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Characterizing the Patient Experience of CS/HIPEC Through In-Depth Interviews with Patients: Identification of Key Concepts in the Development of a Patient-Centered Program

Valerie A. Francescutti MD, MSc, FACS, FRCSC, Allison H. Maciver MD, MSc, FRCSC, Erika Stewart NP, Nikia Clark, Bianca Marrara, Frances G. Saad-Harfouche MSW, Elisa M. Rodriguez MS, PhD
Peritoneal Surface Malignancy
Volume 26, Issue 4 / April , 2019

Abstract

Introduction

The cytoreduction and hyperthermic intraperitoneal chemotherapy (CS/HIPEC) procedure is complex, involving lengthy preparation and recovery in a heterogeneous patient group. Understanding the patient experience is essential to improving interactions with health professionals that is critical to recovery.

Objective

This study sought to characterize the early recovery and return to quality of life (at 3 and 6–12 months post-surgery, respectively) in patients having undergone CS/HIPEC, through structured interviews.

Methods

Two sets of interviews were conducted among 20 CS/HIPEC patients. Interviews were uploaded into QSR NVivo 10 qualitative software (QSR International, Australia) and coded by two study personnel. Interview 1 focused on initial treatment decision making and postoperative hospitalization, while interview 2 focused on recovery, supports, and return to quality of life.

Results

Among the participants, 60% were female and the mean age was 57 years (range 31–71). Diagnoses included disseminated peritoneal adenomucinosis (n = 6), appendiceal adenocarcinoma (n = 4), colorectal adenocarcinoma (n = 6), goblet cell (n = 2), and mesothelioma (n = 2). The first interview identified common themes of perioperative psychosocial isolation, lack of direction, and the importance of an established support system. Patients requested printed and audiovisual materials focused on addressing expectations. The main findings from the second interview captured patient experiences with longer-term complications, as well as surveillance.

Conclusion

Focused interviews with patients recently having undergone CS/HIPEC identified key issues that may be addressed in programs to improve the patient experience. These issues were distinctly different in relation to phase of recovery, and patient-centered programs designed with these factors in mind have the potential to enhance the recovery process.

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