Behavioural profile and human adaptation of survivors after radical cystectomy and ileal conduit

Abstract

BackgroundThere is a lack of good data in the literature evaluating the Health-Related Quality of Life (HR- QoL) in patients with urinary diversions. The aim of this study was to examine the changes in expectation and needs in terms of human adaptation and behavioural profiles in patients with ileal conduit (IC) after radical cystectomy (RC) for bladder cancer (BC).Materials and methodsA qualitative, multicenter cross-sectional study using a “narrative based” approach was planned. We proceed with a sampling reasoned choice (purposive), selecting groups of patients with follow-up from one up to more than 7 years after surgery. Data were collected through individual interviews.ResultsThirty patients participated in the study. The processing of the interviews allowed us to identify 2 major profiles: positive and negative. Patients with a positive profile resumed normal daily activities with no or limited restrictions both on the personal and the social level. This profile reflects a good HR-QoL. The negative profile reflects the patients for whom the ostomy has meant a worsening of HR-QoL. A positive profile was statistically more frequent in older patients (p = 0.023), with a longer follow-up (p = 0.042) and less complications rates (p = 0.0002). According to the length of follow-up and the occurrence of complitations, we identified further 5 intermediate profiles.ConclusionsPatients’ satisfaction is related to the degree of adaptation to their new life with an urinary stoma and its correct management. Live “with urinary diversion” represents a new phase of life and not a deterioration.

Unmet informational and supportive care needs of patients with muscle invasive bladder cancer: A systematic review of the evidence

“…This left 8 articles which fully met the inclusion criteria, of which two articles reported on the same study (Mohamed et al, 2014;Mohamed et al, 2016). In total, there were 6 exploratory qualitative studies (Ali and Khalil, 1989;Cerruto et al, 2014;Fitch et al, 2010;Månsson et al, 1991;Mohamed et al, 2014;Mohamed et al, 2016;Nordström et al, 1992;Perlis et al, 2014) and one feasibility RCT study (Ali and Khalil, 1989) see Table 3 for an overview of the studies included (Supplementary Table 5 contains full data extraction of primary studies). This is a relatively small number of publications and underscores the importance of taking stock of the evidence to understanding the supportive care needs of patients affected by bladder cancer.…”

Health-Related Quality of Life after Radical Cystectomy for Bladder Cancer in Elderly Patients with Ileal Orthotopic Neobladder or Ileal Conduit: Results from a Multicentre Cross-Sectional Study Using Validated Questionnaires

“…Using a qualitative approach to assess HR-QoL aspects in patients with IC, during the 1st year after surgery, the experience perceived by patients is better in terms of QoL compared to that perceived after 3-year follow-up because patients are still optimistic about the success of treatment and recovery [20]. To obtain a positive prolife, a more than 5-year follow-up is needed due to the phenomenon of adaptation.…”

“…The duration of the follow-up, considered a path of self-adaptation to the urinary derivation, is a pivotal parameter in analyzing the impact of UD in patients’ HR-QoL [20]. …”

Quality of Life in Patients with Bladder Cancer Undergoing Ileal Conduit: A Comparison of Women Versus Men

“…According to Cerruto et al, findings regarding IC show patient satisfaction seems to be related to the degree of adaptation to their new life with an IC, a new phase of life and not simply a deterioration (5).…”