Abstract
Colorectal cancer (CRC) is now the third most common malignancy for men and women in New Zealand. The efficacy of surgical and oncological treatment options for CRC continue to develop and improve patients overall survival outcomes. As the projected growth of the aging population in New Zealand is set to rise significantly over the next ten years, there will be an exponential increase in CRC diagnoses. Therefore, in the future NZ will have a large population of CRC survivors. The vision of the Ministry of Health (MOH, 2013a) is to improve the patients’ experience of cancer with an emphasis on enhancing supportive care needs throughout the cancer trajectory. The Cancer Nurse Coordinator (CNC) initiative has been designed to help improve the patients experience by facilitating timely care and providing the patient and family with support and guidance during the cancer trajectory.
The aim of this research was to identify the supportive care needs of CRC patients throughout the cancer trajectory. With a specific focus on understanding the patients’ perspective of any physical, social, emotional and spiritual issues experienced. This study used data collected through two focus groups. A general inductive approach was used to analyse the data. Four themes were generated from the data (communication and information, living beyond cancer, coping strategies and family support). Each main theme produced sub-themes and these are illustrated with patient narratives to reflect the participant’s perspective of supportive care needs.
The results of the study identified that communication and information were fundamental components of supportive care. Physical, spiritual, emotional and social well-being were acknowledged as varying from person to person and fluctuated throughout the cancer trajectory. These themes were not experienced in isolation; they interconnected and influenced the patients overall well-being. Supportive care needs were evident throughout the cancer trajectory. However, were intensified at the point of diagnosis, during treatment and transition into life beyond cancer. Patients and family members were dependant on health professionals for support within the health care environment and the quality of this support varied, impacting on overall well-being. In the community setting patients received the majority of support from family and friends.
This study has provided insight into individual supportive care needs experienced by CRC patient’s throughout the cancer trajectory. Living with, through and beyond CRC treatment can create specific immediate and long-term symptoms which may impact on a patient’s quality of life. The role of the CNC can go some way to help facilitate quality supportive care improvements within the health care environment. With better support, the well-being of patients and family will be enhanced during their cancer experience.