The role of the clinical nurse specialist in caring for patients with prostate cancer: a narrative review

Figures & data

Table 1 Number of articles selected by title, abstract, and full text according to keywords and database

Database	Total identified, n	Total selected, n
		Title	Abstract	Full text
Keywords: “prostatectomy” AND “nursing” AND “care”
CINAHL	3	3	2	1
Cochrane	6	3	2	2
PubMed	55	22	13	10
MEDLINE	48	10	8	7
LILACS	13	8	5	3
BDENF	5	5	4	4
Total	130	51	34	27
Keywords: “prostate” AND “cancer” AND “nursing” AND “care”
CINAHL	11	11	5	5
Cochrane	117	1	0	0
PubMed	364	15	7	7
MEDLINE	644	10	4	4
LILACS	7	2	0	0
BDENF	2	1	0	0
Total	1,145	40	16	16
Keywords: “prostate” AND “cancer” AND “clinical” AND “nursing” AND “care”
CINAHL	0	0	0	0
Cochrane	102	1	0	0
PubMed	103	24	10	6
MEDLINE	154	11	7	7
LILACS	0	0	0	0
BDENF	0	0	0	0
Total	359	36	17	13
Keywords: “prostate cancer” AND “care” AND “clinical nurse”
CINAHL	0	0	0	0
Cochrane	64	2	1	1
PubMed	25	7	6	6
MEDLINE	21	10	4	4
LILACS	0	0	0	0
BDENF	0	0	0	0
Total	110	19	11	11

Table 2 Characteristics of articles included in the review

Article, year, country	Objective	Method and sample	Results^a
			Category 1	Category 2	Category 3	Category 4
Costa et al,^Citation22 2013, Brazil	To investigate therapeutic communication between nurses and patients in the pre-prostatectomy period.	Qualitative descriptive study; eight Brazilian nurses.		Nurse–patient communication before prostatectomy facilitates interpersonal relationships, allowing expression of feelings and information exchange. Most information offered in the preoperative period is related to routine surgical procedures.
Santos et al,^Citation5 2012, Brazil	To synthesize the knowledge produced in articles regarding nursing care provided to patients after prostatectomy.	Integrative review of 19 articles.			The studies addressed patient care in the postoperative period involving nurses’ availability to listen to patients, allowing identification and discussion of their need for emotional support.	Guide and clarify patients’ and partners’/ caregivers’ doubts about postoperative care by providing information about care and pain relief, possibility of erectile dysfunction and urinary incontinence, and possible treatments.
Krumwiede and Krumwiede,^Citation16 2012, USA	To investigate the lived experience of prostate cancer from a patient perspective.	Qualitative descriptive study, hermeneutic phenomenological method; ten men with prostate cancer.	Help patients understand the full implications of the disease process and treatment options.			Offer support to patients and families related to the impacts of cancer diagnosis and treatment; include family members in aspects of health care.
Carvalho and Cristão,^Citation13 2012, Portugal	To understand the process of transition for men with prostate cancer undergoing radical prostatectomy.	Qualitative descriptive exploratory study, content analysis; semi-structured interviews with 18 participants.		Educator nurses’ roles begin in the preoperative period with adaptive strategies to cope with possible postsurgical morbidity.	Nurses can help to establish communication able to assist patients in finding ways to accept their new status; this function is a fundamental aspect of developing confidence, encouraging the health care and more positive relationships, and minimizing patients’ negative life experiences.
Lynch,^Citation20 2012, UK	To explain how those who are at advanced stages in their careers can further develop skills in the voluntary sector as specialist nurses.	Quantitative descriptive study; helpline data captured between 2010 and 2011; specialist nurses’ experiences.	As specialists, nurses can maintain competence and reflection in practice, helping patients and families come to terms with a diagnosis of prostate cancer and the required management of the disease, considering treatment decisions tailored to patients’ lifestyles.			Provision of specialized nurse intervention and individualized care by telephone to patients and family members.
Carter et al,^Citation14 2011, Canada	To better understand the priority supportive care needs of men with advanced prostate cancer.	Qualitative descriptive study; focus groups and interviews with 12 men with hormone-sensitive and 17 men with hormone-refractory prostate cancer.	Patients require support to meet their stage-specific information needs and to address concerns about the diagnosis and feelings about treatment decisions.
Harju et al,^Citation27 2011, Finland	To describe perceived family health in persons with prostate cancer and their family members.	Cross-sectional study, data collected using the modified Family Functioning, Health and Social Support scale; 76 persons with prostate cancer and 71 family members.				Hear, support, and give opportunities to patients and families to participate in care planning and treatment decisions. Pay attention to the feelings and needs of family members.
Inman et al,^Citation26 2011, USA	To determine whether patients receiving additional follow-up education by telephone after radical prostatectomy have increased understanding compared with patients receiving usual care (no follow-up call), and whether the telephone follow-up educational protocol increased overall patient satisfaction.	Randomized controlled trial, telephone education 3–5 days after hospital discharge; 60 patients after radical prostatectomy.			Educational calls provide meaningful information during the period when patients experience management of their own care. Individual follow-up care by telephone to provide postoperative information effectively assists patients in recalling information.
Mata et al,^Citation24 2011, Brazil	To validate the content of nursing interventions in preparing patients who have undergone prostatectomy for discharge.	Methodological study validating 93 interventions; 38 experts.		Implementation of educational intervention strategies during hospitalization period promotes effective interaction and allows detection and resolution of postoperative problems.	84 interventions were validated and shown to be relevant for the patients’ preparation for discharge in the Brazilian context. Provision of information to patients and families about the ability to call with questions about pain relief or urinary urgency or frequency are not yet part of Brazilian nurses’ reality.
Mata and Napoleão,^Citation25 2010, Brazil	To identify the knowledge produced by nursing interventions related to preparing patients for hospital discharge after prostatectomy.	Integrative review of 25 articles.			The following nursing interventions were identified: general interventions; urinary catheter care; prevention of infection; nutrition and hydration care; return to activities; hygiene care; medication administration care; guidance on expected signs and symptoms postoperatively; guidance on signs and symptoms of complications and conduits; guidelines for pelvic muscle exercises and pain control.	Provide written information about postoperative care to minimize anxiety and promote greater safety for patients and their families.
Tarrant et al,^Citation18 2008, UK	To explore the role and value of specialist nurses in prostate cancer care via a survey and patient interviews.	Quantitative questionnaire-based survey of 289 patients; qualitative analysis of semi-structured interviews with 35 men and ten wives.	Provide information about diagnosis and treatment in clearly understandable terms and to facilitate the care process.
McCorkle et al,^Citation29 2007, USA	To determine the effects of a standardized nursing intervention on men’s and their spouses’ levels of depressive symptoms, sexual function, and marital interaction following radical prostatectomy over time.	Secondary analysis of data from 107 patients and spouses; outcome variables measured at baseline and 1, 3, and 6 months following radical prostatectomy.				Levels of affected couples’ depressive symptoms should be assessed and monitored; patients and spouses need to be included in discussions about the effects of cancer and its treatment so that both feel more prepared to manage them.
Couper et al,^Citation28 2006, Australia	To appraise published research on the psychosocial effects on women living with men diagnosed with prostate cancer at whatever point in their “journey”.	Review of 44 articles published between 1994 and 2005.				The literature suggests that partners report more distress than patients, but believe that patients are more distressed; patients’ focus of concern on their sexual function is not shared to an equal degree by their partners.
Rayford,^Citation19 2006, USA	To discuss how low socioeconomic status and educational level can adversely influence therapeutic decision making.	Literature review.	Implementation of educational programs specifically for patients and families of low socioeconomic level improves communication and understanding of prostate cancer and results in higher levels of acceptance of advocated treatments.			Implementing educational strategies designed to improve posttreatment monitoring of patients, advising on management of posttreatment complications, and providing psychosocial support for patients and their families.
Burt et al,^Citation21 2005, Canada	To explore men’s experiences after radical prostatectomy and whether they perceived that preoperative education adequately prepared them for postoperative recovery.	Qualitative descriptive study; semi-structured telephone interviews with 17 participants.		A good source of information helped patients make the decision to have surgery. Nurses need to be prepared educationally and psychologically to observe nonverbal cues and address questions and concerns of significance.	Telephone follow-up helps foster adjustment after surgery and relieves anxiety caused by side effects of surgery and unanswered questions.
Calabrese,^Citation15 2004, USA	To discuss screening, diagnosis, and treatment modalities for prostate cancer in men aged .65 years.	Literature review.	Education about comorbidities that may influence available treatment options helps patients make the best cancer treatment decisions.			To help family members through support, encouragement, and active listening, especially when prostate cancer is a terminal diagnosis.
McGlynn et al,^Citation17 2004, UK	To improve the preoperative process and education for men planning to undergo surgery for genitourinary cancers.	Follow-up telephone calls and administration of International Prostate Symptom Score questionnaire to a convenience sample of 106 patients after radical prostatectomy.	Understand and agree to possible compromises in treatment with regard to the benefits and potential side effects of surgery; help patients adapt to the side effects of radical prostatectomy, particularly incontinence.	Personalized education increased the rate of postoperative return of continence, patients’ satisfaction with surgery, and quality of life.
Iwamoto and Maher,^Citation6 2001, USA	To review advances in radiation therapy for prostate cancer and the nursing care of patients with prostate cancer.	Review of peer-reviewed journal articles.	Managing symptoms associated with the disease and treatment; educating patients and family members about radiotherapy; providing patient support throughout the course of the illness.	Focus on patient education varies depending on the modality and overall goal of radiotherapy (ie, curative or palliative).
Robinson et al,^Citation23 1999, USA	To describe postsurgical nursing interventions for men with prostate cancer.	Secondary descriptive analysis of data collected from 32 randomly selected patients with prostate cancer using the Nursing Intervention Lexicon and Taxonomy.
Jakobsson et al,^Citation12 1997, Sweden	To describe nursing care needs perceived by patients during the inpatient period, and men’s opinions of their quality of life and sense of coherence.	Phenomenological–hermeneutic approach; convenience sample of eleven men with prostate cancer; semi-structured EORTC QLQ-C30.^b	Nurses must be aware of and sensitive to undertones in statements and actively seek to understand patients’ needs.	Two major categories of intervention: patient education and psychological. Data on the most prevalent interventions enable better preparation of nurse generalists to anticipate care needs of men undergoing prostate surgery.

Notes:

a Categories: 1, nursing care at the time of prostate cancer diagnosis; 2, nursing care in the pretreatment period; 3, nursing care in the posttreatment period; 4, nursing care for families and partners of men with prostate cancer;

b a questionnaire developed to assess quality of life in patients with cancer.

Abbreviation: EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.

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