Rectal Cancer and Quality of Life. Aspects on Communication and Patient Education

Sammanfattning: Background This thesis reports the results of three studies based on a pro-spective cohort study of an unselected population of patients with rectal cancer, and one study based on an exploratory study of a new patient edu-cation method as preparation for colorectal cancer surgery. The aim of study I was to investigate whether patient’s or doctor’s delay had an impact on quality of life at diagnosis, and in study III the development of quality of life after treatment for rectal cancer was investigated. The aim of study II was to explore the patient’s experience of communication before, during and after diagnosis of rectal cancer. Study IV used another patient cohort and explored the experience of patients participating in a new patient edu-cation method, before treatment for colorectal cancer. Methods In study I, II and III data from a repeated-measures longitudinal study was used. In study IV, data on information and patient education was taken from a cohort study of patients planned for surgery for colorectal cancer. The statistical methods of study II and IV were descriptive and in study I and III regression models were used. Results Despite that patients did not get information on the planned treat-ment’s possible side-effects on the urinary and sexual function, the patients reported good communication with their surgeon. Timely access to treat-ment for rectal cancer did not have an effect on quality of life when consid-eration was taken to depression and negative intrusive thoughts. The quality of life was recovered to the same as the reference population after 12 months, but bother from urinary, stoma and bowel function hampered quality of life for the individual. Patients attending a group consultation be-fore surgery for colorectal cancer appreciated the group setting and re-ported that it increased their sense of control and active participation in their treatment. Conclusion Information on potential side-effects of rectal cancer treatment is lacking. The preoperative group consultation as a method for patient edu-cation, seems like a feasible complement to the standard consultation to give information before colorectal cancer surgery.