561 research outputs found
A model of consultation in prostate cancer care:evidence from a systematic review
Get PDFBackground: There has been an evolution of various consultation models in the literature. Men affected by prostate cancer can experience a range of unmet supportive care needs. Thus, effective consultations are paramount in the delivery of supportive care to optimize tailored self-management plans at the individual level of need. Objective: The aim of this study is to critically appraise existing models of consultation and make recommendations for a model of consultation within the scope of clinical practice for prostate cancer care. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement Guidelines. Electronic databases were searched using a wide range of keywords and free text items to increase the sensitivity and inclusiveness of the searches. Findings were integrated in a narrative synthesis. Results: A total of 1829 articles were retrieved and 17 papers were included. Beneficial features ranged across a number of models that included a person-centered consultation, shared management plans, and safety netting. None of the reviewed models of consultation are suitable for use in prostate cancer care because of a range of limitations and the clinical context in which models were developed. A Cancer Care Consultation Model was informed from critical appraisal of the evidence and expert clinical and service user comment. Conclusion: Further research is needed to empirically test consultation models in routine clinical practice, specifically for advanced cancer specialist nurses. Implications for Practice: The Prostate Cancer Model of Consultation can be used to structure clinical consultations to target self-management care plans at the individual level of need over the cancer care continuum
Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome.
Get PDFProstatitis is a common condition which can affect men of all ages; however, it is more frequently experienced in younger men with an initial onset around 40 years of age. The two main presenting clinical features of prostatitis are lower urinary tract symptoms and pelvic pain. Other symptoms might include obstructive or irritative voiding symptoms, ejaculatory pain, and hematospermia. A diagnosis is usually based on the man's history, physical examination, urinalysis, and the two-or four-glass test (also known as obtaining urine specimens before, during, and after prostatic massage). Further investigations may also be performed when considering the differential diagnosis. Prostatitis can result in a significant reduction in quality of life (QOL) and pain can be associated with sexual dysfunction in men. Prostatitis can be classified as four distinct types, namely, type I acute prostatitis, type II chronic bacterial prostatitis, type III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and type IV asymptomatic prostatitis. It is unclear whether type III can be linked in all cases to prostatic involvement therefore the alternate denomination CPPS is used in clinical practice. Furthermore, CP/CPPS is further subclassified as type IIIa (inflammatory), and type IIIb (noninflammatory) which is dependent on the presence of inflammatory cells in prostatic secretions. CP/CPPS is considered when pelvic pain is present for at least three of the preceding 6 months with no other identifiable causes determined. There are several hypothesized causes of CP/CPPS which include: neuropsychological factors, infection, inflammation/autoimmunity, and dyssynergia voiding associated with bladder neck hypertrophy. Given the wide range of potential causes of CP/CPPS, there are many pharmacological interventions available in clinical practice to manage this complex condition. It is important to critically summarize evidence-based recommendations to inform the clinical management of men affected by CP/CPPS (Franco et al., 2019)
Using aquablation to treat lower urinary tract symptoms in benign prostatic hyperplasia.
Get PDFThis is a summary by the authors of a nursing care-related review of the Cochrane Review by Hwang, E.C., Jung, J.H., Borofsky, M., Kim, M.H. and Dahm, P. 2019. Aquablation of the prostate for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. Cochrane Database of Systematic Reviews 2019, Issue 2, Art No: CD013143. DOI: 10.1002/14651858.CD013143.pub2
Barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer
Get PDFA pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers
Get PDFPurpose: Men with metastatic prostate cancer experience high levels of unmet supportive care needs in current healthcare delivery. We set out to determine the effectiveness of a multimodality supportive care (ThriverCare) intervention on the prevalence of unmet supportive care needs for men and their partner/caregivers. Methods: A prospective parallel group, pilot randomised controlled pilot trial in 4 hospitals in Scotland. 38 participants with radiologically proven metastatic prostate cancer disease and 10 partners/caregivers were recruited into the study. A two arm 1:1 study design compared the usual standard of care (SC) approach to SC plus ThriverCare intervention. The primary outcome was the Supportive Care Needs Survey at 3 months of intervention. Results: There was no statistical significant difference in the prevalence of unmet supportive care needs between the intervention group and the usual SC group at baseline p=0.112, however a statistically significant difference was observed at 3 months, indicating that the prevalence of unmet supportive care needs were less in the intervention group (1.13, SD 2.5) compared to the usual SC (6.17, SD 7.05), p=0.002. This document includes supplementary information of "A prostate cancer gude to thriveship: Men, it's time to thirve", which can be found at the end of the article. Conclusion: ThriverCare appears to improve the supportive care experience of men with metastatic prostate cancer on hormonal treatment and their partner/caregivers. Our results accentuate that no longer one size of care delivery fits all, care must be responsive and adaptable to meet the individual needs of people affected by cancer to thrive
A qualitative study exploring models of supportive care in men and their partners/caregivers affected by metastatic prostate cancer.
Get PDFPurpose/Objectives: To explore the experiences of patients with metastatic prostate cancer and their partners/caregivers, as well as an interprofessional team, with a nurse-led multimodality supportive care intervention. Research Approach: Qualitative study. Setting: National Health Service (NHS), Tayside, Scotland. Participants: 19 patients, 7 partners/caregivers, and 7 interprofessional members from four hospitals in NHS, Tayside, Scotland. Methodologic Approach: 33 semistructured interviews were conducted to explore patients' and partners/caregivers' experiences of supportive care, and a framework approach was used to analyze the data. Findings: Men and their partners/caregivers experienced a range of unmet physical, psychological, and informational supportive care needs. The participants in the intervention group reported overall high satisfaction with the use of holistic needs assessments and self-management plans, with a decrease in unmet needs compared to the standard of care over time. The prostate cancer specialist nurse was perceived as the hub of survivorship care. Members of the interprofessional team perceived benefit in the nurse-led multimodal supportive care intervention. Interpretation: An emphasis needs to be placed on personalizing care, with supportive care interventions targeted to individual needs. Implications for Nursing: Care can be improved by incorporating holistic needs assessment to target specialized interventions for optimized, individualized care plans. An intervention seminar encouraged self-management and self-efficiency, leading to greater satisfaction for participants
It's all about ticks: a secondary qualitative analysis of nurse perspectives about documentation audit.
Get PDFTo understand how nurses talk about documentation audit in relation to their professional role. Nursing documentation in health services is often audited as an indicator of nursing care and patient outcomes. There are few studies exploring the nurses' perspectives on this common process. Secondary qualitative thematic analysis. Qualitative focus groups (n = 94 nurses) were conducted in nine diverse clinical areas of an Australian metropolitan health service for a service evaluation focussed on comprehensive care planning in 2020. Secondary qualitative analysis of the large data set using reflexive thematic analysis focussed specifically on the nurse experience of audit, as there was the significant emphasis by participants and was outside the scope of the primary study. Nurses': (1) value quality improvement but need to feel involved in the cycle of change, (2) highlight that âfailed auditâ does not equal failed care, (3) describe the tension between audited documentation being just bureaucratic and building constructive nursing workflows, (4) value building rapport (with nurses, patients) but this often contrasted with requirements (organizational, legal and audit) and additionally, (5) describe that the focus on completion of documentation for audit creates unintended and undesirable consequences. Documentation audit, while wellâintended and historically useful, has unintended negative consequences on patients, nurses and workflows. Accreditation systems rely on care being auditable, but when individual legal, organizational and professional standards are implemented via documentation forms and systems, the nursing burden is impacted at the point of care for patients, and risks both incomplete cares for patients and incomplete documentation. Patients participated in the primary study on comprehensive care assessment by nurses but did not make any comments about documentation audit
What are the qualitative experiences of people affected by kidney failure receiving haemodialysis?
Get PDFBackground: People affected by kidney failure receiving haemodialysis experience complexity within their health condition unlike any other chronic illness or condition. Kidney failure impacts the individual in all areas of their life including relationships and activities of daily living. Objective: To conduct a metaâaggregation of studies about the lived experiences of people with kidney failure receiving haemodialysis. Design: Using PRISMA Guidelines, six databases (CINAHL, ClinicalTrials.gov, Cochrane Library, MEDLINE, PsycINFO, and Scopus) were comprehensively searched using keywords and subject headings from January 1990 to October 2021. Articles were assessed according to prespecified eligibility criteria. Data extraction and quality appraisal was conducted. A metaâaggregation of qualitative findings was conducted using the Joanna Briggs Institute methodology for metaâaggregation. Results: Of the 9409 articles screened, 55 studies were included. This represented a total of 188 findings across 45 categories representing a range of unmet supportive care needs. The metaâaggregation identified 11 synthesised findings broadly related to psychological/emotional needs, physical needs, social needs, interpersonal/intimacy needs, patientâclinician communication needs, family related needs, health system/information needs, spiritual needs, daily living needs, practical needs and daily living needs. Conclusions: This metaâaggregation has identified that people affected by kidney failure can experience a range of unmet supportive care needs. It was evident that living with kidney failure and receiving haemodialysis impacted a person's sense of self, introduced practical needs and other complex needs which were not being addressed in existing services. This review has highlighted important implications for clinical practice and future research directions
Development of a Prehabilitation Multimodal Supportive Care Interventions for Men and Their Partners Before Radical Prostatectomy for Localized Prostate Cancer
Get PDFBackground: An important question revolves around when the most opportune time is to introduce recovery-optimizing behaviors for men opting for radical prostatectomy (RP) for localized prostate cancer (PCa). An emerging field of research describes the role of pre-operative strategies to improve treatment tolerance, and overall physical and psychological recovery. Objective: To explore the perceptions of a multimodal pre-habilitation intervention for men and their partners prior to RP for localized PCa. Intervention/Methods: Thirty-four patients who opted for RP for localized PCa and their partners (19) were identified and recruited into the study. The multimodal intervention comprised of educational materials, physiotherapy instruction and a self-management group-based seminar. Results: The multimodal pre-habilitation intervention was perceived as overall helpful with demonstrated acceptability (91.9%). Beneficial themes related to the quality of the information provided to support self-management, open forum questions with multidisciplinary healthcare professionals, and increased knowledge among partners to help with their understanding of how to look after their husbands. Conclusion: The intervention was feasible and beneficial for the prostate cancer dyad. A future pilot RCT study is needed to provide sufficient evidence on the long-term physical and psychological outcomes and cost-effectiveness. Implications for Practice: Oncology nurses play a key role in the development of pre-habilitation care delivery. Pre-habilitation interventions can have a positive effect on improving health outcomes for cancer patients and their partners after surgery and into survivorship
Identifying the impact of audit and feedback on the professional role of the nurse and psychological wellâbeing: an integrative systematic review.
Get PDFThis systematic review aimed to critically synthesis evidence to identify the impact that audit and feedback processes have on the professional role of the nurse and psychological wellâbeing. Little is known about the extent to which audit and feedback processes can positively or negatively impact the professional role of the nurse and psychological wellâbeing. An integrative systematic review was conducted. Covidence systematic review software was used to manage the screening process. Data extraction and methodological quality appraisal were conducted in parallel, and a narrative synthesis was conducted. Nurse participation and responsiveness to audit and feedback processes depended on selfâperceived motivation, content, and delivery; and nurses viewed it as an opportunity for professional development. However, audit was reported to negatively impact nurses' psychological wellâbeing, with impacts on burnout, stress, and demotivation in the workplace. Targeting framing, delivery, and content of audit and feedback is critical to nurses' satisfaction and successful quality improvement
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