Experience In Treatment Of Cancer Research Articles

Palliative Care Initiative for Cameroonian Women With Metastatic Breast Cancer

Background and context: Among the 1.6 million women diagnosed with breast cancer each year worldwide, 1500 cases occur in Cameroonian women, 99% of which arise at advanced stage as there is no organized screening program in the country. Most of the women die because of lack of good diagnostic technique, lack of good treatment and medical insurance. 99% of Cameroonian women with breast cancer probably need palliative care and this is only well established in three medical centers. Most of these women are abandoned and will die in rural areas where they are managed by marabous and traditional healers. Our team has 22 years of experience in cancer screening, diagnosis, treatment and research in Cameroon. This year, SPARC METASTATIC BREAST CANCER CHALLENGE (SPARC MBC) is offering a unique opportunity to enhance our skills, particularly for women with metastatic breast cancer through this pilot initiative. Aim: To establish a pilot palliative care initiative for Cameroonian women with metastatic breast cancer and improve their quality of life. Strategy/Tactics: Using social media and an ambulatory patient care program, we plan to: 1) Establish a holistic palliative care pilot program; establish home visits and perform regular telephone calls to patients. 2) Introduce collaborations with traditional healers 3) Initiate training for health professionals. 4) Develop communication strategies for patients and provide them with psychosocial support. 5) Implement strategies for the provision of pain relieve drugs such as morphine. Program/Policy process: Advocacy visits to communities, hospitals and universities; training of community health professionals, social workers and traditional healers; and mobilization of breast cancers patients. Outcomes: It is expected that through this project, we will improve number of breast cancers detected, increase accessibility to treatment and palliative care for women diagnosed with breast cancer, reduce progression to advanced stages and mortality due to breast cancer, improve treatment outcome particularly among women with advanced stages of breast cancer, trained health professionals on palliative care and breast cancer control. What was learned: SPARC MBC is now offering a unique opportunity for Cameroonian women. We have started a sustainable palliative care program. Health professionals and social workers are now following training, mostly using social media for long distance training, or onsite in our institution. Unfortunately, we overadvertised during the first phase of this program and we are afraid we may not be able to cover the whole country and this may be discriminating or frustrating for some patients. On the other hand, some patients are now coming to our center from some neighboring countries with other cancer subtypes like prostate, cervix, liver, etc. as advertisement with WhatsApp and other social media is widespread and we are afraid we will be unable to cover this epidemic.

The Experiences of Gay and Bisexual Men Post-Prostate Cancer Treatment: A Meta-Synthesis of Qualitative Studies.

Studies suggest that gay and bisexual men are affected by the psychological aspects of prostate cancer treatment differently than that of heterosexual men; however the data have not yet been synthesized. The focus of this meta-synthesis is to explore gay and bisexual men’s experiences of prostate cancer posttreatment. Empirical research published in peer reviewed journals between January 1990 and January 2018 were identified in six databases: CINAHL, Cochrane, Medline, PsycINFO, PubMed, and Web of Science. Titles and abstracts were checked by two reviewers. The six studies that met the inclusion criteria were selected and reviewed for quality and the extracted data were then synthesized. The main themes that emerged were sexual impact, physical and psychological difficulties, challenges to intimacy, and support mechanisms. Gay and bisexual men can have specific sexual roles and developing prostate cancer and undergoing treatment may compromise their ability to perform their sexual role. The needs of heterosexual men were perceived to be accommodated more often than that of gay and bisexual men because of engrained heteronormativity in the health-care system. The review suggests that more support groups specifically for gay and bisexual men should be established, while urologists should cater to the sexual and masculine implications of treatment, and not frame problems for gay and bisexual men in heterosexual terms. By failing to address the salient needs and concerns of gay and bisexual men, health-care professionals are reinforcing invisibility and marginalization of gay and bisexual men with prostate cancer.

Improving Children's cancer pain management in the home setting: Development and formative evaluation of a web-based program for parents

Background and methodsDespite advances in health care, the majority of children undergoing cancer treatment experience pain, particularly in the home setting. Mobile health tools provide a promising avenue to deliver pain management education and information to parents of children receiving cancer treatment. The current study describes the development and formative evaluation of a novel intervention, Cancer-Tailored Intervention for Pain and Symptoms (C-TIPS), which provides empirically-based pharmacological and non-pharmacological pain management information and coping skills training to parents of pediatric cancer patients. C-TIPS is a web-based application including a tailoring algorithm, customization tools, guided diaphragmatic breathing training, relaxation practice, and educational material (COPE modules). Thirty parents of children undergoing chemotherapy treatment for cancer participated in this initial mixed methods pilot study. Participants completed quantitative measures assessing their stress and relaxation ratings and satisfaction with C-TIPS. Formative evaluation and qualitative data were collected using individual and group interviews. ResultsParents reported high satisfaction with both the educational and skills training modules of C-TIPS (ps < 0.001). Parent self-reported stress significantly reduced (p = 0.004) and relaxation increased (p = 0.05) following participation with the skills training module. ConclusionsC-TIPS is a feasible and well-received web-based intervention that promises to improve pain management in children undergoing cancer treatment, improve stress management in parents, and increase parents' knowledge and understanding of their child's cancer treatment. Results from the current study will help make improvements to C-TIPS in preparation for a randomized-controlled trial of this innovative program.

Patterns of treatment failure in salivary gland cancers.

The purpose of the study was to publish our experience of salivary gland cancer treatment with large number of patients treated at a single institution. Salivary gland cancers are rare tumors of the head and neck representing about 5% of cancers in that region and about 0.5% of all malignancies. Due to the rarity of the disease, most of the studies regarding treatment outcome consist of low number of patients, thus making it difficult to draw conclusions. 115 patients with primary salivary gland cancer were included in a retrospective study. The subsites of tumor were the parotid gland (58% patients), submandibular gland (19%) and minor salivary glands (23%). All patients underwent primary surgical resection. The following were collected: age, stage of the disease, T status, N status, grade of tumor, perineurial invasion, lymphovascular invasion, extracapsular spread, final histological margin status and postoperative treatment. Details of local, regional or distant recurrence, disease free survival and overall survival were included. The majority (65%) of patients presented in early stage, T1 and T2 tumors. 81% of patients were N0. Free surgical margins were achieved in 18% of patients, close in 28% patients and positive surgical margins in 54% (62) patients. Factors that significantly increased the risk of recurrence: T stage (p=0.0006); N-positive status (p<0.0001); advanced stage of the disease (p<0.0001); high grade of tumor (p=0.0007); PNI (p=0.0061); LVI (p=0.0022); ECS (p=0.0136); positive surgical margins (p=0.0022). On multivariate analysis, high grade of tumor and positive surgical margins remained significant independent adverse factors for recurrence formation. This report shows a single institution results of oncological treatment in patients with malignant salivary gland tumors, where positive surgical margins strongly correlate with patients' worse outcome. Whether to extend the procedure, which very often requires sacrificing the nerve is still a question of debate.

The cancer may come back: experiencing and managing worries of relapse in a North Norwegian village after treatment

ABSTRACTLittle is known about how people living in the aftermath of cancer treatment experience and manage worries about possible signs of cancer relapse, not as an individual enterprise but as socially embedded management. One-year ethnographic fieldwork was conducted in a coastal village of under 3000 inhabitants in northern Norway. Ten villagers who had undergone cancer treatment from six months to five years earlier were the main informants. During fieldwork, the first author conducted qualitative, semi-structured monthly interviews with them, and participated in their everyday activities and relationships, including families, friends and co-villagers. In this article, we contemplate human emotions as arising in contexts of transactions, capable of creating social realities. By including this perspective, we highlight how people who recover from cancer construct and experience worry about possible relapse in relation to close family members, friends and co-villagers in the socially closely-knit and relatively isolated village. These emotional experiences emerge through relationships with others have communicative characteristics and take place in interaction with the social environment of their village. While informants attempt to protect family members by avoiding sharing worries with them, they express the need to share their worries within friendships. However, they experience both comfort and challenges in managing their worries in relation to acquaintances in the village. Overall, the study enhances understanding of the social embeddedness of emotions in everyday life, by revealing how worries of relapse of cancer configure and relate to various social contexts.

Health care improvement and survivorship priorities of colorectal cancer survivors: findings from the PORTAL colorectal cancer cohort survey.

Few population-level surveys have explored patient-centered priorities for improving colorectal cancer survivors' care. Working with patients, we designed a survey to identify care improvement and survivorship priorities. We surveyed a random sample of 4000 patients from a retrospective, population-based cohort of colorectal cancer survivors diagnosed during 2010-2014. The survey included two multiple response questions: "What would you have changed about your cancer diagnosis and treatment experience?" and "What are your biggest health or lifestyle concerns (other than having cancer) since being diagnosed?" Multivariable regression identified characteristics associated with endorsement of health care experience and survivorship concerns. Survey response rate was 50.2% (2000/3986). Fifty-three percent reported at least one unmet need, most commonly for more information about life after treatment (26.7%). Survivors of rectal cancer reported more needs than respondents with colon cancer; persons of color reported more needs than non-Hispanic whites; individuals without high school diplomas reported more needs than individuals with more education. Fear of recurrence was the most common health/lifestyle concern (58.9%). Respondents under age 65 reported nearly all health/lifestyle concerns more often than respondents over age 74. Rectal cancer survivors reported more concerns about activity limitation, changes, and body function and appearance than colon cancer survivors. Persons of color were more likely to report financial concerns than non-Hispanic whites. The greatest needs for intervention are among survivors of rectal cancer, survivors of minority racial/ethnic background, and survivors of younger age. Survivors with low educational attainment and those with higher stage disease could also benefit.

Patterns of patient-reported chemotherapy toxicities across twenty-eight ambulatory oncology settings.

e18721Background: The National Cancer Institute and other key stakeholders endorse soliciting patient-reported outcomes to understand cancer treatment experiences outside of clinical trials. We exa...

Out-of-pocket expenses experienced by rural Western Australians diagnosed with cancer.

Out-of-pocket expenses (OOPE) can have a significant impact on patients' experiences of cancer treatment. This cross-sectional study sought to quantify the OOPEs experienced by rural cancer patients in Western Australia (WA), and determine factors that contributed to higher OOPE. Four hundred people diagnosed with breast, lung, colorectal or prostate cancer who resided in selected rural regions of WA were recruited through the WA Cancer Registry and contacted at least 3months after diagnosis to report the medical OOPE (such as surgery or chemotherapy, supportive care, medication and tests) and non-medical OOPE (such as travel costs, new clothing and utilities) they had experienced as a result of accessing and receiving treatment. Bootstrapped t tests identified demographic, financial and treatment-related factors to include in multivariate analysis, performed using log-linked generalised linear models with gamma distribution. After a median 21weeks post-diagnosis, participants experienced an average OOPE of AU$2179 (bootstrapped 95% confidence interval $1873-$2518), and 45 (11%) spent more than 10% of their household income on these expenses. Participants likely to experience higher total OOPE were younger than 65years (p = 0.008), resided outside the South West region (p = 0.007) and had private health insurance (PHI) (p < 0.001). Rural WA cancer patients experience significant OOPE following their diagnosis. The impact these expenses have on patient wellbeing and their treatment decisions need to be further explored.

Cluster analysis of Qian Jing-hua's experience in treatment of lung cancer

Cluster analysis of Qian Jing-hua's experience in treatment of lung cancer

Diagnosis and treatment of early gastric cancer: experience of one center.

IntroductionGastric cancer is one of the most common malignant neoplasms in the world. Currently it constitutes the third cause of death among all malignancies. New endoscopic techniques have a potential to improve treatment results due to more frequent detection of early gastric cancer.AimTo summarize our experience in diagnosis and treatment of early gastric cancer patients.Material and methodsWe analyzed the results of endoscopic examination, histopathological findings and treatment methods in 16 patients who were diagnosed with early gastric cancer in the Endoscopy Unit of the Oncology Center in Bydgoszcz between 2014 and 2016.ResultsBetween 2014 and 2016 sixteen patients, 12 (75.0%) male and 4 (25.0%) female, were diagnosed with early gastric cancer. The average age of patients was 65.5 years. Surgery qualification concerned mainly G2 and G3 adenocarcinomas. In 12 (75.0%) patients total gastrectomy was performed, and 1 patient underwent wedge resection of the prepyloric part of the stomach. In 3 cases endoscopic submucosal dissection (ESD) was performed. Histopathological examination of both biopsy and postoperative material indicated 8 (50.0%) cases of intestinal-type adenocarcinoma, 7 (43.75%) cases of diffuse-type adenocarcinoma and 1 (6.25%) case of mixed-type adenocarcinoma. During the follow-up after treatment, none of the patients was diagnosed with local or distant recurrence.ConclusionsAccurate examination technique allows for detection of early gastric cancer. Selected cases of early gastric cancer may be treated with advanced endoscopic techniques.

Not a Straight Line-Patients' Experiences of Prostate Cancer and Their Journey Through the Healthcare System.

Cancer and its treatment can severely impact quality of life, giving rise to complex needs with respect to follow-up care. To support patient needs and increase efficiency of care with limited resources, the Swedish government has launched national reforms to redesign cancer care pathways. The aim of this study was to explore how prostate cancer patients experience their journey through the healthcare system when their care is provided according to the standardized care pathway, as described in healthcare policy documents. A qualitative, descriptive approach with individual interviews was used. A template of a standardized prostate cancer pathway, created together with healthcare professionals, was used during interviews. Fourteen interviews were conducted with prostate cancer patients all operated on at a midsized hospital in southeast Sweden between October 2015 and April 2016. The interviews were analyzed with qualitative content analysis and illustrated in a patient journey map. We identified an overall theme, "walking a tightrope," consisting of 4 categories: "waiting," "becoming familiar with a troublesome body," "adjusting to a different life," and "information challenges." The clinical implementation of the standardized care pathway is described as a straight path through care, but patients described their experiences as walking a tightrope. Lack of information, especially about cancer treatment and its adverse effects, was the most common experience. Our findings indicate areas where further healthcare tools could improve patient experiences of cancer treatment. This could include offering individualized information and tools to increase patient empowerment, as well as patient/caregiver collaboration (co-care).

Jon’s Tricky Journey by P. McCarthy

McCarthy, Patricia. Jon’s Tricky Journey. Illustrated by Hwai Lim. Inhabit Media, 2017.Jon is a young boy living in Nunavut, who experiences his first trip south when he has to be hospitalized for cancer treatment. This story describes Jon’s impressions of a large urban hospital, his cancer treatment experience, and how he copes with separation from home and family. Questions for the young reader, posed throughout the story, encourage conversation and engagement with the story.The text, author’s notes, and resource section are bilingual, written in Inuktitut and English. Hwei Lim’s detailed illustrations of the hospital environment and images of Northern life complement the descriptions of Jon’s cancer care journey and aspects of life in the North that he brings with him.The book includes tools and information to help family caregivers navigate cancer care processes. Resources include a list of treatment facilities and community resources, an introduction to patient navigation and cancer care team members, and questions to ask the oncology team. There is also a glossary, although it does not always define English-language terms in plain and clear language (e.g., the term lump defined as “an abnormal mass”), which may limit this section’s usefulness. Resources for health professionals include a copy of the Northern Pain Scale, a reference list for Inuit-specific cultural awareness, and cancer information.Author Patricia McCarthy notes that Jon’s Tricky Journey was written to meet the need for pediatric cancer care information relevant to Inuit children and their families. Prepared with input from Inuit organizations and reviewers, and geared toward children with cancer, their families, and health care professionals working in pediatric cancer care, this book would be a welcome addition to a hospital library or a patient and family resource centre.Highly Recommended: 4 out of 4 starsReviewer: Maria TanMaria is a sessional instructor at the University of Alberta and a former editorial team member of the Deakin Review. She is the co-author, with Sandy Campbell, of the Children’s Health Fiction Checklist, described in the October 2014 Special Issue of the Deakin Review (Vol. 4, No. 2) https://ejournals.library.ualberta.ca/index.php/deakinreview/article/view/23321.

Men\u2019s perceptions of prostate cancer diagnosis and care: insights from qualitative interviews in Victoria, Australia

BackgroundThe Victorian Prostate Cancer Registry (Australia) revealed poorer rates of survival for men diagnosed with prostate cancer in one Victorian regional area than for men in metropolitan Melbourne. We sought to explore the perceptions and experiences of prostate cancer diagnosis, treatment, and care of men diagnosed with prostate cancer who lived in regional or metropolitan areas and of men who had not been so diagnosed. Our goal was to contribute to the evidence from which can be built continuing improvements in prostate health care.MethodsUsing the qualitative method of in-depth interviews to gain access to explanation and meaning, we interviewed 21 men: 10 recruited through the Prostate Cancer Outcome Registry-Victoria and 11 from the community. Transcripts were analysed thematically.ResultsWe identified four main themes within which men discussed prostate cancer: Case-finding, Diagnosis, Treatment and Care, and Spreading the Word. Contrasts revealed between regional and metropolitan areas related mostly to the more limited supportive care in regional areas.ConclusionsIt is evident from the perspectives of these men that every aspect of prostate cancer care would benefit from attention: publicising the need to check prostate health, treatment, and supporting men in the years after treatment. Continuing to work on systemic improvements is an important goal for all those committed to men’s health.

Clinical Diagnosis and Treatment of Male Breast Cancer:Analysis of 24 Cases.

Objective To summarize our experiences in the clinical diagnosis and treatment of male breast cancer(MBC).Methods The clinical date of 24 MBC patients treated in our hospital from January 2006 to December 2012 were retrospective analyzed.Results The average age of these 24 patients was(55.7±2.1) years.All the patients received surgical treatment,and the surgical procedures were simple excision of breast lesion in 6 patients,breast resection alone in 5 patients,and modified radical mastectomy in 13 patients(bilateral in 1 case).The pathological diagnoses included invasive ductal carcinoma in 18 cases,papillary carcinoma in 4 cases,mucinous adenocarcinoma in 1 case,and malignant solitary fibrous tumor in 1 case.Twenty patients received chemotherapy,7 received radiotherapy,and 15 received endocrine therapy after operation.The 5-year survival rate was 54.2%.Conclusions The incidence of MBC is low.This malignancy is mainly seen in elderly individuals,with relatively long disease course,poor prognosis,and high risk of metastasis.MBC is mainly treated by surgery,and adjuvant chemotherapy,radiotherapy,and endocrine therapy may be applied,if appropriate,after the operation.

Cancer treatment experiences among survivors of childhood sexual abuse: A qualitative investigation of triggers and reactions to cumulative trauma.

Male and female members of the Amazon Mechanical Turk (N = 159, mean age = 44.27 years, SD = 10.02) participated in an anonymous online survey study. The inclusion criteria included reporting: history of CSA; a diagnosis of colorectal, gynecological, breast, or skin cancer; and experience of triggers and/or difficulties during cancer treatment. Participants' responses to open-ended questions were analyzed using inductive thematic analysis. We identified two primary themes describing CSA survivors' experiences: Theme 1: treatment-related triggers (key subthemes: procedure-related, provider-related, and emotional triggers); and Theme 2: questioning the meaning of cumulative trauma (e.g., "Why me again?"). For CSA survivors, cancer and its treatment can trigger thoughts and emotions associated with the original abuse as well as negative evaluations of themselves, the world, and their future. Our findings are consistent with past research on CSA survivors' experiences in non-cancer healthcare settings and add to the literature by highlighting their struggles during cancer treatment. The present results can inform further research on trauma survivors' reactions to cancer treatment and give cancer care providers the context they need to understand and sensitively serve a substantial yet often overlooked patient group.

A multidimensional view of racial differences in access to prostate cancer care.

Racial disparities in prostate cancer treatment and outcomes are widespread and poorly understood. In the current study, the authors sought to determine whether access to care, measured across multiple dimensions, contributed to racial differences in prostate cancer. The Philadelphia Area Prostate Cancer Access Study (P2 Access) included 2374 men diagnosed with localized prostate cancer between 2012 and 2014. Men were surveyed to assess their experiences accessing care (response rate of 51.1%). The authors determined appointment availability at 151 urology practices using simulated patient telephone calls and calculated travel distances using geospatial techniques. Multivariable logistic regression models were used to determine the association between 5 different domains of access (availability, accessibility, accommodation, affordability, and acceptability) and receipt of treatment, perceived quality of care, and physician-patient communication. There were 1907 non-Hispanic white and 394 black men in the study cohort. Overall, approximately 85% of the men received definitive treatment with no differences noted by race. Black men were less likely to report a high quality of care (69% vs 81%; P<.001) and good physician-patient communication (60% vs 71%; P<.001) compared with white men. In adjusted models, none of the 5 domains of access were found to be associated with definitive treatment overall or with radical prostatectomy. All access domains were associated with perceived quality of care and communication, although these domains did not mediate racial disparities. To the authors' knowledge, the current study presents the first comprehensive assessment of prostate cancer care access, treatment, and patient experience, demonstrating that although access was related to overall perceived quality of care and better physician-patient communication, it did not appear to explain observed racial differences. Cancer 2017;123:4449-57. © 2017 American Cancer Society.

Psychometric Validation of an Instrument to Measure Family Coping During a Child's Hospitalization for Cancer.

Families with children hospitalized for cancer treatment experience multiple, serious challenges. Family coping is a crucial moderator between family stress and family adaptation. A newly developed instrument, the Hospitalization Coping Scale (HCS), measures the effectiveness of family coping during a child's hospitalization. The aims of this study were to revise and validate the psychometric properties of the HCS for families with children hospitalized for cancer treatment in pediatric oncology departments in Mainland China. Psychometric properties of the HCS were examined among 253 families with children hospitalized in pediatric oncology departments in 4 hospitals. Reliability, construct validity, known-group validity, and concurrent validity of the revised HCS were examined. The revised 15-item HCS contains 3 renamed factors: maintaining mental stability, mutual support for child care, and seeking support from external systems. Cronbach's α coefficients for the total and 3 factors were .87, .78, .83, and .79, respectively. The revised scale demonstrated sound known-group validity and concurrent validity. The revised 15-item HCS is a reliable and valid instrument to measure coping effectiveness of families with children hospitalized for cancer treatment. The HCS can be used by pediatric oncology nurses to assess the effectiveness of family coping during a hospitalization of their child with cancer and may help pediatric oncology nurses to develop and implement realistic support strategies based on assessments of family coping effectiveness.

Treatment experiences of Latinas after diagnosis of breast cancer.

The authors examined racial/ethnic differences in patient perspectives regarding their breast cancer treatment experiences. A weighted random sample of women newly diagnosed with breast cancer between 2013 and 2015 in Los Angeles County and Georgia were sent surveys 2 months after undergoing surgery (5080 women; 70% response rate). The analytic sample was limited to patients residing in Los Angeles County (2397 women). The pattern of visits with different specialists before surgery was found to be similar across racial/ethnic groups. Low acculturated Latinas (Latinas-LA) were less likely to report high clinician communication quality for both surgeons and medical oncologists (<69% vs >72% for all other groups; P<.05). The percentage of patients who reported high satisfaction regarding how physicians worked together was similar across racial/ethnic groups. Latinas-LA were more likely to have a low autonomy decision style (48% vs 24%-50% for all other groups; P<.001) and were more likely to report receiving too much information versus other ethnic groups (20% vs <16% for other groups; P<.001). Patients who reported a low autonomy decision style were more likely to rate the amount of information they received for the surgery decision as "too much" (16% vs 9%; P<.001). There appears to be moderate disparity in breast cancer treatment communication and decision-making experiences reported by Latinas-LA versus other groups. The approach to treatment decision making by Latinas-LA represents an important challenge to health care providers. Initiatives are needed to improve patient engagement in decision making and increase clinician awareness of these challenges in this patient population. Cancer 2017;123:3022-30. © 2017 American Cancer Society.

Understanding the patient experience of cancer treatment in Ontario, Canada: A qualitative study.

225 Background: In cancer care, patient experience is most often measured quantitatively. However, this approach has limitations in understanding the entire patient experience. Qualitative methods provide an opportunity to understand self reported and more complex issues most important to patients and their family members. This qualitative study explores the patient experience of outpatient cancer treatment throughout Ontario, Canada. Methods: Qualitative content analysis was done by two researchers using data from the annual Ambulatory Oncology Patient Satisfaction Survey (AOPSS) from 2013-15. The AOPSS is a retrospective, paper-based, mailed survey, designed to capture the experiences of patients who are currently receiving cancer treatment or who have received cancer treatment within the previous six months. Patients surveyed were asked “Is there anything else you would like to tell us about your cancer care services?” The National Research Corporation of Canada’s eight dimensions of patient-centred care was used to guide the analysis. Results: 5,391 patients responded to the open-ended question. Demographic information includes: gender, age, education level and disease site. 7,328 coded responses were generated, of which 3,658 (49.9%) were related to eight dimensions of patient-centred care with accompanying sub-dimensions: patients’ preferences (23.5%): dignity and respect; preferences and decision-making; care provider behaviours; emotional support (21.5%): caring, compassion and comfort; anxiety and stress; resources; and sensitive diagnosis; coordination of care (15.8%): care provider and treatment coordination; wait times; information and education (15.7%): patient-care provider communication; information needs; care provider knowledge and skills; access (9.4%): centre location; transportation and accommodation; system; parking; continuity and transition (8.1%): centre personnel; continuity between departments; continuity in the community; discharge; physical comfort (5.1%): environment; pain management and family and friends (0.8%). Conclusions: Qualitative analysis is an effective tool to capture patient experience on a population level.

African American Women's Recollected Experiences of Adherence to Breast Cancer Treatment.

To explore African American women's recollected experiences of breast cancer treatment. . Qualitative description and narrative analysis. . South Carolina Oncology Associates, an outpatient oncology clinic serving rural and urban populations. . 16 African American women with breast cancer previously enrolled in the control arm (n = 93) of a completed randomized, controlled trial. . Feminist narrative analysis of in-depth individual interviews. . The authors identified three themes within the African American breast cancer survivors' recollected experiences of treatment adherence. Although little evidence was presented of shared decision making with providers, patients were committed to completing the prescribed therapies. The narratives highlighted the value of in-depth examination of patients' perspectives, particularly among minority and underserved groups. With the exception of voicing personal choice of surgical treatment, the women trusted providers' recommendations with a resolve to "just do it." Although trust may enhance treatment adherence, it may also reflect power differentials based on gender, race, education, and culture. . Nurses should listen to patients describe their experience with cancer treatment and compare the themes from this study with their patients' story. This comparison will help nurses support patients through various aspect of diagnosis and treatment.