Email this article 
Unmet supportive care needs in prostate cancer survivors with advanced disease: A mixed-methods exploration
Abstract
Purpose: Men with advanced prostate cancer experience a wide range of side effects from the cancer and its therapies, which have a negative effect on their quality of life (QOL). Few studies have evaluated supportive care needs in these individuals. The purpose of this study was to conduct a holistic supportive care needs assessment among these survivors guided by the Supportive Care Framework for Cancer Care.
Methods: Using a convergent parallel mixed-methods approach, prostate cancer survivors with advanced disease (n = 188) completed a cross-sectional survey. A subset of these survivors (n = 20) participated in an interview to further explore their experience of unmet needs.
Results: Survivors reported unmet supportive care needs in every domain of the framework. Up to 95.2% of the survivors had at least one unmet need, with a mean of 14.9 (range: 0–42). Several areas of convergence among the quantitative and qualitative data (fatigue, sexual dysfunction, practical, and emotional/psychological domains), as well as divergence (informational and spiritual domains, depression, urinary dysfunction) were found through the integration process.
Conclusions: This study confirms that prostate cancer survivors with advanced disease experience high rates of unmet supportive care needs. The findings also highlight the diversity of those unmet needs. These results may assist with future development of patient-centered supportive care interventions that better meet the specific needs of this vulnerable group of cancer survivors.
Keywords: prostate cancer; advanced disease; survivors; supportive care; unmet needs; quality of life; mixed-methods
Full Text:
PDFReferences
Albaugh, J. A., Sufrin, N., Lapin, B. R., Petkewicz, J., Tenfelde, S. (2017). Life after prostate cancer treatment: A mixed-methods study of the experiences of men with sexual dysfunction and their partners. BMC Urology, 17, 45–53.
American Cancer Society. (2019). Cancer treatment and survivorship statistics. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21565
Ball, M., Nelson, C. J., Shuk, E., Starr, T. D., Temple, L., Jandorf, L., Schover, L., Mulhall, J. P., Woo, H., Jennings, S., DuHamel, K. (2013). Men´s experiences with sexual dysfunction post rectal cancer treatment: A qualitative study. Journal of Cancer Education, 28(3), 494–502.
Bauer, A. G., Jefferson, M., Nahhas, G. J., Savage, S., Drake, R., Lilly, M., Ambrose, L., Caulder, S., Mahvi, D., Halbert, C. H. (2020). Financial toxicity and strain among men receiving prostate cancer care in an equal access healthcare system. Cancer Medicine, 9(23), 8765–8771.
Bermat, J. K, Wittman, D. A., Hawley, S. T., Hamstra, D. A., Helfand, A. M., Haggstrom, D. A., Darwish-Yassine, M., Skolarus, T. A. (2016). Symptom burden and information needs in prostate cancer survivors: A case for tailored long-term survivorship care. BJU International, 118(3), 372–378.
Bobridge, A., Bond, M. J., Marshall, V., & Paterson, J. (2015). An investigation of the support needs if men and partners throughout the prostate cancer journey. Psyho-Oncology, 24, 341–347.
Boyes, A., Girgis, A., & Zucca, A. (2004). Supportive care needs survey: A guide to administration scoring, and analysis. Cancer Council New South Wales.
Busolo, D. S., & Woodgate, R. L. (2016). Using a supportive care need framework to understand and improve palliative care among cancer patients in Africa. Palliative Supportive Care, 14(3), 284–301.
Carter, N., Miller, P., Murphy, B. R., Payne, V. J., & Bryant-Lukosius, D. (2014). Healthcare providers’ perspectives of the supportive care needs of men with advanced prostate cancer. Oncology Nursing Forum, 41(4), 421–430.
Carter, N., Lukosius, D. B., DiCenso, A., Blythe, J., & Neville, A. J. (2011). The supportive care needs of men with advanced prostate cancer. Oncology Nursing Forum, 38(2), 189–198.
Chambers, S. K., Hyde, M. K., Laurie, K., Legg, M., Frydenberg, M., Davis, I. D., Lowe, A., & Dunn, J. (2018). Experiences of Australian men diagnosed with advanced prostate cancer: A qualitative study. BMJ Open, 8, 1–12.
Chan, R. J., Yates, P., & McCarthy, A. L. (2016). Fatigue self-management behaviors in patients with advanced cancer: A prospective longitudinal study. Oncology Nursing Forum, 43(6), 762–771.
Cheah, W. L., Ling, N.C., & Chang, K. H. (2016). The supportive care needs for prostate care patients in Sarawak. Chinese Clinical Oncology, 5(1), 7–14.
Cockle-Hearne, J., Charnay-Sonnek, F., Denis, L., Fairbanks, G. E., Kelly, D., Kav, S., Leonard, K., Muilekom, E. V., Fernandez-Ortega, P., Jensen, B. T., & Faithfull, S. (2013). The impact of supportive nursing care on the needs of men with prostate cancer: A study across seven European countries. British Journal of Cancer, 109, 2121–2130.
Cox, A., Lucas, G., Marcu, A., Piano, M., Grosvenor, W., Mold, F., Maguire, R., & Ream, E. (2017). Cancer survivors’ eperience with Telehealth: A systematic review and thematic synthesis. Journal of Medical Internet Research, 19(1), e11.
Crawford, E. D., Petrylak, D., & Sartor, O. (2017). Navigating the evolving therapeutic landscape in advanced prostate cancer. Urologic Oncology, 35, S1–S13.
Creswell, J. W., Plano, Clark. V. L. (2018). Designing and conducting mixed methods research. (3rd ed). Sage Publications.
Creswell, J. W., & Poth, C.N. (2018). Qualitative inquiry research design: Choosing among five approaches. (4th ed.). SAGE Publications.
Darwish-Yassine, M., Berenji, M., Wing, D., et al. (2014). Evaluating long-term patient-centered outcomes following prostate cancer treatment: Findings from the Michigan prostate cancer survivorship study. Journal of Cancer Survivorship, 8, 121–130.
Elo, S., & Kyngas, H. (2007). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107–115.
Fayers, P. M., Aaronson, N. K., Bjordal, K., Groenvold, M., Curran, D., & Bottomley, A. (2001). The EORTC QLQ-C30 scoring manual (3rd Ed). European Organization for Research and Treatment of Cancer, Brussels.
Fetters, M. D., Curry, L. A., & Creswell, J. W. (2013). Achieving integration in mixed methods designs-principles and practices. Health Services Research, 48(6), 2134–2156.
Fitch, M. I. (2008). Supportive care needs framework. Canadian Oncology Nursing Journal, 18(1), 6–14.
Fitch, M. I., & Steel, R. (2010). Identifying supportive care needs of women with ovarian cancer. Canadian Oncology Nursing Journal, 20(2), 66–74.
Fitch, M. I. (2012). Supportive care needs of patients with advanced disease undergoing radiotherapy for symptom control. Canadian Oncology Nursing Journal, 22(2), 84–100.
Gjersing. L., Capplehorn, J. R., & Clausen, T. (2010). Cross-cultural adaptation of research instruments: Language, setting, time, and statistical considerations. BMC Medical Research Methodology, 10, 13.
Handberg, C., Thorne, S., & Maribo, T. (2018). When a policy decision meets practice realities: The case of cancer survivorship care and rehabilitation needs assessment. European Journal of Oncology Nursing, 33, 70–77.
Hart, N. H., Galvao, D. A., & Newton, R. U., (2017) Exercise medicine for advanced prostate cancer. Current Opinion in Supportive and Palliative Care, 11(3), 247–257.
Hatamipour, K., Rassouli, M., Yaghmaie, F., Zendelel, K., & Majd, H. A. (2015). Spiritual needs of cancer patients: A qualitative study. Indian Journal of Palliative Care, 21(1), 61–67.
Haynes-Lewis, H., Clayton, M. F., Viswanathan, S., Moadel-Robblee, A., Clark, L., & Caserta, M. (2018). Distress and supportive care needs of ethnically diverse older adults with advanced or recurrent cancer. Oncology Nursing Forum, 45(4), 496–507.
Holm, M., Doveson, S., Lindqvist, O., Wennman-Larsen, A., F& ransson, P. (2018). Quality of life in men with metastatic prostate cancer in their final years before death – A retrospective analysis of prospective data. BMC Palliative Care, 17, 126–133.
IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. IBM Corp.
Jacobsen, P. B., Nipp, R. D., & Ganz, P. A. (2017). Addressing the survivorship care needs of patients receiving extended cancer treatment. ASCO Educational Book: American Society of Clinical Oncology, 674–682.
Joyce, D., Heslop, D. L., Umoh, J. I., Brown, S. D., Robles, J. A., Wallston, K. A., & Moses, K. A. (2020). Examining the association of health literacy and numeracy with prostate-related knowledge and prostate cancer treatment regret. Urologic Oncology, 38(8), e11–e19.
King, A. J. L., Evans, M., Moore, T. H. M., Paterson, C., Sharp, D., Persad, R., & Huntley, A. L. (2015). Prostate cancer and supportive needs: A systematic review and qualitative synthesis of men´s experiences and unmet needs. European Journal of Cancer Care, 24, 618–634.
Kuon, J., Vogt, J., Mehnert, A., Alt-Epping, B., Van Oorschot, B., Sistermanns, J., Ahlborn, M., Ritterbusch, U., Stevens, S., Kahl, C., Ruellan, A., Matthias, K., Kubin, T., Stahlhut, K., Heider, A., Lordick, F., & Thomas, M. (2019). Symptoms and needs of patients with advanced lung cancer: Early prevalence assessment. Oncology Research & Treatment, 42, 650–659.
Lintz, K., Moynihan, C., Steginga, S., Norman, A., Eeles, R., Huddart, R., Dearnaley, D., & Watson, M. (2003). Prostate cancer patients’ support and psychosocial care needs: Survey from a non-surgical oncology clinic. Psycho-Oncology, 12, 769–783.
Lo, S. S., & Buss, M. K. (2019). What is the difference between supportive and palliative care? American Society of Clinical Oncology. https://dailynews.ascopubs.org/do/10.1200/ADN.19.190354/full/
Lub, V. (2015). Validity in qualitative evaluation: Linking purposes, paradigms, and perspectives. International Journal of Qualitative Methods, 14(5). https//doi.org/10.1177%2F1609406915621406
Maharaj, N., Soheilipour, S., Bender, J.L., & Kazanjian, A. (2018). Understanding prostate cancer support needs: How do they manage living with cancer? Illness, Crisis, & Loss, 0(0), 1–23.
Matthews, A. K., Tejeda, S., Johnson, T., Berbaum, M. L., & Manfredi, C. (2012). Correlated of quality of life among African American and White cancer survivors. Cancer Nursing, 35(5), 355–364.
Miller, K. D., Nogueira, L., Mariotto, A. B., Rowland, J. H., Yabroff, R., Alfano, C. M., Jemal, A., Kramer, J. L., & Siegel, R. L. (2019). Cancer treatment and survivorship statistics. CA: A Cancer Journal for Clinicians. https://doi.org/10.3322/caac.21565
Muñoz, A. R., Salsman, J. M., Stein, K., & Cella, D. (2016). Reference values of the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being (FACIT-Sp 12): A report from American Cancer Society’s studies of cancer survivors. Cancer, 121(11), 1838–1844.
National Cancer Institute. (2020). Cancer stats facts: Prostate cancer. https://seer.cancer.gov/statfacts/html/prost.html
National Comprehensive Cancer Network. (2020). Survivorship care for healthy living. https://www.nccn.org/patients/guidelines/content/PDF/survivorship-hl-patient.pdf
Nekhlyudov, L., Ganz, P. A., Arora, N. K., & Rowland, J. H. (2017). Going beyond being lost in transition: A decade of progress in cancer survivorship. Journal of Clinical Oncology, 35(18), 1978-1981.
Okediji, P. T., Salako, O., & Fatiregun, O. O. (2017). Pattern and predictors of unmet supportive care needs in cancer patients. Cureus, 9(5), e1234.
Oliffe, J. L., Mroz, L. W., Bottorff, J. L., Braybrook, D. E., Ward, A., Goldenberg, L. S. (2015). Heterosexual couples and prostate cancer support groups: A gender relations analysis. Support Care in Cancer, 23, 1127–1133.
O´Shaughnessy, P. K., Laws, T. A., E& sterman, A. J. (2015). The prostate cancer journey: Results from an online survey of men and their partners. Cancer Nursing, 38(1), E1–E12.
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health, 42(5), 533–544.
Paterson, C., Primeau, C., Howard, N., Xiberras, P., Pillay, B., Crowe, H. (2020). Experiences of unmet supportive care for men receiving androgen deprivation therapy for prostate cancer: A bi-national study. Seminars in Oncology Nursing, 36, 151049.
Paterson, C., Primeau, C., & Nabi, G. (2018). A randomized 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. European Journal of Oncology Nursing, 37, 65–73.
Paterson, C., Grzegorz, S., Nandwani, G., Chaudhury, D. D., & Nabi, G. (2017). Unmet supportive care needs of men with locally advanced and metastatic prostate cancer on hormonal treatment: A mixed methods study. Cancer Nursing, 40(6), 497–507.
Paterson, C., Robertson, A., Smith, A., & Nabi, G. (2015). Identifying the unmet supportive care needs of men living with and beyond prostate cancer: A systematic review. European Journal of Oncology Nursing, 19, 405–418.
Potter, J. (2004). Fatigue experience in advanced cancer: A phenomenological approach. International Journal of Palliative Nursing, 10(1), 15–23.
Prostate Conditions Education Council. (2019). Advanced disease. https://www.prostateconditions.org/about-prostate-conditions/prostate-cancer/advanced-disease
Ralph, N., Chambers, S.K., Laurie, K., Oliffe, J., Lazanby, M., & Dunn, J. (2020). Nurse-led supportive care intervention for men with advanced prostate cancer: Healthcare professionals’ perspective. Oncology Nursing Forum, 47(1), 33–43.
Rawla, P. (2019). Epidemiology of prostate cancer. World Journal of Oncology, 10(2), 63–89.
REDCap Software. n.d. About. https://www.project-redcap.org/software/*
Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing and Health, 23, 334–340.
Shaverdian, N., Kishan, A.U., Veruttipong, D., Demanes, D. J., Kupelian, P., McCloskey, S., Steinberg, M. L., & King, C. R. (2018). Impact of the primary information source used for decision making on treatment perceptions and regret in prostate cancer. American Journal of Clinical Oncology, 41(9), 898–904.
Spratt, D. (2019). Novel therapies for prostate cancer. American Society of Clinical Oncology. https://dailynews.ascopubs.org/do/10.1200/ADN.19.190151/full/
Steentjes, L., Siesling, S., Drummond, F. J., Manen, J. G., Sharp, L., & Gavin, A. (2018). Factors associated with current and severe physical side-effects after prostate cancer treatment: What men report. European Journal of Cancer Care, 27, e12589–e12601.
Thorne, S. (2000). Data analysis in qualitative research. BMJ Evidence-Based Nursing, 68(3), 68–70.
Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing and Health Sciences, 15(3), 398–405.
Watson, E., Shinkins, B., Frith, E., Neal, D., Hamdy, F., Walter, F., Weller, D., Wilkinson, C., Faithfull, S., Wolstenholme, J., Sooriakumaran, P., Kastner, C., Campbell, C., Neal, R., Butcher, H., Matthews, M., Perera, R., & Rose, P. (2016). Symptoms, unmet needs, psychological well- being, and health status in survivors of prostate cancer: Implications for redesigning follow-up. BJU International, 117, E10–E19.
Wollersheim, B. M., Stam, M. A., Bosch, R. J. L. H., Pos, F. J., Tillier, C. N., Van der Poel, H. G., & Aaronson, N. K. (2020). Unmet expectations in prostate cancer patients and their associations with decision regret. Journal of Cancer Survivorship,14, 731–738.
Zajdlewicz, L., Hyde, M. K., Lepore, S. J., Gardiner, R. A., & Chambers, S. K. (2017). Health-related quality of life after the diagnosis of locally advances or advanced prostate cancer. Cancer Nursing, 40(5), 412–419.
Refbacks
- There are currently no refbacks.
