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Purpose/Objectives: To describe sexual well-being among non-Hodgkin lymphoma (NHL) survivors.Design: Descriptive, correlational, cross-sectional study.Setting: NHL survivors identified via the Los Angeles County Cancer Surveillance Program.Sample: 222 NHL survivors two- to five-years postdiagnosis.Methods: Data were collected via mailed questionnaire. Multivariate models were used to examine sexual well-being.Main Research Variables: Three indices of sexual well-being were examined in relation to sociodemographic and medical variables: participation in sexual activity, satisfaction with sex life, and sexual function.Findings: Most NHL survivors were participating in sexual activity; however, more than half were dissatisfied with their sex life. A substantial minority "usually or always" experienced problems with sexual function. Associations between study variables and outcomes differed across indices of sexual well-being and by gender; older age was associated with decreased participation, decreased satisfaction, and impaired sexual function for men as well as with decreased participation for women. Poorer physical functioning was associated with decreased participation for men and women as well as poorer sexual function for women. Finally, poorer mental functioning was associated with less satisfaction and poorer sexual function for men and women; shorter times since diagnosis were associated with poorer sexual function for women.Conclusions: Most NHL survivors were sexually active, but many reported difficulties with satisfaction and function. Sexual well-being is a multifaceted construct that requires continued attention throughout survivorship.Implications for Nursing: Oncology nurses are in an excellent position to ensure that survivors' sexual concerns are addressed. Survivorship care plans may help to facilitate communication about survivors' sexual well-being. [ABSTRACT FROM AUTHOR]

Introduction: Post-treatment follow-up represents a crucial aspect of quality cancer care; however, data are lacking regarding follow-up care experiences, perception of provider involvement in care, and perceived quality of care from diverse samples of long-term survivors diagnosed as adults. Methods: Questionnaires were mailed in 2005 to 2006 to breast, prostate, colorectal, endometrial, and ovarian cancer survivors (4 to 14 years after diagnosis), sampled from California SEER cancer registries. Results: Most survivors (n = 1,490) reported recent follow-up care (68.7%), generally from oncology specialists only (47.4%) or shared between oncology and primary care providers (PCPs; 27.6%). Most survivors reported follow-up care advice (79.9%); fewer reported late-effects advice or receipt of a treatment summary (41.7% and 19.9%, respectively). Survivors who identified a PCP as their main follow-up care physician were as likely as those identifying an oncology specialist to rate their care as high quality (odds ratio [OR], 2.56; 95% CI, 0.98 to 6.74); however, survivors who could not identify a main follow-up care provider were less likely to report high-quality care (OR, 0.20; 95% CI, 0.08 to 0.50). Compared with follow-up care by an oncology specialist only, care by a PCP only was associated with a lower quality-of-care rating (OR, 0.34; 95% CI, 0.13 to 0.91), but there was no significant difference in quality rating by survivors when care was shared by an oncology specialist and PCP compared with an oncology specialist only. Conclusion: Long-term survivors commonly report follow-up care years after their diagnosis; however, many patients’ follow- up lacks important components. Care is more likely to be rated as high quality when one main provider is identified and an oncology specialist is involved. [ABSTRACT FROM AUTHOR]

Objective: To investigate health information needs and their association with health-related quality of life (HRQOL) in a diverse, population-based sample of long-term cancer survivors., Methods: We analyzed health information needs from 1197 cancer survivors 4-14 years post-diagnosis drawn from two cancer registries in California. Multivariable regression models were used to identify factors associated with endorsement of total number and different categories of needs. The relationship between number of needs and HRQOL and effect modification by confidence for obtaining information was examined., Results: Survivors reported a high prevalence of unmet information needs in the following categories: side effects & symptoms: 75.8%; tests & treatment: 71.5%; health promotion: 64.5%; interpersonal & emotional: 60.2%; insurance: 39.0%; and sexual functioning & fertility: 34.6%. Survivors who were younger, non-White, and did not receive but wanted a written treatment summary reported a higher number of needs. Number of information needs was inversely related to mental well-being, particularly for those with low confidence for obtaining information (P<0.05)., Conclusion: These patterns suggest disparities in access to important health information in long-term survivors and that affect HRQOL., Practice Implications: Findings suggest a need for tailored interventions to equip survivors with comprehensive health information and to bolster skills for obtaining information., (Published by Elsevier Ireland Ltd.)

Purpose: We assessed cancer survivors' perceptions of the quality of their follow-up care., Methods: We surveyed a population-based cohort of leukemia, bladder, and colorectal cancer survivors diagnosed 2 to 5 years previously in northern California (N = 623; participation rate, 69.2%; overall response rate, 49.2%). Data were collected between April 2003 and November 2004. Ten scales assessed survivors' perceptions of different aspects of care in the last 12 months, and an eleventh scale measured their overall ratings of care., Results: On nine of the 11 scales, mean scores ranged from 88 to 97 on a 0 to 100 response format, indicating very positive experiences. The two areas where quality perceptions were lower were discussions about health promotion and the physician's knowledge of the whole patient. In adjusted analyses, those without private health insurance (P = .02) and Hispanic and Asian survivors compared with whites (P < .001) reported worse timeliness of care. Survivors who had multiple comorbidities reported better scores on timeliness of care (P < .01) and physicians' knowledge (P = .05) than survivors without any comorbidity. Length of the patient-physician relationship was the variable most consistently found to be significantly associated with survivors' quality assessments. Physicians' information exchange had the strongest relationship with overall ratings of care, followed by physicians' affective behavior, their knowledge of the survivor, and survivors' perceptions of coordination of care (P < .001 for all)., Conclusion: Delivery of quality follow-up care to cancer survivors may require efforts to improve patient-centered communication and coordination. Special emphasis may need to be placed on health promotion discussions and adoption of a whole-person orientation.

Objective: To examine methods for identifying and recruiting prostate cancer patients prior to initiating treatment to gain insight into the treatment decision process and avoid recall bias., Study Design and Setting: One recruitment strategy involved providers and nursing staff approaching patients in community and academic urology clinics. The second recruitment strategy used electronic pathology reports to identify newly diagnosed cases in real time in an integrated health system. Our recruitment goal was to have patients complete the survey about the decision-making process prior to initiating therapy., Results: The two recruitment methods yielded different response rates. Of the 226 eligible participants approached in urology clinics, 187 (83%) returned a completed baseline survey. Of the 1177 surveys mailed to potentially eligible participants at KPNC, 617 (52%) returned a completed baseline survey. The number of surveys completed prior to treatment was 125 (67%) for the clinic recruitment approach and 437 (71%) for the electronic medical record approach. Younger participants and patients with less aggressive clinical characteristics were more likely to complete the survey before initiating treatment. Other patient demographic and clinical factors were not associated with the timing of survey return., Conclusions: Recruiting newly diagnosed patients prior to initiating treatment is feasible with both approach methods. The use of electronic medical records to identify subjects was more cost efficient, although it results in a lower response rate.