Patient and family supportive care needs in advanced prostate cancer : development of an advanced practice nurse role

Abstract

PURPOSE: To further understand the unmet healthcare needs of men with Advanced Prostate Cancer (APC) and their family members, how these unmet needs affect the daily lives of these people, and how the delivery of supportive care services could be improved to meet their needs. METHODS: A needs assessment was designed using a qualitative descriptive method. Focus groups and individual interviews were used to collect data from 29 men with APC and 19 family members in South Central Ontario. A smaller study that explored their experiences of participation in focus groups and interviews was also conducted. Audiorecorded and transcribed data were organized using N-Vivo software. Teams of independent reviewers used content analysis to identify themes regarding unmet health needs and health care services. RESULTS: Both patients and family members identified information as their priority supportive care need and the men's struggle to maintain their functional capacity as the greatest challenge. Functional issues described by men included urinary and sexual dysfunction, fatigue and the side effects of their treatment. We also identified the patient need for emotional support. Family members were uncertain about the future and some experienced caregiver burden and isolation and needed more practical assistance. Both patients and families recommended providing more opportunities to discuss APC with healthcare professionals and the creation of small support groups. CONCLUSION: The design and organization of suuportive care services that maximize patient and family resiliency and provide the tools and resources necessary to maintain functional capacity is recommended. This population requires patient focused interventions by advanced practice nurses and other members of the interdisciplinary team to help cope with complex, overlapping supportive care needs that are complicated by advancing age, cancer treatment, and co-morbid conditions.