Online Exclusive Article

Development and Qualitative Evaluation of a Self-Management Workshop for Testicular Cancer Survivor-Initiated Follow-Up

Faith Martin

Andrew Turner

Claire Bourne

Lynn Batehup

testicular neoplasms, cancer, survivors
ONF 2012, 40(1), E14-E23. DOI: 10.1188/13.ONF.E14-E23

Purpose/Objectives: To describe the needs of testicular cancer survivors, develop a nurse-led workshop, and explore the experience of participation.

Research Approach: A systematic intervention development process was used to design a self-management workshop for cancer survivors, which then was evaluated qualitatively.

Setting: Outpatient clinic in England.

Participants: 26 healthcare professionals, charity workers, family members, and testicular cancer survivors participated in the intervention development process. Six testicular cancer survivors attended the workshop and participated in the postintervention focus group discussion.

Methodologic Approach: Ten participants, including four survivors, completed the initial needs assessment interviews. Twenty-six participants then rated the identified needs on two dimensions: importance to self-management and changeability via a self-management intervention. Literature review and expert consultation were used to identify potential workshop components. To explore the experience of attending the intervention, six testicular cancer survivors who participated in the nurse-led workshop were interviewed six weeks later.

Findings: The workshop was well received by participants, who appreciated the goal-setting and information provision activities. The men also felt that they had benefited from the experience of being in the group.

Conclusions: Testicular cancer survivors had unmet post-treatment needs. The systematic intervention development method led to an evidence-based workshop to address those needs. Men reported benefits from attending the workshop, which may help maintain and improve health.

Interpretation: Nurse-led workshops can address the current unmet needs of testicular cancer survivors.

Knowledge Translation: Testicular cancer survivors may require support with health information, maintaining psychological health, and monitoring cancer symptoms. Survivors also need help planning and maintaining an active lifestyle. In addition, a brief workshop approach to intervention delivery is acceptable to testicular cancer survivors.

Jump to a section

    References

    Abraham, C., & Michie, S. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology, 27, 379-387.
    Abraham, C., Wight, D., & Scott, S. (2002). Encouraging safer sex behaviours: Development of a SHARE sex education programme. In D. Rutter & L. Quine (Eds.), Changing health behaviours (pp. 28-48). Buckingham, England: Open University Press.
    Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. American Psychologist, 58, 5-14.
    Akechi, T., Okuyama, T., Sugawara, Y., Nakano, T., Shima, Y., & Uchitomi, Y. (2004). Major depression, adjustment disorders, and post-traumatic stress disorder in terminally ill cancer patients: Associated and predictive factors. Journal of Clinical Oncology, 22, 1957-1965.
    American Cancer Society. (2012). Cancer facts and figures 2012. Retrieved from http://www.cancer.org/Research/CancerFactsFigures/index
    Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: A review. Patient Education and Counseling, 48, 177-187.
    Brenner, H. (2002). Long-term survival rates of cancer patients achieved by the end of the 20th century: A period analysis. Lancet, 360, 1131-1135.
    Buchler, T., Kubankova, P., Boublikova, L., Donatova, Z., Foldyna, M., Kanakova, J., … Abrahamova, J. (2011). Detection of second malignancies during long-term follow-up of testicular cancer survivors. Cancer, 117, 4212-4218. doi:10.1002/cncr.26039
    Cancer Research UK. (2010). Testicular cancer statistics. Retrieved from http://www.cancerresearchuk.org/cancer-info/cancerstats/types/testis
    Cecil, R., McCaughan, E., & Parahoo, K. (2010). "It's hard to take because I am a man's man": An ethnographic exploration of cancer and masculinity. European Journal of Cancer Care, 19, 501-509.
    Chatfield, C., & Simcock, R. (2008). Breast cancer follow-up. Retrieved from http://www.sussexcancer.nhs.uk/EasysiteWeb/getresource.axd?AssetID=358480&type=Full&servicetype=Attachment
    Clark, A., Jones, P. S., Newbold, S., Wilson, M., & Brandwood, K. (2000). Practice development in cancer care: Self-help for men with testicular cancer. Nursing Standard, 14, 41-46.
    Cockle-Hearne, J., & Faithfull, S. (2010). Self-management for men surviving prostate cancer: A review of behavioural and psychosocial interventions to understand what strategies can work, for whom and in what circumstances. Psycho-Oncology, 19, 909-922. doi:10.1002/pon.1657
    Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: The new Medical Research Council guidance. BMJ, 337, a1655.
    Dahl, A., Haaland, C., Mykletun, A., Bremnes, R., Dahl, O., Klepp, O., … Fosså, S. D. (2005). Study of anxiety disorder and depression in long-term survivors of testicular cancer. Journal of Clinical Oncology, 23, 2389-2395. doi:10.1200/JCO.2005.05.061
    Dahl, A., Mykletun, A., & Fosså, S. (2005). Quality of life in survivors of testicular cancer. Urologic Oncology, 23, 193-200. doi:10.1016/j.urolonc.2005.03.004
    Davies, N., & Batehup, L. (2010). Self-management support for cancer suvivors: Guidance for developing interventions: An update of the evidence. London, England: Macmillan Cancer Support.
    Davies, N., & Batehup, L. (2011). Toward a personalised approach to aftercare: A review of cancer follow-up in the UK. Journal of Cancer Survivorship, 1-10. doi:10.1007/s11764-010-0165-3
    Doyle, N. (2008). Cancer survivorship: Evolutionary concept analysis. Journal of Advanced Nursing, 62, 499-509.
    Edelman, M., Meyers, F., & Siegel, D. (1997). The utility of follow-up testing after curative cancer therapy: A critical review and economic analysis. Journal of General Internal Medicine, 12, 318-331.
    Fleer, J., Hoekstra, H., Sleijfer, D., Tuinman, M., & Hoekstra-Weebers, J. (2006). The role of meaning in the prediction of psychosocial well-being in testicular cancer survivors. Quality of Life Research, 15, 705-717. doi:10.1007/s11136-005-3569-1
    Fleer, J., Sleijfer, D., Hoekstra, H., Tuinman, M., Klip, E., & Hoekstra-Weebers, J. (2006). Objective and subjective predictors of cancer-related stress symptoms in testicular cancer survivors. Patient Education and Counseling, 64, 142-150. doi:10.1016/j.pec.2005.12.009
    Fosså, S. D., Oldenburg, J., & Dahl, A. A. (2009). Short- and long-term morbidity after treatment for testicular cancer. BJU International, 104(9, Part B), 1418-1422.
    Foster, G., Taylor, S., Eldridge, S., Ramsay, J., & Griffiths, C. (2007). Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database of Systematic Reviews, 4, CD005108. doi:10.1002/14651858.CD005108.pub2
    Ganz, P. A., Casillas, J., & Hahn, E. E. (2008). Ensuring quality care for cancer survivors: Implementing the survivorship care plan. Seminars in Oncology Nursing, 24, 208-217.
    Graves, K. D. (2003). Social cognitive theory and cancer patients' quality of life: A meta-analysis of psychosocial intervention components. Health Psychology, 22, 210-219.
    Gudbergsson, S. B., Fosså, S. D., & Dahl, A. A. (2008). Is cancer survivorship associated with reduced work engagement? A NOCWO Study. Journal of Cancer Survivorship, 2, 159-168.
    Huddart, R., Norman, A., Shahidi, M., Horwich, A., Coward, D., Nicholls, J., & Dearnaley, D. P. (2003). Cardiovascular disease as a long-term complication of treatment for testicular cancer. Journal of Clinical Oncology, 21, 1513-1523. doi:10.1200/JCO.2003.04.173
    Huyghe, E., Muller, A., Mieusset, R., Bujan, L., Bachaud, J. M., Chevreau, C., … Thonneau, P. (2007). Impact of diagnostic delay in testis cancer: Results of a large population-based study. European Urology, 52, 1710-1716.
    Jerant, A. F., von Friederichs-Fitzwater, M. M., & Moore, M. (2005). Patients' perceived barriers to active self-management of chronic conditions. Patient Education and Counseling, 57, 300-307.
    Joly, F., Héron, J. F., Kalusinski, L., Bottet, P., Brune, D., Allouache, N., … Henry-Amar, M. (2002). Quality of life in long-term survivors of testicular cancer: A population-based case-control study. Journal of Clinical Oncology, 20, 73-80.
    Jordan, J. M., & Osborne, R. H. (2007). Chronic disease self-management education programs: Challenges ahead. Medical Journal of Australia, 186, 84-87.
    Lorig, K. R., & Holman, H. R. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26, 1-7. doi:10.1207/S15324796ABM2601_01
    Martin, F., Turner, A., Wallace, L. M., & Bradbury, N. (2012). Conceptualising self-management interventions for people with early stage dementia. European Journal of Ageing. Advance online publication. doi:10.1007/s10433-012-0253-5
    McCorkle, R., Ercolano, E., Lazenby, M., Schulman-Green, D., Schilling, L. S., Lorig, K. R., … Wagner, E. H. (2011). Self-management: Enabling and empowering patients living with cancer as a chronic illness. CA: A Cancer Journal for Clinicians, 61, 50-62.
    Michie, S., Fixsen, D., Grimshaw, J. M., & Eccles, M. P. (2009). Specifying and reporting complex behaviour change interventions: The need for a scientific method. Implementation Science, 4, 40.
    Morgan, M. A. (2009). Cancer survivorship: History, quality of life issues, and the evolving multidisciplinary approach to implementation of cancer survivorship care plans. Oncology Nursing Forum, 36, 429-436. doi:10.1188/09.ONF.429-436
    Oeffinger, K. C., & McCabe, C. (2006). Models for delivering survivorship care. Journal of Clinical Oncology, 24, 5117-5124. doi:10.1200/JCO.2006.07.0474
    Orre, I., Fosså, S., Murison, R., Bremnes, R., Dahl, O., Klepp, O., … Dahl, A. A. (2008). Chronic cancer-related fatigue in long-term survivors of testicular cancer. Journal of Psychosomatic Research, 64, 363-371. doi:10.1016/j.jpsychores.2008.01.002
    Preyde, M., & Synnott, E. (2009). Psychosocial intervention for adults with cancer: A meta-analysis. Journal of Evidence-Based Social Work, 6, 321-347. doi:10.1080/15433710903126521
    Renger, R., & Hurley, C. (2006). From theory to practice: Lessons learned in the application of the ATM approach to developing logic models. Evaluation and Program Planning, 29, 106-119. doi:10.1016/j.evalprogplan.2006.01.004
    Ritchie, J., & Spencer, L. (1994). Qualitative data analysis for applied policy research. In A. Bryman & R. G. Burgess (Eds.), Analysing qualitative data (pp. 173-194). London, England: Routledge.
    Rossen, P. B., Pedersen, A. F., Zachariae, R., & von der Maase, H. (2009). Health-related quality of life in long-term survivors of testicular cancer. Journal of Clinical Oncology, 27, 5993-5999.
    Rutskij, R., Gaarden, T., Bremnes, R., Dahl, O., Finset, A., Fosså, S. D., … Dahl, A. A. (2010). A study of coping in long-term testicular cancer survivors. Psychology, Health and Medicine, 15, 146-158. doi:10.1002.pon.1437
    Sagstuen, H., Aass, N., Fosså, S., Dahl, O., Klepp, O., Wist, E., … Bremnes, R. M. (2005). Blood pressure and body mass index in long-term survivors of testicular cancer. Journal of Clinical Oncology, 23, 4980-4990. doi:10.1200/JCO.2005.06.882
    Shevil, E., & Finlayson, M. (2009). Process evaluation of a self-management cognitive program for persons with multiple sclerosis. Patient Education and Counseling, 76, 77-83. doi:10.1016/j.pec.2008.11.007
    Shinn, E. H., Basen-Engquist, K., Thornton, B., Spiess, P. E., & Pisters, L. (2007). Health behaviors and depressive symptoms in testicular cancer survivors. Urology, 69, 748-753. doi:10.1016/j.urology.2006.12.022
    Skaali, T., Fosså, S. D., Bremnes, R., Dahl, O., Haaland, C. F., Hauge, E., … Dahl, A. A. (2009). Fear of recurrence in long-term testicular cancer survivors. Psycho-Oncology, 18, 580-588. doi:10.1002.pon.2030
    Sørlie, T., Rosenvinge, J. H., Bremnes, R., Balteskard, L., Dahl, A. A., Klepp, O., & Fosså, S. D. (2006). Management satisfaction in survivors of testicular cancer. Anticancer Research, 26, 1463-1469.
    Stanton, A. L., Ganz, P. A., Kwan, L., Meyerowitz, B. E., Bower, J. E., Krupnick, J. L., … Belin, T. R. (2005). Outcomes from the Moving Beyond Cancer psychoeducational, randomized, controlled trial with breast cancer patients. Journal of Clinical Oncology, 23, 6009-6018. doi:10.1200/JCO.2005.09.101
    Taskila, T., Lindbohm, M. L., Martikainen, R., Lehto, U. S., Hakanen, J., & Hietanen, P. (2006). Cancer survivors' received and needed social support from their work place and the occupational health services. Supportive Care in Cancer, 14, 427-435.
    Travis, L. B., Beard, C. Allan, J. M., Dahl, A., Feldman, D., Oldenburg, J., … Fosså, D. (2010). Testicular cancer survivorship: Research strategies and recommendations. Journal of the National Cancer Institute, 102, 1114-1130. doi:10.1093/jnci/djq216
    Travis, L. B., Curtis, R. E., Storm, H., Hall, P., Holowaty, E., Van Leeuwen, F. E., … Boice, J. D., Jr. (1997). Risk of second malignant neoplasms among long-term survivors of testicular cancer. Journal of the National Cancer Institute, 89, 1429-1439. doi:10.1093/jnci/89.19.1429
    Travis, L. B., Fosså, S. D., Schonfeld, S. J., McMaster, M. L., Lynch, C. F., Storm, H., … Gilbert, E. S. (2005). Second cancers among 40,576 testicular cancer patients: Focus on long-term survivors. Journal of the National Cancer Institute, 97, 1354-1365.
    Turner, A. (2010). The HOPE course. In F. R. Jones (Ed.), Perspectives on lay led self-management courses for people with long-term conditions (pp. 26-33). Oxford, England: Oxford University Press.
    Two Feathers, J., Kieffer, E. C., Palmisano, G., Anderson, M., Janz, N., Spencer, M. S., … James, S. A. (2007). The development, implementation, and process evaluation of the REACH Detroit Partnership's Diabetes Lifestyle Intervention. Diabetes Educator, 33, 509-520. doi:10.1177/0145721707301371
    Vaartio, H., Kiviniemi, K., & Suominen, T. (2003). Men's experiences and their resources from cancer diagnosis to recovery. European Journal of Oncology Nursing, 7, 182-190. doi:10.1016/S1462-3889 (03)00006-1
    Whittemore, R., Chase, S. K., & Mandle, C. L. (2001). Validity in qualitative research. Qualitative Health Research, 11, 522-537. doi:10.1177/104973201129119299
    Wilson, P. M. (2008). The UK Expert Patients Program: Lessons learned and implications for cancer survivors' self-care support programs. Journal of Cancer Survivorship, 2, 45-52.
    Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
    Yoon, R., McKenzie, D. K., Miles, D. A., & Bauman, A. (1991). Characteristics of attenders and nonattenders at an asthma education programme. Thorax, 46, 886-890. doi:10.1136/thx.46.12.886