The purpose of this study was to assess the incidence, pattern and severity of somnolence and fatigue in patients treated with cranial irradiation for primary brain tumours and to identify factors that may influence or mediate symptoms. A detailed prospective study was carried out of 19 patients who received high-dose (45-55 Gy) cranial irradiation as treatment for primary brain tumours. Data were collected for each patient over a 3 month period using a prospective diary utilizing visual analogue scales of common somnolence symptoms and fatigue, and detailed interviews at 2, 6 and 12 weeks following the completion of treatment. Sixteen patients developed somnolence syndrome following treatment. Time series analysis identified a cyclical pattern to the symptoms, with a period of drowsiness and fatigue occurring from day 11 to day 21 and from day 31 to day 35 after radiotherapy. The principal symptoms were those of excessive drowsiness, feeling clumsy, an inability to concentrate, lethargy, being mentally slow and fatigue. Patients treated with accelerated (n = 11) compared with more conventional (n = 8) fractionation experienced more severe drowsiness and fatigue (P
Crosby-Nwaobi RR, Faithfull S (2011) High risk of urinary tract infections in post-operative gynaecology patients: A retrospective case analysis, European Journal of Cancer Care 20 (6) pp. 825-831
This study was undertaken to determine the incidence and risk factors related to the occurrence of urinary tract infections (UTIs), post surgery, in women being treated for a gynaecological cancer. A retrospective case analysis of 215 women was conducted using data collected via case review with domains covering known risk factors for the occurrence of urinary infections. Bacteriuria was defined as greater than 10 5 colony-forming units per millilitre. A total of 30.7% of women had a UTI post-operatively. Among these, 75.7% infections were Escherichia coli. Having a catheter in situ for d3 days was found to be slightly significant in the formation of a UTI post-operatively (U= 3878, P
White ID, Allan H, Faithfull S (2013) DEVELOPMENT OF A PSYCHOSEXUAL CLINICAL ASSESSMENT STRATEGY FOR WOMEN AFTER PELVIC RADIOTHERAPY, JOURNAL OF SEXUAL MEDICINE 10 pp. 140-140 WILEY-BLACKWELL
White ID, Faithfull S (2006) Vaginal dilation associated with pelvic radiotherapy: a UK survey of current practice, INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 16 (3) pp. 1140-1146 BLACKWELL PUBLISHING
Cox A, Illsley M, Knibb W, Lucas C, O'Driscoll M, Potter C, Flowerday A, Faithfull S (2011) The acceptability of e-technology to monitor and assess patient symptoms following palliative radiotherapy for lung cancer., Palliat Med
E-technology is increasingly used in oncology to obtain self-reported symptom assessment information from patients, although its potential to provide a clinical monitoring tool in palliative care is relatively unexplored in the UK. This study aimed to evaluate the support provided to lung cancer patients post palliative radiotherapy using a computerized assessment tool and to determine the clinical acceptability of the tool in a palliative care setting. However, of the 17 clinicians identified as managing patients who met the initial eligibility criteria for the study, only one clinician gave approval for their patient to be contacted regarding participation, therefore the benefits of this novel technology could not be assessed. Thirteen key clinicians from the centres involved in the study were subsequently interviewed. They acknowledged potential benefits of incorporating computerized patient assessment from both a patient and practice perspective, but emphasized the importance of clinical intuition over standardized assessment. Although clinicians were positive about palliative care patients participating in research, they felt that this population of patients were normally too old, with too rapidly deteriorating a condition to participate in a study using e-technology. In order to encourage acceptance of e-technology within palliative care, emphasis is needed on actively promoting the contribution of technologies with the potential to improve patient outcomes and the patient experience.
Faithfull S, Lemanska A, Aslet P, Bhatt N, Coe J, Drudge-Coates L, Feneley M, Glynn-Jones R, Kirby M, Langley S, McNicholas T, Newman J, Smith CC, Sahai A, Trueman E, Payne H (2015) Integrative review on the non-invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies, INTERNATIONAL JOURNAL OF CLINICAL PRACTICE 69 (10) pp. 1184-1208 WILEY-BLACKWELL
Faithfull S, Hilton M, Booth K (2002) Survey of information leaflets on advice for acute radiation skin reactions in UK radiotherapy centres: a rationale for a systematic review of the literature., Eur J Oncol Nurs 6 (3) pp. 176-178
Faithfull S (1996) How many subjects are needed in a research sample in palliative care?, PALLIATIVE MEDICINE 10 (3) pp. 259-261 EDWARD ARNOLD PUBL LTD
Faithfull S (1993) Palliative care. Age-related problems., Nurs Times 89 (38) pp. 66-68
Cockle-Hearne J, Charnay-Sonnek F, Denis L, Fairbanks HE, Kelly D, Kav S, Leonard K, van Muilekom E, Fernandez-Ortega P, Jensen BT, 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 (8) pp. 2121-2130
Cancer Research UK
Background:Prostate cancer is for many men a chronic disease with a long life expectancy after treatment. The impact of prostate cancer therapy on men has been well defined, however, explanation of the consequences of cancer treatment has not been modelled against the wider variables of long-term health-care provision. The aim of this study was to explore the parameters of unmet supportive care needs in men with prostate cancer in relation to the experience of nursing care.Methods:A survey was conducted among a volunteer sample of 1001 men with prostate cancer living in seven European countries.Results:At the time of the survey, 81% of the men had some unmet supportive care needs including psychological, sexual and health system and information needs. Logistic regression indicated that lack of post-treatment nursing care significantly predicted unmet need. Critically, men's contact with nurses and/or receipt of advice and support from nurses, for several different aspects of nursing care significantly had an impact on men's outcomes.Conclusion:Unmet need is related not only to disease and treatment factors but is also associated with the supportive care men received. Imperative to improving men's treatment outcomes is to also consider the access to nursing and the components of supportive care provided, especially after therapy.
Purpose: Caring for a loved one with a malignant fungating wound is very challenging and causes extreme physical and psychological distress. The aim of this study was to explore the experiences of carers who care for a loved one with a fungating breast wound. Method: To explore the lived experiences of carers a methodological framework using Heideggerian hermeneutic phenomenology and semi-structured interviews was used. Seven carers were interviewed from January until November 2009. Results: Having to deal with a situation of a loved one with a visible cancer was hard for all the carers. The visibility of the cancer was one of the most shocking aspects to deal with from the perspective of the patient and the carer. The presence of the visible wound and a cancer at an advanced stage contributed to a change in the relationship and extreme suffering for both the patient and the carer. Despite many problems such as wound odour and copious discharge from the wound, which was difficult to control carers did their best to help their loved one with the wound. Gradually the wound became the centre of the patient and carer?s life and a great deal of time was spent trying to control the wound symptoms. All carers managed the wound on their own without help and advice from health care practitioners. For all of them it was a major burden and they felt isolated. Conclusion: This study contributes to an understanding that the care of women and their carers needs strategies that are integrated in palliative wound care, that takes a holistic and empathic approach that responds to patients and carers psychosocial and emotional needs and a practical need for information to help carers assist in managing the wound related symptoms.
Faithfull S, Wells M (2003) Supportive care in radiotherapy, Elsevier Health Sciences
This book looks at the often debilitating consequences for individuals undergoing radiation therapy and the associated problems for health care professionals ...
Probst S, Arber A, Faithfull S (2011) The Meaning of Living With an Exulcerated Breast Carcinoma, EUROPEAN JOURNAL OF CANCER 47 pp. S296-S297 ELSEVIER SCI LTD
Taghipour A, Vydelingum V, Faithfull S (2011) MEN'S PERCEPTIONS AND EXPERIENCES OF THE EARLY DETECTION OF PROSTATE CANCER: A QUALITATIVE STUDY USING GROUNDED THEORY APPROACH, JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 65 pp. A304-A305 B M J PUBLISHING GROUP
Beech N, Arber A, Faithfull S (2011) Restoring a sense of wellness following colorectal cancer: A grounded theory, Journal of Advanced Nursing
Faithfull S, Hunt G (2005) Exploring nursing values in the development of a nurse-led service, NURSING ETHICS 12 (5) pp. 440-452 ARNOLD, HODDER HEADLINE PLC
Gage H, Storey L, McDowell C, Maguire G, Williams P, Faithfull S, Thomas H, Poole K (2009) Integrated care: Utilisation of complementary and alternative medicine within a conventional cancer treatment centre, COMPLEMENTARY THERAPIES IN MEDICINE 17 (2) pp. 84-91 CHURCHILL LIVINGSTONE
Davidson SE, Faithfull S (2006) Late radiotherapy effects: Is bowel morbidity adequately documented or patients' needs managed appropriately?, CLINICAL ONCOLOGY 18 (5) pp. 419-420 ELSEVIER SCIENCE LONDON
Faithfull S (1995) How to read nursing research, EUROPEAN JOURNAL OF CANCER 31A pp. 1290-1290 PERGAMON-ELSEVIER SCIENCE LTD
Faithfull S, Cockle-Hearne J, Khoo V (2011) Self-management after prostate cancer treatment: evaluating the feasibility of providing a cognitive and behavioural programme for lower urinary tract symptoms, BJU INTERNATIONAL 107 (5) pp. 783-790 WILEY-BLACKWELL
Lemanska A, Cox A, Kirkby N, Chen T, Faithfull S (2014) Predictive Modelling of Patient Reported Radiotherapy-Related Toxicity by the Application of Symptom Clustering and Autoregression, International Journal of Statistics in Medical Research (3) pp. 412-422
Patient reported outcome measures (PROMs) are increasingly being used in research to explore experiences
of cancer survivors. Techniques to predict symptoms, with the aim of providing triage care, rely on the ability to analyse trends in symptoms or quality of life and at present are limited. The secondary analysis in this study uses a statistical method involving the application of autoregression (AR) to PROMs in order to predict symptom intensity following radiotherapy, and to explore its feasibility as an analytical tool. The technique is demonstrated using an existing dataset of 94 prostate cancer patients who completed a validated battery of PROMs over time. In addition the relationship between symptoms was investigated and symptom clusters were identified to determine their value in assisting predictive modeling. Three symptom clusters, namely urinary, gastrointestinal and emotional were identified. The study indicates that incorporating symptom clustering into predictive modeling helps to identify the most informative predictor variables. The analysis also showed that the degree of rise of symptom intensity during radiotherapy has the ability to predict later radiotherapy-related symptoms. The method was most successful for the prediction of urinary and gastrointestinal symptoms. Quantitative or qualitative prediction was possible on different symptoms. The application of this technique to predict radiotherapy outcomes could lead to increased use of PROMs within clinical practice. This in turn would contribute to improvements in both patient care after radiotherapy and also strategies to prevent side effects. In order to further evaluate the predictive ability of the approach, the analysis of a larger dataset with a longer follow up was identified as the next step.
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 (2015) Symptoms, unmet needs, psychological well-being and health status in survivors of prostate cancer: implications for redesigning follow-up., BJU Int 117 (6B) pp. E10-E19
OBJECTIVE: To explore ongoing symptoms, unmet needs, psychological wellbeing, self-efficacy and overall health status in survivors of prostate cancer. PATIENTS AND METHODS: An invitation to participate in a postal questionnaire survey was sent to 546 men, diagnosed with prostate cancer 9-24 months previously at two UK cancer centres. The study group comprised men who had been subject to a range of treatments: surgery, radiotherapy, hormone therapy and active surveillance. The questionnaire included measures of prostate-related quality of life (Expanded Prostate cancer Index Composite 26-item version, EPIC-26); unmet needs (Supportive Care Needs Survey 34-item version, SCNS-SF34); anxiety and depression (Hospital Anxiety and Depression Scale, HADS), self-efficacy (modified Self-efficacy Scale), health status (EuroQol 5D, EQ-5D) and satisfaction with care (questions developed for this study). A single reminder was sent to non-responders after 3 weeks. Data were analysed by age, co-morbidities, and treatment group. RESULTS: In all, 316 men completed questionnaires (64.1% response rate). Overall satisfaction with follow-up care was high, but was lower for psychosocial than physical aspects of care. Urinary, bowel, and sexual functioning was reported as a moderate/big problem in the last month for 15.2% (n = 48), 5.1% (n = 16), and 36.5% (n = 105) men, respectively. The most commonly reported moderate/high unmet needs related to changes in sexual feelings/relationships, managing fear of recurrence/uncertainty, and concerns about the worries of significant others. It was found that 17% of men (51/307) reported potentially moderate-to-severe levels of anxiety and 10.2% (32/308) reported moderate-to-severe levels of depression. The presence of problematic side-effects was associated with higher psychological morbidity, poorer self-efficacy, greater unmet needs, and poorer overall health status. CONCLUSION: While some men report relatively few problems after prostate cancer treatment, this study highlights important physical and psycho-social issues for a significant minority of survivors of prostate cancer. Strategies for identifying those men with on-going problems, alongside new interventions and models of care, tailored to individual needs, are needed to improve quality of life.
Samuel CA, Faithfull S (2013) Complementary therapy support in cancer survivorship: a survey of complementary and alternative medicine practitioners' provision and perception of skills., Eur J Cancer Care (Engl)
This study reviewed the confidence and perceived skills of complementary and alternative medicine (CAM) practitioners in providing care and symptom management for clients post cancer. An e-survey was mailed to approximately 21 000 CAM practitioners, targeted at those working with clients who were experiencing consequences of cancer and its treatments. Questions were asked about the main symptoms and concerns of clients, the confidence and current skill levels of practitioners and additional training requirements. Six hundred and twelve practitioners responded to the survey, 507 of whom were working with individuals experiencing the consequences of cancer and its treatments. Forty-five per cent (n = 134) had undertaken training in cancer prior to working with cancer patients, 61% (n = 182) had undertaken courses or study days relative to cancer care in the past two years. The most often treated symptoms or concerns of patients were those of a psychosocial nature, pain management and lymphoedema. CAM practitioners with limited knowledge and training are providing support to cancer survivors, particularly in services where the National Health Service has limited provision. CAM practitioners may fulfil a future role in providing long-term support for cancer survivors; however, in order to properly safeguard patients they are in need of further training and development.
Faithfull S, Deery P (2004) Implementation of capecitabine (Xeloda) into a cancer centre: UK experience., Eur J Oncol Nurs 8 Suppl 1 pp. S54-S62
Switching patients from intravenous 5-FU/LV to oral capecitabine (Xeloda) for the treatment of metastatic colorectal cancer is associated with a reduction in the need for hospitalisations to manage 5-FU-associated delivery and complications, with resulting healthcare savings. However, implementing oral therapy with capecitabine within a cancer centre in the UK has required a considerable change in attitude within healthcare services. The resulting need for patients to take an active role in their treatment, and the co-ordination and monitoring of such a service at home has raised issues for chemotherapy services. To enhance patient involvement and compliance with medication a patient guide was developed to educate, and support individuals and enable them to understand the rationale for treatment and when to seek help. In addition, patients are encouraged to monitor and record symptoms in a diary. This change in service focus has required an investment in time educating and informing patients, community health workers and hospital practitioners. This change has been co-ordinated through the chemotherapy outpatient clinic. Effective communication between hospital and home has been important in implementing oral chemotherapy. While the initial challenge of monitoring and educating patients receiving capecitabine has been met, the Primary Care team and cancer centre need to continue to assess side effects and patient compliance in order to improve knowledge of capecitabine among healthcare professionals and ensure safe practice.
Cockle Hearne J, Cooke D, Faithfull S (2015) Developing peer support in film for cancer self-management: what do men want other men to know?, Supportive Care in Cancer Springer
Purpose: This study reports an innovative theory-driven approach for developing filmed peer support for cancer self-management. Peer support conventionally includes empathetic interaction between people with shared experiences. This unique study considers how to authentically communicate peer empathy in a one-way film narrative.
Methods: We co-created a film based on phenomenological interviews with seven men who had volunteered to support other men by sharing their experiences of coping with prostate cancer. The film contributed to successful engagement with self-management. Interpretative Phenomenological Analysis of the interview data was conducted to explore the components of experiential empathy that the men had communicated.
Results: Four themes were identified illustrating what men wanted other men to know about coping with prostate cancer: Going into the unknown, it was difficult but I got through highlighted trauma and the importance of having a determined attitude; Only you can do it illustrated the triumph of their journey and of regaining control; I haven?t changed massively reflected the importance of a constant self; and Stay involved represented the overriding need to remain part of pre-cancer social environments.
Conclusions: We propose a construct framework of experiential empathy for men with prostate cancer: Resilience, Regaining Control, Continuity-of-Self and Social Connectedness. Filmed peer support that communicates these constructs will offer wide-ranging benefit to meet the needs of this group of men in both e-health and face-to-face self-management contexts. Further research could develop this theory-driven approach to filmed peer support for other cancer groups.
Faithfull S (2000) Neuro-oncology for nurses, INTERNATIONAL JOURNAL OF NURSING STUDIES 37 (1) pp. 92-92 PERGAMON-ELSEVIER SCIENCE LTD
Higham CE, Faithfull S (2015) Bone Health and Pelvic Radiotherapy, CLINICAL ONCOLOGY 27 (11) pp. 668-678 ELSEVIER SCIENCE LONDON
Faithfull S (2010) Where have all the nurses gone: workforce change a necessity?, EUR J ONCOL NURS 14 pp. S1-S1 ELSEVIER SCI LTD
A new treatment paradigm has emerged with many patients now receiving oral chemotherapy (OC) as first-line treatment for cancer. Treatment with OC has resulted in reduced hospital costs, more autonomy for patients but with added responsibilities for patient self-management. Little is known about patient's knowledge following patient education to enable optimal adherence with OC. A mixed methods study was carried out using a self-report questionnaire to patients on OC for multiple myeloma (MM) followed by semi-structured interviews with patients at home. Analysis identifies high rates of adherence (92.2%) with OC for MM. However, statistically significant knowledge deficits were identified, which were related to patient ethnicity and to gender. There is the potential for non-intentional non-adherence with OC due to deficits in knowledge of OC. Support at home needs to include primary care practitioners such as GPs, practice nurses and pharmacists so that timely support is easily accessible especially in the early phase of treatment.
Faithfull S (2008) Supportive and palliative care using E technology: The role of workforce attitudes in implementation, PSYCHO-ONCOL 17 pp. S61-S62 JOHN WILEY & SONS LTD
Faithfull S (2004) Assessing fatigue and self-care strategies in patients receiving radiotherapy for non-small-cell lung cancer, by Diana Borthwick, Gillian Knowles Shanne McNamara, Rita O'Dea, Paul Stroner [European Journal of Oncology Nursing 7(4), 231-241]., Eur J Oncol Nurs 8 (1) pp. 85-86 Elsevier
Nevidjon B, Kav S, Gullatte M, Faithfull S (2010) EONS-ONS Leadership Workshop - Part II: Clinical leadership empowerment: utilising your leadership skills, EUR J ONCOL NURS 14 pp. S12-S12 ELSEVIER SCI LTD
Taghipour A, Vydelingum V, Faithfull S (2011) Discovering a sequential social process of prostate cancer detection: A socio-epidemiological study of Iranian men's perspectives, HEALTHMED 5 (1) pp. 41-50 DRUNPP-SARAJEVO
Cockle-Heame J, Faithfull S (2007) State of the art in prostate cancer recovery: Self management what is it, what works and how can it help men with coping?, EJC SUPPLEMENTS 5 (4) pp. 427-427 PERGAMON-ELSEVIER SCIENCE LTD
Foubert J, Faithfull S (2006) Education in Europe: are cancer nurses ready for the future?, J BUON 11 (3) pp. 281-284
Much has been written about the need for continuing professional development for nurses to enhance practice and promote quality-nursing care. However, little has been written about the challenges faced by European nurses in keeping up-to-date with health care developments in relation to specialist areas. Educators providing courses are currently facing many challenges; not only the increasing costs of specialist education provision, distance learning, but also the ever increasing changes in health care requiring modification of specialist nursing skills and knowledge within curriculum. This means that educators need to rethink approaches to teaching and learning and links with practice. One of the challenges for the future is how to shift the skills needed for support of cancer patients out into the community , providing quality care for those requiring outpatient and ambulatory cancer care provision. However, continuing professional development is often encouraged as a mechanism for delivering service training rather perceived as developmental for the individual. The European Oncology Nursing Society (EONS) as a society has grasped the initiative for educational development with educational needs analysis, a curriculum identifying practice as central to learning, practice-related topics such as TITAN and the development of education for cancer in older people. There are enormous possibilities opening up within health care for us to develop cancer nursing in many settings and contexts, not only as a result of improved survival and treatments but because vocational education is being scrutinised as part of the Bologna agreement. Lastly, educationalists need to grasp these opportunities and take the initiative and strengthen education for nurses who don't know they need it. Improvements in specialist cancer care are shared and lessons learnt can translate into other nursing services so that we can provide better care for cancer patients throughout their cancer journey.
Faithfull S (1992) Oncology: chemotherapy for elderly people., Nurs Stand 6 (47) pp. 25-28
Elderly people form a large proportion of cancer patients. This has implications for cancer care, in that age is a substantial risk factor in developing cancer. In spite of efforts to reduce cancer mortality through health education and screening, cancer rates are likely to increase in proportion to the ageing population. It has been suggested that health care professionals generally view elderly people in a negative fashion, which influences the care that these individuals receive. At present, there is a scarcity of information on the nature of cancer in elderly people, their tolerance to cytotoxic treatment, and specific age-related problems. Knowledge in all these areas remains fragmented and the research data conflicting. The nurse plays an important role in assessing and monitoring the impact of cytotoxic chemotherapy treatment. It is, therefore, imperative for cancer nurses to develop specialist knowledge in this area to enable them to understand the effect cytotoxic chemotherapy treatments have on elderly people.
White I, Faithfull S, Allan H (2007) Development of an integrated psychosexual clinical assessment strategy for women receiving pelvic radiotherapy, EJC SUPPLEMENTS 5 (4) pp. 429-429 PERGAMON-ELSEVIER SCIENCE LTD
Faithfull S (2006) E. Milly L. Haagedoorn Lecture EACE 2006. Developing oncology nurse education and training across Europe., J Cancer Educ 21 (4) pp. 212-215
Education is an important tool in the development of specialist nursing within Europe. Awareness of cancer and its treatment and the impact it has on individuals and families helps in reducing negative perceptions and fatalistic attitudes. Education not only improves care, but can enhance outcomes; research studies have identified that appropriate and timely nursing can make a difference. There are several drivers for change within cancer nurse education. First, the increasing complexity of cancer treatment delivery plus the shift of cancer therapy and support into community and ambulatory settings are demanding wider skills. Second, the implementation of the Bologna Process across Europe aiming to make study programs compatible and comparable to facilitate transparency and academic recognition at a European level. As a result of the Bologna declaration, educational systems in most European countries are in the process of reform. These changes are an opportunity for cancer nursing to establish and constitute a starting point for providing a commonality of curricula for cancer nurses across Europe.
Faithfull S, Brada M (1996) Somnolence syndrome: Toxicity of cranial irradiation, BRITISH JOURNAL OF CANCER 74 pp. PO48-PO48 STOCKTON PRESS
Chemotherapy-induced peripheral neuropathy (CIPN) may persist after treatment ends and may lead
to functional decline and falls. This study compared objective and self-report measures of physical
function, gait patterns, and falls between women cancer survivors with and without symptoms of
CIPN to identify targets for functional rehabilitation.
A secondary data analysis of 512 women cancer survivors (age, 62 6 6 years; time since diagnosis,
5.8 6 4.1 years) categorized and compared women self-reporting symptoms of CIPN (CIPN+) with
asymptomatic women (CIPN2) on the following: maximal leg strength, timed chair stand, physical
function battery, gait characteristics (speed; step number, rate, and length; base of support), selfreport
physical function and disability, and falls in the past year.
After an average of 6 years after treatment, 47% of women still reported symptoms of CIPN. CIPN+
had significantly worse self-report and objectively measured function than did CIPN2, with the
exception of maximal leg strength and base of support during a usual walk. Gait was slower among
CIPN+, with those women taking significantly more, but slower and shorter, steps than did CIPN2
(all P,.05). CIPN+ reported significantly more disability and 1.8 times the risk of falls compared with
CIPN2 (P , .0001). Increasing symptom severity was linearly associated with worsening function,
increasing disability, and higher fall risk (all P , .05).
This work makes a significant contribution toward understanding the functional impact of CIPN
symptoms on cancer survivors. Remarkably, 47% of women in our sample had CIPN symptoms
many years after treatment, together with worse function, greater disability, and more falls. CIPN
must be assessed earlier in the clinical pathway, and strategies to limit symptom progression and to
improve function must be included in clinical and survivorship care plans.
Desnoo L, Faithfull S (2006) A qualitative study of anterior resection syndrome: the experiences of cancer survivors who have undergone resection surgery, EUROPEAN JOURNAL OF CANCER CARE 15 (3) pp. 244-251 BLACKWELL PUBLISHING
Cockle-Hearne J, Faithfull S (2014) Peer Volunteers in Cancer Self-Management: What Are the Key Characteristics to Look for? Findings From a Phenomenological Study Among Men With Prostate Cancer, PSYCHO-ONCOLOGY 23 pp. 345-346 WILEY-BLACKWELL
Faithfull S (1994) Ageing matters. Negative perceptions., Nurs Times 90 (1) pp. 62-64
Winters-Stone KM, Hilton C, Luoh S-W, Jacobs P, Faithfull S, Horak FB (2016) Comparison of physical function and falls among women with persistent symptoms of chemotherapy-induced peripheral neuropathy, JOURNAL OF CLINICAL ONCOLOGY 34 (3) AMER SOC CLINICAL ONCOLOGY
Faithfull S, Hearne JC, Fairbanks HE, Laing R (2015) Self-management for chronic symptoms in the survivorship phase of illness: A randomised controlled trial of a group intervention for radiotherapy side effects versus usual care for men after treatment for prostate cancer, EUROPEAN JOURNAL OF CANCER 51 pp. S260-S260 ELSEVIER SCI LTD
Faithfull S (2006) Developing oncology nurse education and training across Europe, JOURNAL OF CANCER EDUCATION 21 (4) pp. 212-215 LAWRENCE ERLBAUM ASSOC INC-TAYLOR & FRANCIS
Faithfull S, White I (2008) Delivering sensitive health care information: Challenging the taboo of women's sexual health after pelvic radiotherapy, PATIENT EDUCATION AND COUNSELING 71 (2) pp. 228-233 ELSEVIER IRELAND LTD
Patients receiving cancer treatment often have one or more co-morbid conditions that are treated pharmacologically. Co-morbidities are recorded in clinical trials usually only at baseline. However, co-morbidities evolve and new ones emerge during cancer treatment. The interaction between multi-morbidity and cancer recovery is significant but poorly understood.
To investigate the effect of co-morbidities (e.g. cardiovascular and diabetes) and medications (e.g. statins, antihypertensives, metformin) on radiotherapy-related toxicity and long-term symptoms in order to identify potential risk factors. The possible protective effect of medications such as statins or antihypertensives in reducing radiotherapy-related toxicity will also be explored.
Two datasets will be linked. 1) CHHiP (Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy for Prostate Cancer) randomised control trial. CHHiP contains pelvic symptoms and radiation-related toxicity reported by patients and clinicians. 2) GP (General Practice) data from RCGP RSC (Royal College of General Practitioners Research and Surveillance Centre). The GP records of CHHiP patients will be extracted, including cardiovascular co-morbidities, diabetes and prescription medications. Statistical analysis of the combined dataset will be performed in order to investigate the effect.
Linking two sources of healthcare data is an exciting area of big healthcare data research. With limited data in clinical trials (not all clinical trials collect information on co-morbidities or medications) and limited lengths of follow-up, linking different sources of information is increasingly needed to investigate long-term outcomes. With increasing pressures to collect detailed information in clinical trials (e.g. co-morbidities, medications), linkage to routinely collected data offers the potential to support efficient conduct of clinical trials.
Purpose: This study reports an innovative theory-driven approach for developing filmed peer support for cancer self-management. Peer support conventionally includes empathetic interaction between people with shared experiences. This unique study considers how to authentically communicate peer empathy in a one-way film narrative. Methods: We co-created a film based on phenomenological interviews with seven men who had volunteered to support other men by sharing their experiences of coping with prostate cancer. The film contributed to successful engagement with self-management. Interpretative Phenomenological Analysis of the interview data was conducted to explore the components of experiential empathy that the men had communicated. Results: Four themes were identified illustrating what men wanted other men to know about coping with prostate cancer: Going into the unknown, it was difficult but I got through highlighted trauma and the importance of having a determined attitude; Only you can do it illustrated the triumph of their journey and of regaining control; I haven?t changed massively reflected the importance of a constant self; and Stay involved represented the overriding need to remain part of pre-cancer social environments. Conclusions: We propose a construct framework of experiential empathy for men with prostate cancer: Resilience, Regaining Control, Continuity-of-Self and Social Connectedness. Filmed peer support that communicates these constructs will offer wide-ranging benefit to meet the needs of this group of men in both e-health and face-to-face self-management contexts. Further research could develop this theory-driven approach to filmed peer support for other cancer groups.
Neurodegenerative diseases (NDDs) are incurable and debilitating, and result in progressive deterioration of cognitive (dementias) and physical (ataxias) functioning. People with these conditions have constantly changing needs due to steady deterioration, with episodes of rapid decline,1,2 which places a heavy burden both on patients and their carers. Greater emphasis is now placed on keeping patients in their own homes in order to meet their personal wishes and reduce hospital/institutional costs.3,4 Respite can offer several avenues of support including rehabilitation, maximisation of functionality and improved quality of life for the patient. It can also be crucial in enabling carers to continue in their caring roles.
In the UK, palliative care plays an important role in supporting patients and their carers during the course of a progressive and life-threatening illness. There has been much research into people?s preferred place of care and death, the future care needs of an aging society and the lack of resources and services in the community to support people?s wishes.1,2 There have also been numerous national drivers to emphasise and promote community-based care...
Rates of cancer survival have increased in recent decades due to earlier diagnosis and improved therapies, but a longer life span does not necessarily equate to a healthier life. Chronic illness as a consequence of cancer and its treatment is reported in a significant proportion of survivors. An increased risk of cardiovascular diseases, such as myocardial infarction, stroke and heart failure. Is one of the side effects of some cancer therapies. Nurses in oncology and primary care can minimise cardiovascular risks by improving people?s awareness of symptoms, conducting health assessment and appropriate referrals. Secondary prevention through lifestyle advice, smoking cessation and obesity reduction is also essential. This should be in combination with more detailed cardiac assessment for those high-risk groups at all stages of the patient pathway. Appropriate risk management and early detection of heart problems can prevent long term illness and reduce multimorbidity for people living with and beyond cancer.
Purpose: To investigate the role of symptom clusters in the analysis and utilisation of Patient-Reported Outcome Measures (PROMs) for data modelling and clinical practice. To compare symptom clusters with scales, and explore their value in PROMs interpretation and symptom management. Methods: A dataset called RT01 (ISCRTN47772397) of 843 prostate cancer patients was used. PROMs were reported with the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI). Symptom clusters were explored with hierarchical cluster analysis (HCA) and average linkage method (correlation >0.6). The reliability of the Urinary Function Scale was evaluated with Cronbach's Alpha. The strength of the relationship between the items was investigated with Spearman's correlation. Predictive accuracy of the clusters was compared to the scales by receiver operating characteristic (ROC) analysis. Presence of urinary symptoms at 3 years measured with the Late Effects on Normal Tissue: Subjective, Objective, Management tool (LENT/SOM) was an endpoint. Results: Two symptom clusters were identified (Urinary Cluster and Sexual Cluster). The grouping of symptom clusters was different than UCLA-PCI Scales. Two items of the Urinary Function Scales (?Number of pads? and ?Urinary leak interfering with sex?) were excluded from the Urinary Cluster. The correlation with the other items in the scale ranged from 0.20-0.21 and 0.31-0.39 respectively. Cronbach's Alpha showed low correlation of those items with the Urinary Function Scale (0.14-0.36 and 0.33-0.44 respectively). All Urinary Function Scale items were subject to a ceiling effect. Clusters had better predictive accuracy, AUC = 0.70-0.65, while scales AUC = 0.67-0.61. Conclusion: This study adds to the knowledge on how cluster analysis can be applied for the interpretation and utilisation of PROMs. We conclude that multiple-item scales should be evaluated and that symptom clusters provide an adaptive and study specific approach for modelling and interpretation of PROMs.
Purpose: To examine the findings of existing studies in relation to men's cultural beliefs about changes to
their bodies relevant to prostate cancer and how these affect interpretation of bodily changes and helpseeking
Method: We undertook a narrative review of studies conducted from 2004 to 2017 in 6 databases that
highlighted men's beliefs and help-seeking actions for bodily changes suggestive of prostate cancer.
Results: Eighteen (18) studies reflecting men from various ethnicities and nationalities were included.
The belief that blood and painful urination were warning signs to seek medical help delayed helpseeking
among men compared to men that did not experience these symptoms. The belief that urinary
symptoms such as dribbling, cystitis and urinary hesitancy were transient and related to ageing,
normality and infection significantly delayed symptom appraisal and help-seeking. Men also held the
belief that sexual changes, such as impotence and ejaculation dysfunction were private, embarrassing
and a taboo. These beliefs impeded timely help-seeking. Cultural beliefs, spirituality and the role of
wives/partners were significant for men to help appraise symptoms as requiring medical attention thus
sanctioning the need for help-seeking.
Conclusions: This review underscores a critical need for further empirical research into men's beliefs
about bodily changes relevant to prostate health and how these beliefs affect their interpretation of
symptoms and subsequent help-seeking actions.
Older adults live with multimorbidity including frailty and cognitive impairment often requiring hospitalization. While physical activity interventions (PAIs) are a normal rehabilitative treatment, their clinical effect in hospitalized older adults is uncertain.
To observe PAI dosing characteristics and determine their impact on clinical performance parameters.
A single-site prospective observational cohort study in an older persons' unit.
Seventy-five older persons' unit patients e65 years.
PAI; therapeutic contact between physiotherapy clinician and patient.
Parameters included changes in activities-of-daily-living (Barthel Index), handgrip strength, balance confidence, and gait velocity, measured between admission and discharge (episode). Dosing characteristics were PAI temporal initiation, frequency, and duration. Frailty/cognition status was dichotomized independently per participant yielding 4 subgroups: frail/nonfrail and cognitively-impaired/cognitively-unimpaired.
Median (interquartile range) PAI initiation occurred after 2 days (1-4), frequency was 0.4 PAIs per day (0.3-0.5), and PAI duration per episode was 3.75 hours (1.8-7.2). All clinical parameters improved significantly across episodes: grip strength median (interquartile range) change, 2.0 kg (0.0-2.3) (P
PAI dosing is consistent. However, while clinical changes during hospital episodes are positive, more favourable responses to PAIs occur if patients are nonfrail/cognitively-unimpaired. Therefore, to deliver a personalized rehabilitation approach, adaptation of PAI dose based on patient presentation is desirable.
Watson E, Shinkins B, Matheson L, Burns R, Frith E, Neal D, Hamdy F, Walter F, Weller D, Wilkinson C, Faithfull S, Sooriakumaran P, Kastner C, Campbell C, Neal R, Butcher H, Matthews M, Perera R, Wolstenholme J, Rose P (2017) Supporting prostate cancer survivors in primary care: Findings from a pilot
trial of a nurse-led psycho-educational intervention (PROSPECTIV), European Journal of Oncology Nursing 32 pp. 73-81
This study sought to test the acceptability and feasibility of a nurse-led psycho-educational intervention
(NLPI) delivered in primary care to prostate cancer survivors, and to provide preliminary estimates of the effectiveness
of the intervention.
Men who reported an ongoing problem with urinary, bowel, sexual or hormone-related functioning/
vitality on a self-completion questionnaire were invited to participate. Participants were randomly assigned to
the NLPI plus usual care, or to usual care alone. Recruitment and retention rates were assessed. Prostate-related
quality of life, self-efficacy, unmet needs, and psychological morbidity were measured at baseline and 9 months.
Health-care resource use data was also collected. An integrated qualitative study assessed experiences of the
61% eligible men (83/136) participated in the trial, with an 87% (72/83) completion rate. Interviews
indicated that the intervention filled an important gap in care following treatment completion, helping men to
self-manage, and improving their sense of well-being. However, only a small reduction in unmet needs and small
improvement in self-efficacy was observed, and no difference in prostate-related quality of life or psychological
morbidity. Patients receiving the NLPI recorded more primary care visits, while the usual care group recorded
more secondary care visits. Most men (70%; (21/30)) felt the optimal time for the intervention was around the
time of diagnosis/before the end of treatment.
Findings suggest a nurse-led psycho-educational intervention in primary care is feasible, acceptable
and potentially useful to prostate cancer survivors.
To identify symptom clusters and predisposing factors associated with long-term symptoms and health-related quality of life (HRQOL) following radiotherapy in men with prostate cancer.
Patient-reported outcomes (PROs) data from the Medical Research Council RT01 radiotherapy with neoadjuvant androgen deprivation therapy (ADT) trial of 843 patients were used. PROs were collected over 5 years with the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) and the 36-Item Short-Form Health Survey (SF-36). Symptom clusters were explored using hierarchical cluster analysis (HCA). The association of treatment dose, baseline patient characteristics and early symptom clusters with the change in severity of PROs over three years was investigated with multivariate linear mixed effects models.
Seven symptom clusters of three or more symptoms were identified. The clusters were stable over time. The longitudinal profiles of symptom clusters showed the onset of acute symptoms during treatment for all symptom clusters and significant recovery by six months. Some clusters such as Physical Health and Sexual Function were adversely affected more than others by ADT, and were less likely to return to pre-treatment levels over time. Older age was significantly associated with decreased long-term Physical Function, Physical Health and Sexual Function (p
Men with poorer physical function and health prior to or during treatment were more likely to report poorer PROs at year three. Early assessment using PROs and lifestyle interventions should be employed to identify those with higher needs and provide targeted rehabilitation and symptom management.
Background: Distress after prostate cancer treatment is a substantial burden for up to one-third of men diagnosed. Physical and emotional symptoms and health service use can intensify, yet men are reticent to accept support. To provide accessible support that can be cost effectively integrated into care pathways, we developed a unique, Web-based, self-guided, cognitive-behavior program incorporating filmed and interactive peer support.
Objective: To assess feasibility of the intervention among men experiencing distress after prostate cancer treatment. Demand, acceptability, change in distress and self-efficacy, and challenges for implementation in clinical practice were measured.
Methods: A pre-post, within-participant comparison, mixed-methods research design was followed. Phase I and II were conducted in primary care psychological service and secondary care cancer service, respectively. Men received clinician-generated postal invitations: phase I, 432 men diagnosed
Results: A total of 135 men consented (phase I, 61/432, 14.1%; phase II, 74/606, 12.2%); from 96 eligible men screened for distress, 32% (30/96) entered the intervention (phase I, n=10; phase II, n=20). Twenty-four completed the Web-based program and assessments (phase I, n=8; phase II, n=16). Adherence for phase I and II was module completion rate 63% (mean 2.5, SD 1.9) versus 92% (mean 3.7, SD 1.0); rate of completing cognitive behavior therapy exercises 77% (mean 16.1, SD 6.2) versus 88% (mean 18.6, SD 3.9). Chat room activity occurred among 63% (5/8) and 75% (12/16) of men, respectively. In phase I, 75% (6/8) of men viewed all the films; in phase II, the total number of unique views weekly was 16, 11, 11, and 10, respectively. The phase II mood diary was completed by 100% (16/16) of men. Satisfaction was high for the program and films. Limited efficacy testing indicated improvement in distress baseline to post intervention: phase I, P=.03, r=?.55; phase II, P=.001, r=?.59. Self-efficacy improved for coping P=.02, r=?.41. Service assessment confirmed ease of assimilation into clinical practice and clarified health care practitioner roles.
Conclusions: The Web-based program is acceptable and innovative in clinical practice. It was endorsed by patients and has potential to positively impact the experience of men with distress after prostate cancer treatment. It can potentially be delivered in a stepped model of psychological support in primary or secondary care. Feasibility evidence is compelling, supporting further evaluative research to determine clinical and cost effectiveness.