Date of Award

2021

Embargo Period

8-1-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Nursing

First Advisor

Suparna Qanungo

Second Advisor

Susan Newman

Third Advisor

Martina Mueller

Fourth Advisor

Katherine Sterba

Abstract

According to the National Cancer Institute, in 2019, there were approximately 17 million cancer survivors in the United States, of whom 3.7 million were prostate cancer (PC) survivors. Due to an increase in life expectancy, extensive screening, and novel therapies, this number is expected to continue rising in the coming years. PC survivors in advanced stages (III, IV, or recurrent) are particularly prone to experience a wide range of harmful effects that stem from cancer and the many treatments they undergo during this cancer’s long trajectory. Past research has highlighted the importance of implementing supportive care as a standard for cancer survivors due to its multiple benefits, such as reducing morbidity and improving both quality of life (QOL) and health outcomes. However, little is known about supportive care needs and implementation among this subset of survivors. This information is vital to inform future patient-centered, holistic supportive care strategies that aim to optimize this population’s QOL and rehabilitation. This dissertation work found robust guidance from the Supportive Care Framework for Cancer Care due to its comprehensive taxonomy and holistic view of the cancer continuum. The first manuscript explored the supportive care interventions available to men with advanced prostate cancer. Next, a holistic needs assessment in American advanced disease PC survivors was conducted using a mixed-methods approach in order to provide a more comprehensive picture of their perceived supportive care needs. Finally, an exploration of the existing barriers and facilitators to supportive care implementation was performed before taking the next step in this line of research. The results of the three manuscripts included in this dissertation reported that advanced disease PC survivors suffer from unmet needs that affect every dimension of the individual. Existing supportive care interventions were promising but limited, focusing primarily on specific domains of needs. Implementing supportive care can only become a standard of care if researchers and clinicians find ways to minimize identified barriers while they maximize facilitators.

Rights

All rights reserved. Copyright is held by the author.

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