Keywords

Head and neck cancer, Instruction, Oncology nursing, Patient discharge, Professional-patient relations, Qualitative research

 

Authors

  1. de Leeuw, Jacqueline MScN, RN
  2. Prins, Judith B. PhD
  3. Merkx, Matthias A.W. MD, PhD, DMD
  4. Marres, Henri A.M. MD, PhD
  5. van Achterberg, Theo PhD

Abstract

Background: Cancer patients are presented with advice and instructions during treatment and at discharge. Most recommendations aim at relief of physical problems, psychosocial well-being, and patients' health care behaviors. Patients often struggle to incorporate advice into daily life, and this influences symptom relief, quality of life, and even longevity.

 

Objective: The aim of this study was to gain insight into the content and form of discharge advice to cancer patients and to determine the factors that hinder or promote the actual adoption of advice by patients.

 

Methods: Using a descriptive, exploratory research design, data were collected using structured interviews in a convenience sample of 21 head and neck cancer patients who had completed treatment with curative intent 2 to 6 months earlier. Descriptive statistics and a thematic content analysis procedure were used to analyze the data.

 

Results: Findings showed that advice or instructions received by individual patients had a range from 1 to 13, and that 17 out of 21 patients received 4 advices or more. Relevant influencing factors included patient characteristics (cognition, emotion, behavior, and social aspects) and characteristics of health professionals (content and efficacy of advice, professional attitude, behavior, and communication).

 

Conclusions: Cancer patients try but often struggle to fit the multitude and complexity of advice from health professionals into everyday life.

 

Implications for Practice: There seems to be an excellent opportunity for health professionals to support cancer patients by further tailoring of follow-up care. Knowledge and insight into the challenges patients face posttreatment will benefit both professionals and patients.