The concerns of patients and spouses after the diagnosis of colon cancer: A qualitative analysis

Abstract

Purpose: The purposes of this study were to describe the concerns of patients and their spouses after a diagnosis of colon cancer and to identify ways in which health care professionals could assist both patients and their spouses to cope more effectively with this illness and its treatment. Design: Descriptive, cross-sectional study. Setting and Subjects: Thirty patients with colon cancer and their spouses completed interviews in their homes. Most patients (83%) had undergone partial colon resection, and 77% had no evidence of cancer in adjacent lymph nodes. Twelve of the patients (40%) had a colostomy at the time the data were collected. Methods: Patients and spouses participated in semistructured interviews that elicited information concerning their reactions to a diagnosis of colon cancer, to a colostomy (if present), to changes in lifestyle, to their satisfaction with information they received, and to ways that health care professionals could assist them with the illness and treatments. Content analysis was used to analyze the interview data and to group data into inductively derived categories. Interrater reliability was obtained by having 2 researchers independently code the data. Results: Spouses tended to regard a colon cancer diagnosis more negatively than did patents. Both patients and spouses reported that fear of cancer's recurrence was their greatest concern. Most also reported lifestyle changes (80%) as a result of the illness; but the patients reported more changes in their functional ability, whereas spouses reported more changes in their roles and relationships. Half of the patients and most of the spouses (75%) reported a favorable reaction to the colostomy. Approximately half of the couples expressed satisfaction with the information they received; they reported a need for more information about treatments and management of side effects. When asked how professionals could help them, most couples stated that they wanted more information about the expected course of recovery. Conclusion: Spouses should be included in health assessment and teaching because they regard the illness more negatively than do patients. Both patients and spouses desire information that will help them to understand the typical course of recovery, assist them to plan for lifestyle changes, and enable them to manage the side effects of treatment.