Radical cystectomy for bladder cancer: A qualitative study of patient experiences and implications for practice

Margaret I. Fitch, Debbie Miller, Sharon Sharir, Alison McAndrew

Abstract


Patients being treated for bladder cancer share issues in common with other cancer patients, but also experience issues that are unique to their surgical treatment. This study used a descriptive qualitative approach to explore the experiences of patients who had undergone radical cystectomy for bladder cancer. Twenty-two participants were interviewed in-depth on one occasion and were invited to attend a focus group session following the analysis of the interview transcripts. Participants described the shock of their diagnosis, their lack of information about bladder cancer, the importance of clear communication with care providers, and the types of adjustments they had to make following surgery. Specifically, changes in bodily function, body image, sexual relationships, and intimacy presented challenges for these participants. Although there was a sense of acceptance about the treatment-related events, there were still significant adjustments required by individuals following their surgery. Information, open communication, and support from family and friends were seen as important factors in helping patients adjust after surgery. Patients require clear, concise and consistent information about their cancer, treatment options, and course of care. Nurses caring for patients following surgery for bladder cancer need to understand the unique needs of these patients.


Full Text:

PDF

References


Beitz, J.M., & Zuzelo, P.R. (2003). The lived experience of having a

neobladder. Western Journal of Nursing Research, 25(3), 294–316.

Canadian Cancer Society/National Cancer Institute of Canada.

(2009). Canadian Cancer Statistics 2009. Toronto, ON: Author.

Connelly, L.M., & Yoder, L.H. (2000). Improving qualitative proposals:

Common problem areas. Clinical Nurse Specialist, 1(2), 69–74.

Dutta, S.C., Chang, S.C., Coffey, C.S., Smith, J.A. Jr., Jack, G., &

Cookson, M.S. (2002). Health related quality of life assessment

after radical cystectomy: Comparison of ileal conduit with continent

orthotopic neobladder. Journal of Urology, 168(1), 164–167.

Gerharz, E.W., Mansson, A., Hunt, S., Skinner, E.C., & Mansson, W.

(2005). Quality of life after cystectomy and urinary diversion: An

evidence-based analysis. Journal of Urology, 174(5), 1729–1736.

Giorgi, A. (1985). Sketch of a phenomenological method. In A. Giorgi

(Ed.), Phenomenology and Psychological Research (pp. 8–22).

Pittsburgh, PA: Pittsburgh Duquesne University Press.

Hart, S., Skinner, E.C., Meyerowitz, B.E., Boyde, S., Lieskovsky, G., &

Skinner, D.G. (1999). Quality of life after radical cystectomy for

bladder cancer in patients with an ileal conduit, cutaneous or

urethral Kock pouch. Journal of Urology, 162(1), 77–81.

Henningsohn, L., Steven, K., Kallestrup, E.B., & Steineck, G. (2002).

Distressful symptoms and well-being after radical cystectomy

and orthotopic bladder substitution compared with a matched

control population. Journal of Urology, 168(1), 168–174.

Kulaksizoglu, H., Toktas, G., Kulaksizoglu, I.B., Aglamis, E., & Unlüer,

E. (2002). When should quality of life be measured after radical

cystectomy? European Urology, 42(4), 350–355.

Lagana, L., Classen, C., Caldwell, R., McGarvey, E.L., Baum, L.D.,

Cheasty, E., et al. (2005). Sexual difficulties of patients with gynecological

cancers. Professional Psychology: Research & Practice,

(4), 391–399.

Lincoln, Y.S., & Guba, E. (1985). Naturalistic Inquiry. Thousand Oaks,

CA: Sage Publications Inc.

Madeb, R., & Messing, E.M. (2004). Gender, racial and age differences

in bladder cancer incidence and mortality. Urologic Oncology,

(2), 86–92.

McGuire, M.S., Grimaldi, G., Grotas, J., & Russo, P. (2000). The type of

urinary diversion after radical cystectomy significantly impacts

on the patient’s quality of life [see comment]. Annals of Surgical

Oncology, 7(1), 4–8.

Nordström, G.M., & Nyman, C.R. (1992). Male and female sexual

function and activity following ileal conduit urinary diversion.

British Journal of Urology, 70(1), 33–39.

Patel, A.R., & Campbell, S.C. (2009). Current trends in the management

of bladder cancer. Journal of Wound, Ostomy and

Continence Nursing, 36(4), 413–421.

Porter, M.P., & Penson, D.F. (2005). Health-related quality of life after

radical cystectomy and urinary diversion for bladder cancer: A

systematic review and critical analysis of the literature. Journal

of Urology, 173, 1318–1322.

Sandelowski, M. (1986). The problem of rigor in qualitative research.

Advances in Nursing Science, 8(3), 27–37.

Sandelowski, M. (1993). Rigor or rigor mortis: The problem of rigor

in qualitative research revisited. Advances in Nursing Science,

(2), 1–8.

Sandelowski, M. (1995). Sample size in qualitative research.

Research in Nursing & Health, 18(2) 179–183.

Sandelowski, M. (1997). “To be of useâ€: Enhancing the utility of qualitative

research. Nursing Outlook, 45(3), 125–132.

Schover, L.R. (2004). Sexuality after treatment of pelvic cancer (pp.

–195). Linthicum, MD: American Urological Association.

Somani, B.K, Gimlin, D., Fayers, P., & N’dow, J. (2009). Quality of life

and body image for bladder cancer patients undergoing radical

cystectomy and urinary diversion—A prospective cohort study

with a systematic review of literature. Urology, 74(5), 1138–43.

Tabano, M., Condosta, D., & Coons, M. (2002). Symptoms affecting

the quality of life in women with gynecologic cancer. Seminars in

Oncology Nursing, 18(3), 223–230.

Thorne, S., Kirkham, S.R., & MacDonald-Emes, J. (1997). Interpretive

description: A noncategorical qualitative alternative for developing

nursing knowledge. Research in Nursing & Health, 20(2),

–177.

Zippe, C.D., Raina, R., Shah, A.D., Massavayi, E.Z., Agarwal, A.,

Ulchaker, J., et al. (2004). Female sexual dysfunction after radical

cystectomy: A new outcome measure. Urology, 63(6),

–1157.


Refbacks

  • There are currently no refbacks.