Impact of consultation recordings on patient-reported outcomes in patients with brain tumors: a parallel randomized controlled trial.

Objective: We aimed to determine the impact of a primary treatment consultation recording on perception of being informed, satisfaction with cancer care, satisfaction with the oncologist, and psychological distress in patients with brain tumors.

Methods: This was a prospective, double-blind, parallel, randomized controlled trial conducted in 3 Canadian cities, in which patients who had their initial treatment consultation recorded were assigned to either receive their digital recording or not. It was hypothesized that patients who received their recording would realize statistically significant benefit on the outcomes of interest at 1 week, 3 months, and 6 months post-consultation in comparison to patients who did not receive their recording.

Anxiety, depression and defense mechanisms associated with treatment decisional preferences and quality of life in non-metastatic breast cancer: a 1-year prospective study.

Objective: Treatment decisional preferences impact breast cancer patients' health-related quality of life (HRQoL) and may relate to psychological variables, although many aspects of this relationship remain unknown. This prospective study aimed to assess psychological correlates of treatment decisional preferences and predictors of HRQoL in women with early non-metastatic breast cancer.

Methods: Of the 124 women initially assessed for anxiety (Spielberger's State-Trait Anxiety Inventory) and depressive (Center for Epidemiologic Studies-Depression (CES-D)) symptoms, HRQoL (WHOQOL-BREF), and defense mechanisms (Life Style Index), 82 (66.

Promoting consultation recording practice in oncology: identification of critical implementation factors and determination of patient benefit.

Objective: The objectives of this implementation study were to (i) address the evidentiary, contextual, and facilitative mechanisms that serve to retard or promote the transfer and uptake of consultation recording use in oncology practice and (ii) follow patients during the first few days following receipt of the consultation recording to document, from the patient's perspective, the benefits realized from listening to the recording.

Methods: Nine medical and nine radiation oncologists from cancer centers in three Canadian cities (Calgary, Vancouver, and Winnipeg) recorded their primary consultations for 228 patients newly diagnosed with breast (n = 174) or prostate cancer (n = 54). The Digital Recording Use Semi-Structured Interview was conducted at 2 days and 1 week postconsultation.

Behind closed doors II: systematic analysis of prostate cancer patients' primary treatment consultations with radiation oncologists and predictors of satisfaction with communication.

Objective: The purpose of this investigation was to explicate the content of primary treatment consultations in prostate oncology and examine the predictive relationships between patient, significant other, and oncologist consultation factors and patient satisfaction with communication.

Methods: The recorded consultations of 156 newly diagnosed prostate cancer patients from three Canadian cancer centers were examined using the Medical Interaction Process System (MIPS). The MIPS findings, independent observer ratings of patient, significant other, and oncologist affective behavior, and derived consultation ratios of patient centeredness, patient directedness, and psychosocial focus, were used to predict patient satisfaction with communication post-consultation and at 12-weeks post-consultation.

Facilitating the implementation of empirically valid interventions in psychosocial oncology and supportive care.

Purpose: Over the past two decades, the fields of psychosocial oncology and supportive care have seen clinically effective tools as underutilized despite proven benefits to cancer patients and their families. The purpose of this paper is to discuss the reasons for the failure of psychosocial and supportive care interventions in oncology to realize broad clinical implementation and to demonstrate how a knowledge management framework offers several advantages for increasing the probability of successful implementation.

Methods: This paper is based on a systematic review of the literature pertaining to efforts to implement psychosocial oncology and supportive care interventions.

Study protocol: addressing evidence and context to facilitate transfer and uptake of consultation recording use in oncology: a knowledge translation implementation study.

Background: The time period from diagnosis to the end of treatment is challenging for newly diagnosed cancer patients. Patients have a substantial need for information, decision aids, and psychosocial support. Recordings of initial oncology consultations improve information recall, reduce anxiety, enhance patient satisfaction with communication, and increase patients' perceptions that the essential aspects of their disease and treatment have been addressed during the consultation.

Preferred roles in treatment decision making among patients with cancer: a pooled analysis of studies using the Control Preferences Scale.

Objectives: To collect normative data, assess differences between demographic groups, and indirectly compare US and Canadian medical systems relative to patient expectations of involvement in cancer treatment decision making.

Study Design: Meta-analysis.

Methods: Individual patient data were compiled across 6 clinical studies among 3491 patients with cancer who completed the 2-item Control Preferences Scale indicating the roles they preferred versus actually experienced in treatment decision making.

Decision-making preferences and information needs among Greek breast cancer patients.

Objectives: We aimed at assessing Greek breast cancer patients' preferences for participation in treatment decision making and their information needs.

Methods: In a cross-sectional study, 329 breast cancer patients were administered at the Control Preferences Scale, a card-sort measurement designed to elicit preferences for participation in decision making. Information needs were assessed with Cassileth's Information Styles Questionnaire.

Penile length shortening after radical prostatectomy: men's responses.

Background: Prostate cancer (PC) is the most common type of male-specific cancer in North American men, and many men choose radical prostatectomy (RP) to remove their cancer. Although penile length shortening (PLS) occurs in a reported 68% to 71% of men undergoing RP, little is known about it. In an electronic journal search, only 9 medical articles (with no nursing publications) were published between 1980 and 2007.

Study protocol for the translating research in elder care (TREC): building context through case studies in long-term care project (project two).

Background: The organizational context in which healthcare is delivered is thought to play an important role in mediating the use of knowledge in practice. Additionally, a number of potentially modifiable contextual factors have been shown to make an organizational context more amenable to change. However, understanding of how these factors operate to influence organizational context and knowledge use remains limited.

Translating research in elder care: an introduction to a study protocol series.

Background: The knowledge translation field is undermined by two interrelated gaps - underdevelopment of the science and limited use of research in health services and health systems decision making. The importance of context in theory development and successful translation of knowledge has been identified in past research. Additionally, examination of knowledge translation in the long-term care (LTC) sector has been seriously neglected, despite the fact that aging is increasingly identified as a priority area in health and health services research.

Predictors of distress and quality of life in patients undergoing cancer therapy: impact of treatment type and decisional role.

Purpose: The purpose of this secondary investigation was to examine the impact of the type of treatment received and the perceived role in treatment decision making in predicting distress and cancer-specific quality of life in patients newly diagnosed with breast or prostate cancer.

Method: Participants included 1057 newly diagnosed breast and prostate cancer patients from four Canadian cancer centers who partook in a randomized controlled trial examining the utility of providing patients with an audio-recording of their treatment planning consultation. A MANCOVA was performed to predict distress and cancer-specific quality of life at 12 weeks post-consultation based on control variables (patient age, education, residence, tumor size (breast sample), gleason score (prostate sample), and receipt of an initial treatment consultation recording), predictor variables (treatment type--chemotherapy, hormone therapy, radiation therapy; decisional role--active, collaborative, passive), and interactions between these predictors.

Behind closed doors: systematic analysis of breast cancer consultation communication and predictors of satisfaction with communication.

Objective: The purpose of this investigation was to explicate the content of primary adjuvant treatment consultations in breast oncology and examine the predictive relationships between patient and oncologist consultation factors and patient satisfaction with communication.

Methods: The recorded consultations of 172 newly diagnosed breast cancer patients from four Canadian cancer centers were randomly drawn from a larger subset of 481 recordings and examined by three coders using the Medical Interaction Process System (MIPS); a system that categorizes the content and mode of each distinct utterance. The MIPS findings, independent observer ratings of patient and oncologist affective behavior, and derived consultation ratios of patient centeredness, patient directedness, and psychosocial focus, were used to predict patient satisfaction with communication post-consultation and at 12-weeks post-consultation.

Uncertainty after treatment for prostate cancer: definition, assessment, and management.

Prostate cancer is the second most common type of cancer in men living in the United States and the most common type of malignancy in Canadian men, accounting for 186,320 new cases in the United States and 24,700 in Canada in 2008. Uncertainty, a component of all illness experiences, influences how men perceive the processes of treatment and adaptation. The Reconceptualized Uncertainty in Illness Theory explains the chronic nature of uncertainty in cancer survivorship by describing a shift from an emergent acute phase of uncertainty in survivors to a new level of uncertainty that is no longer acute and becomes a part of daily life.

Smoking behavior and patient education practices of oncology nurses in six countries.

Worldwide, tobacco is the leading cause of preventable death, resulting in approximately 5 million deaths annually. Nurses are keenly positioned to work toward reducing tobacco-related illness and deaths. Therefore, guided by the health belief model, the purpose of this study was to explore the smoking behavior, beliefs, smoking cessation education practices, and existing smoking policies at the institutions of a sample of practicing oncology nurses in Canada, Japan, Korea, Taiwan, United Kingdom, and the United States.

Symptom prevalence, intensity, and distress in patients with inoperable lung cancer in relation to time of death.

Purpose: To examine symptom prevalence, intensity, and association with distress in patients with inoperable lung cancer (LC), using time to death as point of reference.

Patients And Methods: A consecutive sample of 400 patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 plus a 13-item LC-specific scale and the Thurstone Scale of Symptom Distress-Lung Cancer at six time points during the first year after diagnosis. Patients were divided into subgroups, using data from the time point closest to death (< 1; 1 to 2; > 2 to 3; > 3 to 6; > 6 to 12; and > 12 months before death) for analysis.

Developing a living with hope program for caregivers of family members with advanced cancer.

A theory-based intervention, the Living with Hope Program (LWHP), was designed to foster hope in caregivers of family members with advanced cancer. The LWHP was developed from qualitative data and using Harding and Higginson's recommendations for family caregiver interventions as a guide. The LHWP is: (a) focused specifically on the caregivers themselves, (b) theory based, (c) feasible, (d) acceptable, and (e) pilot tested.

Living with hope: initial evaluation of a psychosocial hope intervention for older palliative home care patients.

The overall purpose of this study was to evaluate the effectiveness of a psychosocial supportive intervention called the "Living with Hope Program" (LWHP) in increasing hope and quality of life for older adult, community-living, terminally ill cancer patients. Using a mixed method concurrent nested experimental design, 60 terminally ill cancer patients over the age of 60 years were randomly assigned to a treatment group and a control group. Baseline hope (Herth Hope Index [HHI]) and quality-of-life scores (McGill Quality of Life Questionnaire [MQOL]) were collected at the first visit in the patients' homes by trained research assistants.

Impact of providing audiotapes of primary treatment consultations to men with prostate cancer: a multi-site, randomized, controlled trial.

Background: The purpose of this investigation was to systematically examine the efficacy of providing men with prostate cancer with an audiotape of their primary treatment consultation.

Method: Participants included 425 men newly diagnosed with prostate cancer and 15 radiation oncologists from 4 cancer centers in Canada. Patients were block randomized to one of four consultation groups: 1.

Parents of children with cancer: factors influencing their treatment decision making roles.

This study examined the factors that parents identified as influencing their role in treatment decision making (TDM) for their child with cancer. Content analysis of qualitative data from semistructured interviews with 36 parents as part of a mixed-methods study revealed numerous themes related to parents' TDM roles. Factors that were frequently identified included: relationship with the physician, nature of communication, trust in the physician, parents' and physician's knowledge and experience, and importance of parental role.

Perception of risk and surveillance practices of women with a family history of breast cancer.

A retrospective study was designed to examine the relationship between perception of risk and surveillance activities (mammography and clinical breast examination) in women with a family history of breast cancer. The Revised Susceptibility, Benefits, and Barriers Scale for Mammography Screening, the Centre for Epidemiology Studies--Depression Scale (CES-D), and a demographic form were administered to a convenience sample of 56 women. There were no significant relationships between perceived risk and screening activities.

Clarifying the concepts in knowledge transfer: a literature review.

Aim: The aim of this paper is to examine the concepts of opinion leaders, facilitators, champions, linking agents and change agents as described in health, education and management literature in order to determine the conceptual underpinnings of each.

Background: The knowledge utilization and diffusion of innovation literature encompasses many different disciplines, from management to education to nursing. Due to the involvement of multiple specialties, concepts are often borrowed or used interchangeably and may lack standard definition.

Promoting enhanced patient and family caregiver congruence on lung cancer symptom experiences.

Purpose/objectives: To test the effects of different perspective-taking instructional sets, gender, caregivers' personal histories with cancer, and caregiving relationship factors on family caregiver and patient perceptual agreement of symptom experiences of patients with lung cancer.

Design: Counterbalanced.

Setting: Thoracic oncology outpatient clinical setting in Canada.