Survivorship Health Information Counseling for Patients With Prostate Cancer
Survivorship Health Information Counseling for Patients With Prostate Cancer
The Johns Hopkins Nursing evidence-based practice appraisal tool was used as a guide to assess the strength and quality of research and non-research evidence. Strength of research is indicated by Levels (Levels I to III for experimental, quasi-experimental, and descriptive or qualitative research, and Levels IV to V for non-research guidelines or expert opinions) and quality of research with the terms High, Good, or Low (Newhouse, Dearholt, Poe, Pugh, & White, 2007). The strength of evidence ratings reflected five Level 1 Research (randomized controlled trial [RCT] or meta-analysis of RCTs), one Level II Research (quasi-experimental) study, and one Level III Research (non-experimental or qualitative) study. One Level IV expert committee consensus guideline report was also reviewed. The critical analysis was organized by two themes related to prostate cancer patient satisfaction: survivorship interactive education interventions, and survivorship health content (see Table 1).
Gysels and Higginson (2007) conducted a meta-analysis of nine RCTs with 1,678 patients. The meta-analysis revealed a positive correlation between patient and health provider interactive survivorship interventions. The RCTs tested dichotomous innovative interactive educational technology interventions (such as computer use and videotaping) against conventional interactive educational interventions (such as written reading material or verbal interactions). Interactive technologies improved patient knowledge and satisfaction.
Harden and colleagues (2009) and Northouse, Mood, Schafenacker, and colleagues (2007) reports similar findings that suggest a strong positive correlation between interactive, face-to-face family and health provider counseling sessions to allow survivorship health information to manage chronic treatment side effects and satisfaction. Following a cross validation RCT, Northouse, Mood, Schafenacker, and colleagues (2007) reported that men with prostate cancer and their spouses had positive outcomes from interactive and face-to-face counseling interventions that offered information and support. The information included survivorship and symptom management content that focused on urinary incontinence and bowel and sexual difficulties. Similarly, Harden and colleagues (2009) reported that patients with prostate cancer had high satisfaction with survivorship health information programs. Most patients (71%) reported the survivorship health information content most valuable was information to cope with diagnosis, treatment, and post-treatment side effects.
Similar findings among researchers support that providing prostate cancer survivorship education and counseling for management of chronic and/or adverse side effects of prostate cancer treatment is important. Face-to-face interaction of the health care provider with the patient and family may be the most valuable intervention to improve patient satisfaction (Gysels & Higginson, 2007; Harden et al., 2009; Northouse, Mood, Schafenacker et al., 2007). Moreover, the IOM (2006) recommends an interactive exchange of health information between the patient and the health provider addressing chronic symptoms resulting from treatment.
Hawes and colleagues (2006), in a secondary analysis of an RCT, focused on identifying if additional survivorship health problems exist among patients as a result of prostate cancer treatment and need to be included in patient health information. They noted that education regarding how to live with the effects of prostate cancer treatment, such as impotence, incontinence, and osteoporosis, were important concepts for survivorship content. A meta-analysis by Carstons (2009) focused on these same key concepts for cancer patient health information, health care decision-making, and the effectiveness of patient education about cancer. The evidence of the studies reviewed suggested a positive relationship between providing evidence-based cancer survivorship health information on effects of treatment following assessment of patient readiness to learn and the desire to no longer be a passive recipient of care.
Demark-Wahnefried, Aziz, Rowland, and Pinto (2005) also supported the need for the provision of prostate cancer survivorship health content based on patient needs and preferences to manage chronic side or adverse effects of prostate cancer treatment. They further noted the education material should be tailored to patient needs and may include topics such as fatigue, impotence, incontinence, obesity, and functional decline, as well as methods to improve overall health with diet, exercise, and other lifestyle changes. The study also examined the preferences of patients with prostate cancer for learning to apply problem-solving steps as active participants in managing their care. A qualitative analysis by Harden, Northouse, and Mood (2006) also noted that educational material include the topics noted by Demark-Wahnefried and colleagues (2005).
Similar findings among researchers support that prostate cancer survivorship education must be specific to the needs of each patient but may include information related to impotence, incontinence, obesity, osteoporosis, fatigue, functional de cline, and health promotion strategies related to diet and exercise (Carstons, 2009; Demark-Wahnefried et al., 2005; Harden et al., 2006; Hawes et al., 2006). These studies support the IOM (2006) recommendations that cancer survivorship health education be focused on patient-specific management of side effects to improve patient satisfaction.
Literature Review
The Johns Hopkins Nursing evidence-based practice appraisal tool was used as a guide to assess the strength and quality of research and non-research evidence. Strength of research is indicated by Levels (Levels I to III for experimental, quasi-experimental, and descriptive or qualitative research, and Levels IV to V for non-research guidelines or expert opinions) and quality of research with the terms High, Good, or Low (Newhouse, Dearholt, Poe, Pugh, & White, 2007). The strength of evidence ratings reflected five Level 1 Research (randomized controlled trial [RCT] or meta-analysis of RCTs), one Level II Research (quasi-experimental) study, and one Level III Research (non-experimental or qualitative) study. One Level IV expert committee consensus guideline report was also reviewed. The critical analysis was organized by two themes related to prostate cancer patient satisfaction: survivorship interactive education interventions, and survivorship health content (see Table 1).
Survivorship Interactive Education
Gysels and Higginson (2007) conducted a meta-analysis of nine RCTs with 1,678 patients. The meta-analysis revealed a positive correlation between patient and health provider interactive survivorship interventions. The RCTs tested dichotomous innovative interactive educational technology interventions (such as computer use and videotaping) against conventional interactive educational interventions (such as written reading material or verbal interactions). Interactive technologies improved patient knowledge and satisfaction.
Harden and colleagues (2009) and Northouse, Mood, Schafenacker, and colleagues (2007) reports similar findings that suggest a strong positive correlation between interactive, face-to-face family and health provider counseling sessions to allow survivorship health information to manage chronic treatment side effects and satisfaction. Following a cross validation RCT, Northouse, Mood, Schafenacker, and colleagues (2007) reported that men with prostate cancer and their spouses had positive outcomes from interactive and face-to-face counseling interventions that offered information and support. The information included survivorship and symptom management content that focused on urinary incontinence and bowel and sexual difficulties. Similarly, Harden and colleagues (2009) reported that patients with prostate cancer had high satisfaction with survivorship health information programs. Most patients (71%) reported the survivorship health information content most valuable was information to cope with diagnosis, treatment, and post-treatment side effects.
Similar findings among researchers support that providing prostate cancer survivorship education and counseling for management of chronic and/or adverse side effects of prostate cancer treatment is important. Face-to-face interaction of the health care provider with the patient and family may be the most valuable intervention to improve patient satisfaction (Gysels & Higginson, 2007; Harden et al., 2009; Northouse, Mood, Schafenacker et al., 2007). Moreover, the IOM (2006) recommends an interactive exchange of health information between the patient and the health provider addressing chronic symptoms resulting from treatment.
Survivorship Health Content
Hawes and colleagues (2006), in a secondary analysis of an RCT, focused on identifying if additional survivorship health problems exist among patients as a result of prostate cancer treatment and need to be included in patient health information. They noted that education regarding how to live with the effects of prostate cancer treatment, such as impotence, incontinence, and osteoporosis, were important concepts for survivorship content. A meta-analysis by Carstons (2009) focused on these same key concepts for cancer patient health information, health care decision-making, and the effectiveness of patient education about cancer. The evidence of the studies reviewed suggested a positive relationship between providing evidence-based cancer survivorship health information on effects of treatment following assessment of patient readiness to learn and the desire to no longer be a passive recipient of care.
Demark-Wahnefried, Aziz, Rowland, and Pinto (2005) also supported the need for the provision of prostate cancer survivorship health content based on patient needs and preferences to manage chronic side or adverse effects of prostate cancer treatment. They further noted the education material should be tailored to patient needs and may include topics such as fatigue, impotence, incontinence, obesity, and functional decline, as well as methods to improve overall health with diet, exercise, and other lifestyle changes. The study also examined the preferences of patients with prostate cancer for learning to apply problem-solving steps as active participants in managing their care. A qualitative analysis by Harden, Northouse, and Mood (2006) also noted that educational material include the topics noted by Demark-Wahnefried and colleagues (2005).
Similar findings among researchers support that prostate cancer survivorship education must be specific to the needs of each patient but may include information related to impotence, incontinence, obesity, osteoporosis, fatigue, functional de cline, and health promotion strategies related to diet and exercise (Carstons, 2009; Demark-Wahnefried et al., 2005; Harden et al., 2006; Hawes et al., 2006). These studies support the IOM (2006) recommendations that cancer survivorship health education be focused on patient-specific management of side effects to improve patient satisfaction.
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