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Patient Experiences of Self-Care Management after Radical Prostatectomy
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Kalmar County, Sweden.ORCID iD: 0000-0002-7158-2883
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. (reaction)ORCID iD: 0000-0002-0895-674x
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.ORCID iD: 0000-0001-8398-9552
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Karolinska Institutet, Sweden. (DISA;reaction)ORCID iD: 0000-0002-4108-391x
2021 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 50, article id 101894Article in journal (Refereed) Published
Abstract [en]

Purpose: Prostate cancer is the most common cancer form in Sweden and side effects of the leading treatment, radical prostatectomy, include urinary leakage and erectile dysfunction. Patients are recommended to perform self-care to reduce side effects, but their experiences of performing self-care management after radical prostatectomy are largely unexplored. The aim of this study was to deepen the understanding about patient experiences of support for managing self-care during the first six months after radical prostatectomy.

Methods: Eighteen patients were consecutively recruited six months after surgery and individual interviews were conducted. The study had a descriptive qualitative approach and inductive content analysis was used. Results: Patients described self-care management during the first half-year after surgery as a progression with growth in self-management skills through interconnected phases, from initially striving to get a grasp of the situation and find supportive relationships, to getting grounded in the new situation and taking command of the situation. At six months after surgery, patients had reached a point where they needed to maneuver feelings about long-term consequences.

Conclusions: Standardized routines ensure a certain level of care, but are sparsely adjustable to patients & rsquo; progression in self-care management. For sustained self-care behaviors, tailored and interactive support is required from multiple disciplines and peers, in order for a patient to get grounded in and take command of the situation.

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 50, article id 101894
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-102060DOI: 10.1016/j.ejon.2020.101894ISI: 000632612300012PubMedID: 33529792Scopus ID: 2-s2.0-85099925161OAI: oai:DiVA.org:lnu-102060DiVA, id: diva2:1543211
Funder
The Kamprad Family FoundationSwedish Cancer SocietyAvailable from: 2021-04-09 Created: 2021-04-09 Last updated: 2024-05-07Bibliographically approved
In thesis
1. Support for patients and the role of eHealth in rehabilitation after radical prostatectomy
Open this publication in new window or tab >>Support for patients and the role of eHealth in rehabilitation after radical prostatectomy
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Patients undergoing radical prostatectomy for prostate cancer often experience urinary incontinence and sexual dysfunction posttreatment. Active self-care can reduce this burden. However, support maybe needed to maintain motivation during the long rehabilitation. eHealth has the potential to provide such support.

Aim: To investigate the effects of eHealth support and describe patients'experiences of support in self-care during the rehabilitation after radical prostatectomy.

Method: The Medical Research Council’s framework for complex interventions governed the overall design of this thesis. In Study I, patients’ experiences of the usability of a new eHealth support, the electronic Patient Activation in Treatment at Home (ePATH), was described using individual interviews and deductive content analysis. The effects of ePATH on symptoms and activation were evaluated through a multicenter longitudinal randomized controlled trial (II, III). Patients planned for radical prostatectomy at three sites were eligible for inclusion. The intervention group had access to ePATH during one year after surgery. Questionnaires at five timepoints were analyzed with linear mixed models and generalized estimation equations. Study IV described patients’ experiences of support for managing self-care through individual interviews and inductive content analysis.

Results: Study I covered the usability of ePATH as to managing the technology, turning input into output, and how the eHealth support assisted in task performance. The randomized controlled trial showed no significant differences between groups regarding urinary incontinence, sexual function, physical activity, pelvic floor exercises (II), or patient activation (III). In the intervention group, 64% used ePATH. Initial patient activation and depression significantly influenced patient activation over the course of the rehabilitation year. In Study IV, patients described a progression in self-care management, where their abilities grew through interconnected phases.

Conclusion: The needs for support differ during a patient's journey through prostate cancer rehabilitation. This places demands on the support and underscores the need for accessibility, individual adaptation, and continuity. Future research should focus on adjustable aids for patients in long-term rehabilitation, integrating multiple aspects, to enable tailoring of the support.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2024. p. 105
Series
Linnaeus University Dissertations ; 522
Keywords
eHealth, patient activation, prostate cancer, radical prostatectomy, randomized controlled trial, self-care, support, telemedicine, usability
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-129194 (URN)10.15626/LUD.522.2024 (DOI)9789180821513 (ISBN)9789180821520 (ISBN)
Public defence
2024-05-31, Fullriggaren, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2024-05-07 Created: 2024-05-07 Last updated: 2024-05-13Bibliographically approved

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Wennerberg, CamillaSchildmeijer, KristinaHellström, AmandaEkstedt, Mirjam

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