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Preparedness for colorectal cancer surgery and recovery through a person-centred information and communication intervention - A quasi-experimental longitudinal design.

Journal article
Authors Joakim Öhlén
RIchard Sawatzky
Monica Pettersson
Elisabeth Kenne Sarenmalm
Larsdotter Cecilia
Frida Smith
Catarina Wallengren
Febe Friberg
Karl Kodeda
Eva Carlsson
Published in PLoS ONE
Volume 14
Issue 12
ISSN 1932-6203
Publication year 2019
Published at Institute of Clinical Sciences, Department of Surgery
University of Gothenburg Centre for person-centred care (GPCC)
Institute of Health and Care Sciences
Language en
Links dx.doi.org/10.1371/journal.pone.022...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Person-centered care, communication, oncological care, surgical care, Complex clinical intervention
Subject categories Surgery, Nursing

Abstract

To meet patients' information and communication needs over time in order to improve their recovery is particularly challenging for patients undergoing cancer surgery. The aim of the study was to evaluate whether an intervention with a person-centred approach to information and communication for patients diagnosed with colorectal cancer undergoing surgery can improve the patients' preparedness for surgery, discharge and recovery during six months following diagnosis and initial treatment. The intervention components involving a novel written interactive patient education material and person-centred communication was based on critical analysis of conventional information and communication for these patients. During 2014-2016, 488 consecutive patients undergoing elective surgery for colorectal cancer were enrolled in a quasi-experimental longitudinal study. In three hospitals, first a conventional care group (n = 250) was recruited, then the intervention was introduced, and finally the intervention group was recruited (n = 238). Patients' trajectories of preparedness for surgery and recovery (Preparedness for Colorectal Cancer Surgery Questionnaire-PCSQ) health related quality of life (EORTC QLQ-C30) and distress (NCCS Distress Thermometer) were evaluated based on self-reported data at five time points, from pre-surgery to 6 months. Length of hospital stay and patients' behavior in seeking health care pre- and post-surgery were extracted from patient records. Longitudinal structural equation models were used to test the hypothesized effects over time. Statistically significant positive effects were detected for two of the four PCSQ domains (patients searching for and making use of information, and making sense of the recovery) and for the role functioning domain of the EORTC QLQ-C30. Patients in the intervention group were also more likely to contact their assigned cancer "contact nurse" (a.k.a. nurse navigator) instead of contacting a nurse on duty at the ward or visiting the emergency department. In conclusion, the overall hypothesis was not confirmed. Further research is recommended on written and oral support tools to facilitate person-centred communication.

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