Top

Published in:

01-04-2019 | Peritoneal Surface Malignancy

Characterizing the Patient Experience of CS/HIPEC Through In-Depth Interviews with Patients: Identification of Key Concepts in the Development of a Patient-Centered Program

Authors: Valerie A. Francescutti, MD, MSc, FACS, FRCSC, Allison H. Maciver, MD, MSc, FRCSC, Erika Stewart, NP, Nikia Clark, Bianca Marrara, Frances G. Saad-Harfouche, MSW, Elisa M. Rodriguez, MS, PhD

Published in: Annals of Surgical Oncology | Issue 4/2019

Abstract

Introduction

The cytoreduction and hyperthermic intraperitoneal chemotherapy (CS/HIPEC) procedure is complex, involving lengthy preparation and recovery in a heterogeneous patient group. Understanding the patient experience is essential to improving interactions with health professionals that is critical to recovery.

Objective

This study sought to characterize the early recovery and return to quality of life (at 3 and 6–12 months post-surgery, respectively) in patients having undergone CS/HIPEC, through structured interviews.

Methods

Two sets of interviews were conducted among 20 CS/HIPEC patients. Interviews were uploaded into QSR NVivo 10 qualitative software (QSR International, Australia) and coded by two study personnel. Interview 1 focused on initial treatment decision making and postoperative hospitalization, while interview 2 focused on recovery, supports, and return to quality of life.

Results

Among the participants, 60% were female and the mean age was 57 years (range 31–71). Diagnoses included disseminated peritoneal adenomucinosis (n = 6), appendiceal adenocarcinoma (n = 4), colorectal adenocarcinoma (n = 6), goblet cell (n = 2), and mesothelioma (n = 2). The first interview identified common themes of perioperative psychosocial isolation, lack of direction, and the importance of an established support system. Patients requested printed and audiovisual materials focused on addressing expectations. The main findings from the second interview captured patient experiences with longer-term complications, as well as surveillance.

Conclusion

Focused interviews with patients recently having undergone CS/HIPEC identified key issues that may be addressed in programs to improve the patient experience. These issues were distinctly different in relation to phase of recovery, and patient-centered programs designed with these factors in mind have the potential to enhance the recovery process.

Available only for authorised users

Improving the Patient Experience, The Beryl Institute website. Available at www.theberylinstitute.org. Accessed 30 April 2018.

Denkin N, Lincoln Y. Handbook on qualitative research. Thousand Oaks, CA: Sage Publishing Company; 1994.

Patton M. Qualitative research and evaluation methods. Thousand Oaks, CA: Sage Publishing Company; 2002.

Taylor G. Integrating quantitative and qualitative methods in research. New York: University Press of America; 2004.

Sugarbaker P. Peritonectomy procedures. Ann Surg. 1995;221(1):29–42.CrossRefPubMedPubMedCentral

Verwaal VJ, van Ruth S, de Bree E, van Sloothen GW, van Tinteren H, Boot H, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003;21(20):3737–43.CrossRefPubMed

Glehen O, Kwiatkowski F, Sugarbaker PH, Elias D, Levine EA, De Simone M, et al. Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol. 2004;22(16):3284–92.CrossRefPubMed

Dodson RM, McQuellon RP, Mogal HD, Duckworth KE, Russell GB, Votanopoulos KI, et al. Quality-of-life evaluation after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol. 2016;23 Suppl 5:772–783.CrossRefPubMedPubMedCentral

Haslinger M, Francescutti V, Attwood K, McCart JA, Fakih M, Kane JM 3rd, et al. A contemporary analysis of morbidity and outcomes in cytoreduction/hyperthermic intraperitoneal chemoperfusion. Cancer Med. 2013;2(3):334–42.CrossRefPubMedPubMedCentral

10.

Eriksson H, Haglund K, Leo Swenne C, Arakelian E. Patients’ experiences of postoperative health related to cytoreductive surgery and hyperthermic intraoperative chemotherapy. J Clin Nurs. 2014;23(1–2):201–10.CrossRefPubMed

11.

Leo Swenne C, Cederholm K, Gustafsson M, Arakelian E. Postoperative health and patients’ experiences of efficiency and quality of care after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, two to six months after surgery. Eur J Oncol Nurs. 2015;19:191–197.CrossRefPubMed

12.

Maciver AH, Al-Sukhni E, Esquivel J, Skitzki JJ, Kane JM 3rd, Francescutti VA. Current delivery of hyperthermic intraperitoneal chemotherapy with cytoreductive surgery (CS/HIPEC) and perioperative practices: an international survey of high-volume surgeons. Ann Surg Oncol. 2017;24(4):923–930.CrossRefPubMed

13.

Werner BC, Wong AC, Chang B, Craig EV, Dines DM, Warren RF, et al. Depression and patient-reported outcomes following total shoulder arthroplasty. J Bone Joint Surg Am. 2017;99(8):688–695.CrossRefPubMed

14.

Koorevaar RC, van’t Riet E, Gerritsen MJ, Madden K, Bulstra SK. The influence of preoperative and postoperative psychological symptoms of clinical outcome after shoulder surgery: a prospective longitudinal cohort study. PLoS ONE. 2016;11(11):e0166555.CrossRefPubMedPubMedCentral

15.

Stenberg U, Cvancarova M, Ekstedt M, Olsson M, Ruland C. Family caregiver of cancer patients: perceived burden and symptoms during the early phases of cancer treatment. Soc Work Health Care. 2014;53(3):289–309.CrossRefPubMed

16.

Hung HC, Tsai MC, Chen SC, Liao CT, Chen YR, Liu JF. Change and predictors of social support in caregivers or newly diagnosed oral cavity cancer patients during the first 3 months after discharge. Cancer Nurs. 2013;36(6): E17–24.CrossRefPubMed

Title: Characterizing the Patient Experience of CS/HIPEC Through In-Depth Interviews with Patients: Identification of Key Concepts in the Development of a Patient-Centered Program
Authors: Valerie A. Francescutti, MD, MSc, FACS, FRCSC
Allison H. Maciver, MD, MSc, FRCSC
Erika Stewart, NP
Nikia Clark
Bianca Marrara
Frances G. Saad-Harfouche, MSW
Elisa M. Rodriguez, MS, PhD
Publication date: 01-04-2019
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 4/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-018-07120-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Characterizing the Patient Experience of CS/HIPEC Through In-Depth Interviews with Patients: Identification of Key Concepts in the Development of a Patient-Centered Program

Abstract

Introduction

Objective

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2019

Establishment of a New Scirrhous Gastric Cancer Cell Line with FGFR2 Overexpression, OCUM-14

Cost-Effectiveness Analysis of Cytoreductive Surgery and HIPEC Compared With Systemic Chemotherapy in Isolated Peritoneal Carcinomatosis From Metastatic Colorectal Cancer

Endoscopic Retrograde Biliary Drainage Causes Intra-Abdominal Abscess in Pancreaticoduodenectomy Patients: An Important But Neglected Risk Factor

Correlation Between Intraoperative and Pathological Findings for Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Should Multidisciplinary Treatment Differ for Esophageal Adenocarcinoma Versus Esophageal Squamous Cell Cancer?

Prognostic Nomogram for Disease-Specific Survival in Patients with Non-metastatic Ampullary Carcinoma After Surgery