Indiana University-Purdue University Indianapolis (IUPUI) / Symptom management is the main focus of care for patients living with advanced
pancreatic cancer (APC). However, evidence shows that symptom management is far
from satisfactory for this population. Poorly managed symptoms have had a profound
negative impact on APC patients’ and caregivers’ life. While communicating symptoms
with healthcare providers is the first step to achieve effective symptom management,
some studies have revealed the poor quality of symptom discussions among cancer
patients, their caregivers, and healthcare providers.
The purpose of this dissertation was to advance the sciences of nursing, symptom
management, and patient/caregiver and provider communication in patients with APC.
Chapter two, three, and four represented three sub-studies which addressed three specific
aims: (1) synthesizing the current evidence regarding the symptom experience of patients
with APC, (2) examining recorded healthcare encounters between patients with APC,
their caregivers, and healthcare providers to better understand the symptom experiences
of patients with APC as told to their healthcare providers, and (3) developing a typology
describing patterns and essential elements of real discussions between APC patients/
caregivers and healthcare providers in regards to symptoms. Specifically, chapter two
was an integrative review which synthesized sixteen quantitative studies (n=1630
pancreatic cancer patients) and found that pain, fatigue, and appetite loss were primary
and intense symptoms experienced by patients with APC. Chapter three was a qualitative
descriptive study which used content analysis to examine 37 transcripts of APC patient/caregiver-provider health encounters originally collected for a larger
communication study. This study identified ten major symptom groups often described as
intense, distressing, and negatively impacting their quality of life. For chapter four,
thematic analysis was used to examine 37 transcripts of APC/giver and provider
interactions to develop a typology to describe patterns of interactions in regards to
symptoms and symptom management. Eight common patient/caregiver-provider
interaction patterns regarding symptoms and symptom management were identified.
These typologies can be used to enhance patient/caregiver and provider communication
programs to promote patient-centered care and improve symptom management in patients
with APC. Findings overall will contribute to effective symptom management as it will
deepen our understanding of symptom experience and communication processes. / 2 years
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/13852 |
| Date | 13 June 2017 |
| Creators | Tang, Chia-Chun |
| Contributors | Von Ah, Diane, Burke Draucker, Claire, Hickman, Susan E., Shields, Cleveland G. |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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