiting Times ◽

Health Issues ◽

Structured Interviews ◽

Regular Care ◽

Practice Models ◽

Qualitative Interview Study ◽

Gp Care ◽

Supportive Practice

This study aimed to understand what barriers exist or choices are made by patients who access regular care for long-term health issues from multiple GPs. This was a qualitative interview study in Western Sydney community settings consisting of semi-structured interviews and inductive thematic analysis. Twenty participants who accessed GP care were interviewed. Sixteen had seen multiple GPs over the previous twelve months and all had seen multiple GPs over preceding years. Participants valued interpersonal continuity of care. Nevertheless, they made decisions to meet their needs by seeing multiple GPs. They considered waiting times, preference for an individual GP based on their consultation style or perception of their particular area of expertise, experiences with reception staff and the practice model of care. Participants were aware that interpersonal continuity of care was considered important by GPs and were reticent to be seen as ‘doctor shoppers’. Therefore, they did not usually disclose that they saw multiple doctors and were unlikely to discuss continuity of care with a GP. Participants made considered choices about health care. Despite general practice promoting interpersonal continuity of care, it is not always achievable or desired by patients. GPs can promote care continuity through supportive practice models and dialogue about when continuity is desirable.

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Phenomenology Study : Family Experience in Elderly Care In Depok Jawa Barat

Research Journal of Life Science ◽

10.21776/ub.rjls.2020.007.03.8 ◽

2020 ◽

Vol 7 (3) ◽

pp. 177-185

Author(s):

Yati Sri Hayati ◽

Asti Melani Astari

Keyword(s):

Health Workers ◽

Elderly Care ◽

The Elderly ◽

Phenomenological Approach ◽

Structured Interviews ◽

Term Care ◽

Care For The Elderly ◽

The Family ◽

At Home

The family has an important role in elderly care at home, where the majority of assistance and long-term care for the elderly is provided by the family. The nurse is responsible for assisting the family in caring for the elderly, so that in the end the family is able to provide elderly care independently at home. This study aims to explore family experiences in caring for the elderly at home. Researchers used qualitative research methods with a phenomenological approach. Data obtained through semi-structured interviews with 6 (six) participants. The research produced 5 themes: care for the elderly is a form of devotion to parents, care for the elderly requires physical and mental readiness, care for the elderly requires knowledge related to the elderly and how to care for the elderly, care for the elderly requires support from extended families, and feel the importance of supporting cadres and health workers. For conclusion, elderly families have a responsibility to meet the needs of the elderly, so that efforts are needed to improve the knowledge and skills of the family in order to properly care for and meet the needs of the elderly.

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Bone Marrow Transplants: Neither Ethical nor Imperative?!

PEDIATRICS ◽

10.1542/peds.84.1.195 ◽

1989 ◽

Vol 84 (1) ◽

pp. 195-195

Author(s):

LYDIA FURMAN

Keyword(s):

Bone Marrow ◽

Bone Marrow Transplantation ◽

Side Effects ◽

Marrow Transplantation ◽

Undergo Bone Marrow Transplantation ◽

Bone Marrow Transplants ◽

Ethical Imperative ◽

Current State ◽

Dying Children

In the thoughtful essay by Durbin (Pediatrics. 1988;82:774-783) concerning bone marrow transplantation, she speaks of the "ethical imperative" for bone marrow transplantation. Yet, she notes that patients who undergo bone marrow transplantation have a high mortality rate and that survivors, especially children, suffer a "variety of long-term side effects." I would like to play devil's advocate and suggest that bone marrow transplantation in its current state may be neither ethical nor imperative as a therapy for dying children and that at the very least we need to take a long, hand look at when it is appropriate and how the technology is being developed.

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Responsibility experience for your own life through volunteering

SHS Web of Conferences ◽

10.1051/shsconf/202213103007 ◽

2022 ◽

Vol 131 ◽

pp. 03007

Author(s):

Vida Gudzinskiene ◽

Neringa Kurapkaitiene

Keyword(s):

Young Adults ◽

Life Experience ◽

Prior Experience ◽

Phenomenological Approach ◽

Age Group ◽

Structured Interviews ◽

Research Participants ◽

Is Research ◽

Change Of Life

Phenomenon of the Volunteering reveals itself through dedicated time for volunteering, duration of volunteering commitment, area where volunteering is implemented and through age group of the volunteers. The object of the study is volunteering experience of young adults. Interpretative Phenomenological Analyses is research methodology. According to the phenomenological approach, research itself is not focusing on any foreseen objectives, oriented to the volunteers’ experience. In this article is presented part of the research, giving deeper view on one of the super-ordinates theme, with the aim: to present responsibility for your own life experience of young adults in long term and fulltime volunteering, while volunteered is held in social help area. In the study participated 6 research participants, 3 young men and 3 young women, 20–30 years old. To collect the data of the research were used semi-structured interviews. Conclusions of the study presented in this article shows 1) that through volunteering experience research participants perceived power and duty of own life’s quality. They got awareness about their own life – they can and they must be responsible of own life. 2) This power of responsibility is hidden in themselves and change of own life depends on the decisions made by them while volunteering. Prior experience of responsibility is opening decision possibilities and freedom possibilities in any change of life.

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Cutaneous ulcers following hydroxyurea therapy

Phlebologie ◽

10.1055/s-0037-1621559 ◽

2004 ◽

Vol 33 (06) ◽

pp. 202-205 ◽

Cited By ~ 2

Author(s):

K. Hartmann ◽

S. Nagel ◽

T. Erichsen ◽

E. Rabe ◽

K. H. Grips ◽

...

Keyword(s):

Side Effects ◽

Side Effect ◽

Antineoplastic Agent ◽

Limited Time ◽

Myeloproliferative Diseases ◽

Dermatological Side Effects ◽

Chronic Myeloproliferative Diseases ◽

Hydroxyurea Therapy

SummaryHydroxyurea (HU) is usually a well tolerated antineoplastic agent and is commonly used in the treatment of chronic myeloproliferative diseases. Dermatological side effects are frequently seen in patients receiving longterm HU therapy. Cutaneous ulcers have been reported occasionally.We report on four patients with cutaneous ulcers whilst on long-term hydroxyurea therapy for myeloproliferative diseases. In all patients we were able to reduce the dose, or stop HU altogether and their ulcers markedly improved. Our observations suggest that cutaneous ulcers should be considered as possible side effect of long-term HU therapy and healing of the ulcers can be achieved not only by cessation of the HU treatment, but also by reducing the dose of hydroxyurea for a limited time.

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Long-term side effects following pneumonectomy: A case report and review of the literature

10.1055/s-0039-1694143 ◽

2019 ◽

Author(s):

BA Högerle ◽

EL Bulut ◽

L Klotz ◽

F Eichhorn ◽

M Eichhorn ◽

...

Keyword(s):

Case Report ◽

Side Effects ◽

Review Of The Literature

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