Supporting self‐management of radiation‐induced bowel and bladder dysfunction in pelvic‐cancer rehabilitation: An ethnographic study

Abstract

Aims and objectives To describe and understand strategies that oncological nurses use to support self‐management of radiation‐induced bowel and bladder issues in pelvic‐cancer rehabilitation patients. Background Nurse‐led self‐management of radiation‐induced bowel and bladder issues holds the potential to support cancer survivors. Design An ethnographic approach was applied in this study, which adhered to Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Methods Data collection was conducted in Sweden between October 2015–April 2018, involving observations of nurses’ daily work, formal and informal interviews, individual and group interviews, and reviews of relevant documents used in the studied practice. Furthermore, 15 supportive nurse–patient talks were observed, and an ethnographic analysis was performed. Results The analysis identified the following three categories of nursing strategies that support self‐management of radiation‐induced bowel and bladder issues in pelvic‐cancer rehabilitation patients: encouraging self‐reflection, tailoring solutions together and keeping patients motivated. Nurses and patients jointly make sense of patients’ symptoms using data that patients collect about themselves. Based on their shared understanding, they can co‐create solutions to meet each individual patient's needs and develop routines to keep the patient motivated in performing the devised solutions. Conclusions The results indicate that the strategies nurses use to support patients in self‐management of radiation‐induced bowel and bladder issues entail intertwining patients’ experiences with their nurses’ medical knowledge and specific clinical practice. Nurses’ strategies build on their ability to connect patients’ experiences and the elements of their own work practice. Relevance to clinical practice A deeper understanding of nurses’ strategies to support self‐management of radiation‐induced bowel and bladder issues in pelvic‐cancer rehabilitation patients can improve other self‐management programmes, inform nurses’ education and aid in the design of tools for pelvic‐cancer rehabilitation support.

Cohort profile: an observational longitudinal data collection of health aspects in a cohort of female cancer survivors with a history of pelvic radiotherapy—a population-based cohort in the western region of Sweden

“…In Sweden, promising steps are being taken towards developing a programme for national coordination of cancer rehabilitation practice. Cerna et al , 23 in a study concerning self-management from an educational perspective, observed that patients and nurses can together create tailor-made solutions. The nurses focus on encouraging the patients to self-reflect and on maintaining the patient’s motivation to continue to engage in self-care.…”

Effectiveness of Comfort Nursing Combined with Continuous Nursing on Patients with Colorectal Cancer Chemotherapy

“…In this regard, surgery cannot benefit patients; thus, chemotherapy is frequently used. As a damaging treatment, chemotherapy can produce strong side effects, making it prone to hair loss, abdominal pain, liver and kidney function damage [ 3 ], and further damaging the body's immune cells to undermine immune function. In addition, up to 65% of patients develop psychological stress reaction during chemotherapy, in the most direct manner of poor psychological state and sleep quality.…”