0
No votes yet
Online Exclusive Article

Written Information Improves Patient Knowledge About Implanted Ports

Michela Piredda
Amelia Migliozzi
Valentina Biagioli
Massimiliano Carassiti
Maria Grazia De Marinis
CJON 2016, 20(2), E28-E33 DOI: 10.1188/16.CJON.E28-E33

Background: Implanted ports are frequently used for patients with cancer who require IV chemotherapy. In addition to verbal communication with healthcare providers, patients with cancer may benefit from written information.

Objectives: This pre/post study evaluated the effectiveness of an informational booklet by improving knowledge about ports and assessed the history, need, and preferences for information.

Methods: Patients with cancer who had an implanted port for at least six months were provided with an informational booklet about ports. Knowledge about ports was tested before (T0) and after (T1) patients read the booklet. Information needs and preferred sources of information were also assessed at T0. Patients reported their opinions of the booklet at T1.

Findings: The sample included 129 patients; 49% were male, with a mean age of 59 years. Most patients want to receive as much information as possible, preferably before the port is implanted. However, 43% of patients reported they had received little information about ports. After reading the booklet, patients’ knowledge, which was measured with a validated seven-item instrument, improved from T0 to T1 (p < 0.001, effect size = 0.689). Oncology nurses, by providing written and verbal information, can increase patients’ knowledge about implanted ports and their confidence in caring for their ports.

Effective patient education and information are increasingly necessary because of demographic and health transitions, which are changing the landscape of health care. The crucial role played by patient education is associated with an increase in life expectancy and a decrease in mortality, with the increasing prevalence of chronic conditions like cancer. In addition, cuts in healthcare resources have reduced the length of hospital stays and decreased nurse staffing. Education is effective when it enhances patients’ self-efficacy beliefs by activating empowerment strategies, so that patients play an active role in managing their conditions (Germino et al., 2013). They also have increased autonomy and satisfaction (Papadakos et al., 2014).

Patients with cancer need information about different aspects of the disease and its treatment, and nurses are important providers of information (Koutsopoulou, Papathanassoglou, Katapodi, & Patiraki, 2010). Nurses in this role may help to improve quality of life for patients with cancer and contribute to cost reduction (De Lorenzo et al., 2004).

Providing information is not always a standardized or simple process for nurses. Healthcare professionals’ beliefs about information priorities often differ from those of patients’ (Capirci et al., 2005). In addition, information needs vary according to patients’ characteristics, such as age (Pinto, Chaves, Lourenco, & Mari, 2004), length of time since diagnosis, physical condition (Sainio & Eriksson, 2003), and income (Al Qadire, 2014). Therefore, a careful assessment of patients’ preferences and information needs is crucial for effective improvements in health literacy.

Many studies have investigated patients’ information needs and found that most patients would like to receive as much information as possible (Al-Amri, 2009; Cox, Jenkins, Catt, Langridge, & Fallowfield, 2006; Piredda et al., 2008; Skalla, Bakitas, Furstenberg, Ahles, & Henderson, 2004). Because patients are usually discharged home after short hospital stays in acute settings, care requirements must be met at home by the patients or by caregivers (Camp-Sorrell, 2010). However, patients often return home from the hospital without all the information they need to manage their condition and the consequences of treatment (Kinnane, 2012). Therefore, most patients are not completely satisfied with the amount of information they receive (Li et al., 2011; Rees & Bath, 2000), whether it concerns different aspects of their disease, medical tests, treatment (Husson et al., 2014), self-care (James-Martin, Koczwara, Smith, & Miller, 2014), or aftercare (Beaver et al., 2010).

Because healthcare professionals have little time to provide information to patients, giving written information is one of the most common aids to verbal information (Rutten, Arora, Bakos, Aziz, & Rowland, 2005). Several studies reported that patients with cancer benefit from written information, in addition to verbal communication with healthcare providers, when the written information is personalized (Shea-Budgell, Kostaras, Myhill, & Hagen, 2014) and easy to read (Piredda et al., 2007, 2008). Researchers who performed a systematic review recommended a combination of verbal and written information to patients and their caregivers for standardized care information and to increase knowledge and satisfaction (Johnson & Sandford, 2005). In addition, patients may neglect or misunderstand verbal information, so written aids provide continuous reinforcement and increase knowledge retention because patients can read leaflets or booklets again at home and discuss them with relatives or friends (Boundouki, Humphris, & Field, 2004; Chabrera et al., 2015).

Patients with cancer often require long-term central venous access devices (CVADs), which facilitate the safe and cyclic delivery of IV chemotherapy, blood transfusions, and blood tests (Gallieni, Pittiruti, & Biffi, 2008). Some patients may need indefinite venous access for palliative therapies. Therefore, implanted ports are the preferred CVADs for this population because there is little interference with daily activities, no need for external dressing between therapies when the needle is absent, and a relatively low incidence of complications (Bassi, Giri, Pattanayak, Abraham, & Pandey, 2012; Dal Molin, Rasero, Guerretta, Perfetti, & Clerico, 2011; Goossens, Stas, Jérôme, & Moons, 2011; Vescia et al., 2008). Evidence-based guidelines recommend patient education containing clear and comprehensive written information about long-term CVADs (Bishop et al., 2007; Dougherty et al., 2010). Some patients feel confident with their knowledge about port management, but others are cautious and uncertain about the correct actions to perform (Weingart, Hsieh, Lane, & Cleary, 2014). Oncology nurses who provide information about the required care of implanted ports can increase patients’ knowledge of the device and help them achieve increased confidence.

Therefore, the aims of this pre/post study are (a) to evaluate the effectiveness of a written information intervention in improving knowledge about implanted ports in patients with cancer who have had a port for at least six months and (b) to assess the history, need, and preferences for port information.

Methods

Sample and Setting

Patients admitted to the outpatient infusion service of the day hospital at Campus Bio-Medico University in Rome, Italy, were invited to participate in the study. Inclusion criteria were patients who had an implanted port for at least six months, were aged 18 years or older, were able to speak and write Italian, and were in adequate psychological and physical condition, as determined by the researchers, to complete the questionnaires. A period of at least six months was chosen because it allowed for multiple clinic visits, with repeated opportunities to receive and ask for information. It seemed unlikely that a difference in information about ports could occur after six months, and detailed information about the amount of time after implantation was not collected. Patients with ports were cared for by a multidisciplinary team, including oncologists, nurses, and anesthesiologists. The ethical committee of the university approved the study before it began (protocol 46/12 ComEt CBM, July 31, 2012).

Instruments

Knowledge about implanted ports: A seven-item instrument with four possible answers, including “I do not know,” was used to measure knowledge about ports. An example of an item is the following: “How is the port flushed?” Each correct answer received one point, and the score ranged from 0–7, with 7 indicating the optimum level of knowledge about ports. This questionnaire was previously validated in patients with cancer and showed good reliability with a Cronbach alpha coefficient of 0.85 (Piredda, Conte, & Bartolozzi, 2005).

Information needs and preferred sources of information: A seven-item questionnaire, with three, four, or five possible answers, was used to assess patients’ information history, opinions, and preferences about receiving information about implanted ports. An example of an item is the following: “How much information did you receive about the port?” The instrument was adapted from a previously validated tool that showed good reliability (Cronbach alpha coefficient = 0.88) (Piredda et al., 2008).

Implanted port booklet: An informational booklet about implanted ports was developed using previous data about adult patients’ demographics, literacy level, and information preferences (Piredda et al., 2005). A multidisciplinary group, including nurses, anesthesiologists who implant ports, oncologists, communication experts, psychologists, and graphic designers, designed the booklet. It was based on the following criteria: inclusion of evidence-based and important information; plain written text; and attractive design, colors, and images. The content included information about the port’s structure and usefulness, implantation procedure, management, complication signs, phone contacts in case of problems or questions, and port removal. Forty lay people, with wide-ranging age, education, and social levels, were asked to read the booklet and to evaluate its clarity, readability, and acceptability. Their recommendations were used to improve the text and illustrations.

Opinion about the booklet: An eight-item questionnaire with three possible answers (including an open response) was used to assess patients’ opinions about the booklet received. Demographic data included age, gender, and educational level. Clinical data, such as difficulty reading and hearing, were also recorded to ensure the appropriateness of providing written information materials.

Data Collection

A consecutive sample of 140 patients with cancer who visited the outpatient infusion service to receive treatments, IV-supporting therapies via the port, or port flushing from August to September 2012 were recruited to participate in the study. A researcher approached eligible patients at the start of their clinic visit, informed them about the study, and obtained their verbal consent to participate. Participating patients completed a set of four questionnaires. At T0, the patients filled out two questionnaires that assessed knowledge about ports, information needs, and preferred sources of information. Then, the patients were given the port booklet and asked to read it before they completed the test of knowledge about ports again and provided their opinion about the booklet (T1). The test was not open book, and no additional verbal information about ports was provided by the researcher. Participants completed the post-test before they left the day hospital.

Statistical Analysis

Descriptive statistics were used to analyze sociodemographic variables. Each item about “information needs and preferred sources of information” and “opinion about informational brochure” was analyzed with frequencies and percentages as a categorical variable. A total score was computed for “knowledge about implanted ports” for each patient, and the mean for the sample was calculated for T0 and T1. To investigate the effects of information needs and preferences on knowledge, univariate analysis of variance (ANOVA) was performed with the independent variable (each “information needs and preferred sources of information” item) and the dependent variable (the total score for “knowledge about implanted ports”). The Tukey post-hoc test was calculated when more than two groups were compared. The paired t test was used to evaluate the change in knowledge scores about ports from T0 to T1. McNemar’s test for correlated samples was used to test the responsiveness of each item of the “knowledge about implanted ports” questionnaire from T0 and T1. Data were analyzed using SPSS®, version 21.0.

Results

One hundred and thirty-three patients (response rate = 95%) consented to participate and filled out the questionnaires. Four sets of questionnaires were incomplete; therefore, data from 129 patients were analyzed. The sample was balanced in gender (n = 66, 51% female), and the mean age was 59 years (SD = 12, range = 34–81). Twenty-one (16%) participants had completed elementary school, 35 (27%) had completed middle school, 48 (37%) had completed high school, 20 (16%) had completed university, and 5 (4%) had a postgraduate degree. No participant reported having severe difficulties in reading or hearing.

Patients improved their knowledge about ports from 4.72 (SD = 1.28) at T0 to 6.53 (SD = 0.65) at T1. The improvements from T0 to T1 were significant (p < 0.001; effect size = 0.689; power = 1). Participants’ answers to the questionnaires on information needs and preferred sources of information, as well as opinions about the informational booklet, are synthesized in Tables 1 and 2, respectively. At baseline, 43% of the participants reported they had received little information about ports, and 14% reported they had never been informed. However, 67% wanted to receive “a lot” of information, and 30% wanted “as much as possible.” Most (95%) respondents identified the period before port implantation as the most appropriate time for receiving information. However, only 65% received information before port implantation. The oncologist was the most frequent source of information about ports (39%), followed by the anesthesiologist who implanted the port (34%) and the oncology nurse (23%). The preferred source of information about ports was the oncologist (60%), followed by the anesthesiologist (35%) and the oncology nurse (4%). No patient preferred to receive information from a general practitioner. All participants believed that giving an informational booklet to patients with a port was very useful (75%) or useful (24%).

ANOVA at T0 showed that patients who wanted as much information as possible (n = 39) scored higher in knowledge about ports than patients who wanted a lot or enough information (n = 90) about ports (mean = 5.15, SD = 1.5 versus mean = 4.54, SD = 1.2; p < 0.05). The ANOVAs at T0 revealed no significant differences in knowledge about ports according to gender, age, and education. Every item of the “knowledge about implanted ports” questionnaire was responsive and showed improvement from T0 to T1 (see Table 3). Item difficulty was acceptable because more than 35% of the participants at T0 and 85% at T1 answered each question correctly.

All participants read the booklet, and the majority judged it was complete (98%), not difficult to understand (97%), and satisfactory (95%). Seventy-four percent responded “yes” to a question about whether the booklet decreased their anxiety level. Only 7% reported that information in the booklet was different from the information they had received previously. Five percent admitted that problems occurred that could have been avoided if the participants had received the booklet before the port was implanted.

Discussion

The study aimed to evaluate the effectiveness of a booklet to improve knowledge about implanted ports for patients with cancer who had had a port for at least six months and to assess patients’ history, needs, and preferences for receiving information. Patients’ baseline knowledge about ports was not satisfactory, similar to the findings of earlier studies in patients with ports (Piredda et al., 2005; Yesibalkan, Kir, Karadakovan, & Uslu, 2009). Unsatisfactory knowledge was reported even though participants were not naïve about ports and had a device implanted for six months or more and regularly accessed an outpatient infusion service. This revealed a lack of information provided to patients not only before port implantation, but also during outpatient care. Most patients wanted to receive as much information as possible and, in particular, to be informed before port implantation. In addition, knowledge about implanted ports was not affected by gender, age, or education, in accordance with Piredda et al. (2005) and Yesibalkan et al. (2009). This suggests that the lack of patient information before the intervention was not because of gender, age, or education, which have been reported in the literature as influencing patients’ ability and willingness to learn (Rutten et al., 2005), but because of an actual lack of information. Patients reported a strong wish to be informed, and their knowledge improved significantly after they received the booklet. Therefore, it seems clear that the limited knowledge participants had at baseline was because of the scarce provision of information rather than a lack of willingness to learn more about implanted ports. Patients who wanted as much information as possible scored higher on the knowledge test than other patients. This suggests that patients with a great motivation to know are proactive in finding information but could be disappointed by the limited information provided by healthcare professionals.

Knowledge about ports improved significantly after the patients read the new booklet. Similar results were found in a randomized, controlled trial on written information for patients scheduled for port implantation (Piredda et al., 2016) and are consistent with recommendations by Johnson and Sandford (2005).

The most frequent and preferred providers of information about the port are healthcare professionals who work in oncology and/or are experts in port management. No patient mentioned that he or she wanted to be informed by the family doctor, which is in accordance with results found by Piredda et al. (2005) and may be related to patients’ awareness that ports are high-technology devices that require specialized competencies. More patients in this study received information from the oncology nurse (23%) than in a previous study (5%) conducted among Italian patients with cancer (Piredda et al., 2005), which probably reflects an improvement and greater use of educational competencies among Italian oncology nurses. However, few patients reported that the oncology nurse was the first choice for providing information about ports, possibly because the educational role of nurses in Italy needs to be further developed and recognized by the public.

Limitations

Some methodologic limitations should be acknowledged. This was a single-site study; therefore, the authors do not know whether the results can be generalized to other patients with cancer or patients in other countries. The sample included patients who had had a port for at least six months, but detailed information about the actual time since implantation was not collected. Therefore, it was not possible to correlate knowledge with time and to measure changes in knowledge over time, taking into account this variable. In addition, a pre-/post-study design was used, which is not the gold standard for evaluating the effectiveness of interventions.

Conclusion

This pre/post study supports the usefulness of giving written information about ports to all patients scheduled for port implantation. This can help nurses, particularly those who are very busy, provide effective information with fewer time constraints. Most patients in this study expressed the desire to be informed as much as possible about their port, preferably before the device was implanted. The booklet improved patients’ knowledge about ports and was perceived as reducing patients’ anxiety. In addition, oncology nurses should provide information about ports not only to patients, but also to caregivers, who can support patients in port management at home.

This is one of the first studies to address the effectiveness of informational booklets about ports for improving patients’ knowledge. However, additional research is needed, using multicenter randomized, controlled trials to test the provision of written information before implantation and measuring the retention of information at follow-up. Evaluation of the effectiveness of written information in decreasing health complications and costs and improving port management, care quality, and patient satisfaction is also needed. Oncology nurses, by providing written and verbal information, can contribute to patients’ empowerment and active participation in care while increasing their knowledge and confidence with port management.

The authors gratefully acknowledge the patients who participated in the study, as well as Marianne Bengstonn Agostino, RN, PhD, for language editing.

References

Al-Amri, A.M. (2009). Cancer patients’ desire for information: A study in a teaching hospital in Saudi Arabia. Eastern Mediterranean Health Journal, 15, 19–24.

Al Qadire, M. (2014). Jordanian cancer patients’ information needs and information-seeking behaviour: A descriptive study. European Journal of Oncology Nursing, 18, 46–51. doi:10.1016/j.ejon.2013.09.007

Bassi, K., Giri, A., Pattanayak, M., Abraham, S., & Pandey, K. (2012). Totally implantable venous access ports: Retrospective review of long-term complications in 81 patients. Indian Journal of Cancer, 49, 114. doi:10.4103/0019-509X.98934

Beaver, K., Latif, S., Williamson, S., Procter, D., Sheridan, J., Heath, J., . . . Luker, K. (2010). An exploratory study of the follow-up care needs of patients treated for colorectal cancer. Journal of Clinical Nursing, 19, 3291–3300. doi:10.1111/j.1365-2702.2010.03407.x

Bishop, L., Dougherty, L., Bodenham, A., Mansi, J., Crowe, P., Kibbler, C., . . . Treleaven, J. (2007). Guidelines on the insertion and management of central venous access devices in adults. International Journal of Laboratory Hematology, 29, 261–278. doi:10.1111/j.1751-553X.2007.00931.x

Boundouki, G., Humphris, G., & Field, A. (2004). Knowledge of oral cancer, distress and screening intentions: Longer term effects of a patient information leaflet. Patient Education and Counseling, 53, 71–77. doi:10.1016/S0738-3991(03)00118-6

Camp-Sorrell, D. (2010). State of the science of oncology vascular access devices. Seminars in Oncology Nursing, 26, 80–87. doi:10.1016/j.soncn.2010.02.001

Capirci, C., Feldman-Stewart, D., Mandoliti, G., Brundage, M., Belluco, G., & Magnani, K. (2005). Information priorities of Italian early-stage prostate cancer patients and of their health-care professionals. Patient Education and Counseling, 56, 174–181. doi:10.1016/j.pec.2004.02.006

Chabrera, C., Zabalegui, A., Bonet, F.M., Caro, M., Areal, J., González, J.R., & Font, A. (2015). A decision aid to support informed choices for patients recently diagnosed with prostate cancer: A randomized controlled trial. Cancer Nursing, 38, E42–E50. doi:10.1097/ncc.0000000000000170

Cox, A., Jenkins, V., Catt, S., Langridge, C., & Fallowfield, L. (2006). Information needs and experiences: An audit of UK cancer patients. European Journal of Oncology Nursing, 10, 263–272. doi:10.1016/j.ejon.2005.10.007

Dal Molin, A., Rasero, L., Guerretta, L., Perfetti, E., & Clerico, M. (2011). The late complications of totally implantable central venous access ports: The results from an Italian multicenter prospective observation study. European Journal of Oncology Nursing, 15, 377–381. doi:10.1016/j.ejon.2010.11.007

De Lorenzo, F., Ballatori, E., Di Costanzo, F., Giacalone, A., Ruggeri, B., & Tirelli, U. (2004). Improving information to Italian cancer patients: Results of a randomized study. Annals of Oncology, 15, 721–725. doi:10.1093/annonc/mdh190

Dougherty, L., Bravery, K., Gabriel, J., Kayley, J., Malster, M., Scales, K., & Inwood, S. (2010). Standards for infusion therapy: The RCN IV Therapy Forum (3rd ed.). Retrieved from http://www.bbraun.it/documents/RCN-Guidlines-for-IV-therapy.pdf

Gallieni, M., Pittiruti, M., & Biffi, R. (2008). Vascular access in oncology patients. CA: A Cancer Journal for Clinicians, 58, 323–346. doi:10.3322/ca.2008.0015

Germino, B., Mishel, M., Crandell, J., Porter, L., Blyler, D., Jenerette, C., & Gil, K. (2013). Outcomes of an uncertainty management intervention in younger African American and Caucasian breast cancer survivors. Oncology Nursing Forum, 40, 82–92. doi:10.1188/13.ONF.82-92

Goossens, G.A., Stas, M., Jérôme, M., & Moons, P. (2011). Systematic review: Malfunction of totally implantable venous access devices in cancer patients. Supportive Care in Cancer, 19, 883–898.

Husson, O., Mols, F., Oranje, W.A., Haak, H.R., Nieuwlaat, W.A., Netea-Maier, R.T., . . . van de Poll-Franse, L.V. (2014). Unmet information needs and impact of cancer in (long-term) thyroid cancer survivors: Results of the PROFILES registry. Psycho-Oncology, 23, 946–952. doi:10.1002/pon.3514

James-Martin, G., Koczwara, B., Smith, E.L., & Miller, M.D. (2014). Information needs of cancer patients and survivors regarding diet, exercise and weight management: A qualitative study. European Journal of Cancer Care, 23, 340–348. doi:10.1111/ecc.12159

Johnson, A., & Sandford, J. (2005). Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home: Systematic review. Health Education Research, 20, 423–429. doi:10.1093/her/cyg141

Kinnane, N.A. (2012). Evaluation of a hospital-based cancer information and support centre. Supportive Care in Cancer, 20, 287–300. doi:10.1007/s00520-010-1071-y

Koutsopoulou, S., Papathanassoglou, E.D., Katapodi, M.C., & Patiraki, E.I. (2010). A critical review of the evidence for nurses as information providers to cancer patients. Journal of Clinical Nursing, 19, 749–765. doi:10.1111/j.1365-2702.2009.02954.x

Li, P.W., So, W.K., Fong, D.Y., Lui, L.Y., Lo, J.C., & Lau, S. (2011). The information needs of breast cancer patients in Hong Kong and their levels of satisfaction with the provision of information. Cancer Nursing, 34, 49–57. doi:10.1097/NCC.0b013e3181ef77a0

Papadakos, J., Urowitz, S., Olmstead, C., Jusko Friedman, A., Zhu, J., & Catton, P. (2014). Informational needs of gastrointestinal oncology patients. Health Expectations, 18, 3088–3098. doi:10.1111/hex.12296

Pinto, R.N., Chaves, A.C., Lourenco, M.T., & Mari, J. (2004). Information needs of recently diagnosed cancer patients in Brazil. International Journal of Psychiatry in Medicine, 34, 319–329. doi:10.2190/KE6T-ECM1-03EE-0WGQ

Piredda, M., Biagioli, V., Giannarelli, D., Incletoli, D., Grieco, F., Carassiti, M., & De Marinis, M.G. (2016). Improving cancer patients’ knowledge about totally implantable access port: A randomized controlled trial. Supportive Care in Cancer, 24, 833–841. doi:10.1007/s00520-015-2851-1

Piredda, M., Conte, F., & Bartolozzi, F. (2005). Totally implantable central venous device (port): An educational project for patients. International Nursing Perspectives, 5, 93–104.

Piredda, M., De Marinis, M., Rocci, L., Gualandi, R., Tartaglini, D., & Ream, E. (2007). Meeting information needs on cancer-related fatigue: An exploration of views held by Italian patients and nurses. Supportive Care in Cancer, 15, 1231–1241. doi:10.1007/s00520-007-0240-0

Piredda, M., Rocci, L., Gualandi, R., Petitti, T., Vincenzi, B., & De Marinis, M.G. (2008). Survey on learning needs and preferred sources of information to meet these needs in Italian oncology patients receiving chemotherapy. European Journal of Oncology Nursing, 12, 120–126. doi:10.1016/j.ejon.2007.10.004

Rees, C.E., & Bath, P.A. (2000). The information needs and source preferences of women with breast cancer and their family members: A review of the literature published between 1988 and 1998. Journal of Advanced Nursing, 31, 833–841. doi:10.1046/j.1365-2648.2000.01341.x

Rutten, L.J.F., Arora, N.K., Bakos, A.D., Aziz, N., & Rowland, J. (2005). Information needs and sources of information among cancer patients: A systematic review of research (1980–2003). Patient Education and Counseling, 57, 250–261. doi:10.1016/j.pec.2004.06.006

Sainio, C., & Eriksson, E. (2003). Keeping cancer patients informed: A challenge for nursing. European Journal of Oncology Nursing, 7, 39–49. doi:10.1054/ejon.2002.0218

Shea-Budgell, M., Kostaras, X., Myhill, K., & Hagen, N. (2014). Information needs and sources of information for patients during cancer follow-up. Current Oncology, 21, 165–173. doi:10.3747/co.21.1932

Skalla, K.A., Bakitas, M., Furstenberg, C.T., Ahles, T., & Henderson, J.V. (2004). Patients’ need for information about cancer therapy. Oncology Nursing Forum, 31, 313–319. doi:10.1188/04.ONF.313-319

Vescia, S., Baumgärtner, A., Jacobs, V., Kiechle-Bahat, M., Rody, A., Loibl, S., & Harbeck, N. (2008). Management of venous port systems in oncology: A review of current evidence. Annals of Oncology, 19, 9–15. doi:10.1093/annonc/mdm272

Weingart, S.N., Hsieh, C., Lane, S., & Cleary, A.M. (2014). Standardizing central venous catheter care by using observations from patients with cancer. Clinical Journal of Oncology Nursing, 18, 321–326. doi:10.1188/14.CJON.321-326

Yesilbalkan, Ö.U., Kir, S., Karadakovan, A., & Uslu, R. (2009). Knowledge and attitudes of Turkish cancer patients regarding the implantable port catheter. Turk Onkoloji Dergisi, 24, 108–114.

About the Author(s)

Michela Piredda, PhD, MSc, RN, and Amelia Migliozzi, RN, are RNs at Campus Bio-Medico University; Valentina Biagioli, MSN, RN, is a nurse and doctoral candidate in the School of Nursing at Tor Vergata University; and Massimiliano Carassiti, MD, PhD, is an associate professor in the Department of Anesthesia Intensive Care and Pain Management and Maria Grazia De Marinis, MSN, RN, is a professor and the president of the School of Nursing, both at Campus Bio-Medico University, all in Rome, Italy. The authors take full responsibility for the content of the article. The authors did not receive honoraria for this work. The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or editorial staff. Piredda can be reached at m.piredda@unicampus.it, with copy to editor at CJONEditor@ons.org. (Submitted May 2015. Revision submitted June 2015. Accepted for publication July 1, 2015.)

 

References 

Al-Amri, A.M. (2009). Cancer patients’ desire for information: A study in a teaching hospital in Saudi Arabia. Eastern Mediterranean Health Journal, 15, 19–24.

Al Qadire, M. (2014). Jordanian cancer patients’ information needs and information-seeking behaviour: A descriptive study. European Journal of Oncology Nursing, 18, 46–51. doi:10.1016/j.ejon.2013.09.007

Bassi, K., Giri, A., Pattanayak, M., Abraham, S., & Pandey, K. (2012). Totally implantable venous access ports: Retrospective review of long-term complications in 81 patients. Indian Journal of Cancer, 49, 114. doi:10.4103/0019-509X.98934

Beaver, K., Latif, S., Williamson, S., Procter, D., Sheridan, J., Heath, J., . . . Luker, K. (2010). An exploratory study of the follow-up care needs of patients treated for colorectal cancer. Journal of Clinical Nursing, 19, 3291–3300. doi:10.1111/j.1365-2702.2010.03407.x

Bishop, L., Dougherty, L., Bodenham, A., Mansi, J., Crowe, P., Kibbler, C., . . . Treleaven, J. (2007). Guidelines on the insertion and management of central venous access devices in adults. International Journal of Laboratory Hematology, 29, 261–278. doi:10.1111/j.1751-553X.2007.00931.x

Boundouki, G., Humphris, G., & Field, A. (2004). Knowledge of oral cancer, distress and screening intentions: Longer term effects of a patient information leaflet. Patient Education and Counseling, 53, 71–77. doi:10.1016/S0738-3991(03)00118-6

Camp-Sorrell, D. (2010). State of the science of oncology vascular access devices. Seminars in Oncology Nursing, 26, 80–87. doi:10.1016/j.soncn.2010.02.001

Capirci, C., Feldman-Stewart, D., Mandoliti, G., Brundage, M., Belluco, G., & Magnani, K. (2005). Information priorities of Italian early-stage prostate cancer patients and of their health-care professionals. Patient Education and Counseling, 56, 174–181. doi:10.1016/j.pec.2004.02.006

Chabrera, C., Zabalegui, A., Bonet, F.M., Caro, M., Areal, J., González, J.R., & Font, A. (2015). A decision aid to support informed choices for patients recently diagnosed with prostate cancer: A randomized controlled trial. Cancer Nursing, 38, E42–E50. doi:10.1097/ncc.0000000000000170

Cox, A., Jenkins, V., Catt, S., Langridge, C., & Fallowfield, L. (2006). Information needs and experiences: An audit of UK cancer patients. European Journal of Oncology Nursing, 10, 263–272. doi:10.1016/j.ejon.2005.10.007

Dal Molin, A., Rasero, L., Guerretta, L., Perfetti, E., & Clerico, M. (2011). The late complications of totally implantable central venous access ports: The results from an Italian multicenter prospective observation study. European Journal of Oncology Nursing, 15, 377–381. doi:10.1016/j.ejon.2010.11.007

De Lorenzo, F., Ballatori, E., Di Costanzo, F., Giacalone, A., Ruggeri, B., & Tirelli, U. (2004). Improving information to Italian cancer patients: Results of a randomized study. Annals of Oncology, 15, 721–725. doi:10.1093/annonc/mdh190

Dougherty, L., Bravery, K., Gabriel, J., Kayley, J., Malster, M., Scales, K., & Inwood, S. (2010). Standards for infusion therapy: The RCN IV Therapy Forum (3rd ed.). Retrieved from http://www.bbraun.it/documents/RCN-Guidlines-for-IV-therapy.pdf

Gallieni, M., Pittiruti, M., & Biffi, R. (2008). Vascular access in oncology patients. CA: A Cancer Journal for Clinicians, 58, 323–346. doi:10.3322/ca.2008.0015

Germino, B., Mishel, M., Crandell, J., Porter, L., Blyler, D., Jenerette, C., & Gil, K. (2013). Outcomes of an uncertainty management intervention in younger African American and Caucasian breast cancer survivors. Oncology Nursing Forum, 40, 82–92. doi:10.1188/13.ONF.82-92

Goossens, G.A., Stas, M., Jérôme, M., & Moons, P. (2011). Systematic review: Malfunction of totally implantable venous access devices in cancer patients. Supportive Care in Cancer, 19, 883–898.

Husson, O., Mols, F., Oranje, W.A., Haak, H.R., Nieuwlaat, W.A., Netea-Maier, R.T., . . . van de Poll-Franse, L.V. (2014). Unmet information needs and impact of cancer in (long-term) thyroid cancer survivors: Results of the PROFILES registry. Psycho-Oncology, 23, 946–952. doi:10.1002/pon.3514

James-Martin, G., Koczwara, B., Smith, E.L., & Miller, M.D. (2014). Information needs of cancer patients and survivors regarding diet, exercise and weight management: A qualitative study. European Journal of Cancer Care, 23, 340–348. doi:10.1111/ecc.12159

Johnson, A., & Sandford, J. (2005). Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home: Systematic review. Health Education Research, 20, 423–429. doi:10.1093/her/cyg141

Kinnane, N.A. (2012). Evaluation of a hospital-based cancer information and support centre. Supportive Care in Cancer, 20, 287–300. doi:10.1007/s00520-010-1071-y

Koutsopoulou, S., Papathanassoglou, E.D., Katapodi, M.C., & Patiraki, E.I. (2010). A critical review of the evidence for nurses as information providers to cancer patients. Journal of Clinical Nursing, 19, 749–765. doi:10.1111/j.1365-2702.2009.02954.x

Li, P.W., So, W.K., Fong, D.Y., Lui, L.Y., Lo, J.C., & Lau, S. (2011). The information needs of breast cancer patients in Hong Kong and their levels of satisfaction with the provision of information. Cancer Nursing, 34, 49–57. doi:10.1097/NCC.0b013e3181ef77a0

Papadakos, J., Urowitz, S., Olmstead, C., Jusko Friedman, A., Zhu, J., & Catton, P. (2014). Informational needs of gastrointestinal oncology patients. Health Expectations, 18, 3088–3098. doi:10.1111/hex.12296

Pinto, R.N., Chaves, A.C., Lourenco, M.T., & Mari, J. (2004). Information needs of recently diagnosed cancer patients in Brazil. International Journal of Psychiatry in Medicine, 34, 319–329. doi:10.2190/KE6T-ECM1-03EE-0WGQ

Piredda, M., Biagioli, V., Giannarelli, D., Incletoli, D., Grieco, F., Carassiti, M., & De Marinis, M.G. (2016). Improving cancer patients’ knowledge about totally implantable access port: A randomized controlled trial. Supportive Care in Cancer, 24, 833–841. doi:10.1007/s00520-015-2851-1

Piredda, M., Conte, F., & Bartolozzi, F. (2005). Totally implantable central venous device (port): An educational project for patients. International Nursing Perspectives, 5, 93–104.

Piredda, M., De Marinis, M., Rocci, L., Gualandi, R., Tartaglini, D., & Ream, E. (2007). Meeting information needs on cancer-related fatigue: An exploration of views held by Italian patients and nurses. Supportive Care in Cancer, 15, 1231–1241. doi:10.1007/s00520-007-0240-0

Piredda, M., Rocci, L., Gualandi, R., Petitti, T., Vincenzi, B., & De Marinis, M.G. (2008). Survey on learning needs and preferred sources of information to meet these needs in Italian oncology patients receiving chemotherapy. European Journal of Oncology Nursing, 12, 120–126. doi:10.1016/j.ejon.2007.10.004

Rees, C.E., & Bath, P.A. (2000). The information needs and source preferences of women with breast cancer and their family members: A review of the literature published between 1988 and 1998. Journal of Advanced Nursing, 31, 833–841. doi:10.1046/j.1365-2648.2000.01341.x

Rutten, L.J.F., Arora, N.K., Bakos, A.D., Aziz, N., & Rowland, J. (2005). Information needs and sources of information among cancer patients: A systematic review of research (1980–2003). Patient Education and Counseling, 57, 250–261. doi:10.1016/j.pec.2004.06.006

Sainio, C., & Eriksson, E. (2003). Keeping cancer patients informed: A challenge for nursing. European Journal of Oncology Nursing, 7, 39–49. doi:10.1054/ejon.2002.0218

Shea-Budgell, M., Kostaras, X., Myhill, K., & Hagen, N. (2014). Information needs and sources of information for patients during cancer follow-up. Current Oncology, 21, 165–173. doi:10.3747/co.21.1932

Skalla, K.A., Bakitas, M., Furstenberg, C.T., Ahles, T., & Henderson, J.V. (2004). Patients’ need for information about cancer therapy. Oncology Nursing Forum, 31, 313–319. doi:10.1188/04.ONF.313-319

Vescia, S., Baumgärtner, A., Jacobs, V., Kiechle-Bahat, M., Rody, A., Loibl, S., & Harbeck, N. (2008). Management of venous port systems in oncology: A review of current evidence. Annals of Oncology, 19, 9–15. doi:10.1093/annonc/mdm272

Weingart, S.N., Hsieh, C., Lane, S., & Cleary, A.M. (2014). Standardizing central venous catheter care by using observations from patients with cancer. Clinical Journal of Oncology Nursing, 18, 321–326. doi:10.1188/14.CJON.321-326

Yesilbalkan, Ö.U., Kir, S., Karadakovan, A., & Uslu, R. (2009). Knowledge and attitudes of Turkish cancer patients regarding the implantable port catheter. Turk Onkoloji Dergisi, 24, 108–114.