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Bowel dysfunction-related needs assessment in colorectal cancer survivors.
Background: Bowel dysfunction is common following treatment for colorectal cancer (CRC), with substantial impact on survivors’ quality of life (QOL). There are few evidence-based protocols to support positive adjustments to bowel function changes. The purpose of this study was to assess CRC survivors’ bowel dysfunction related information needs following surgery. Methods: CRC survivors who were within 1-3 months post-resection (n=37) completed questionnaires on bowel function, fecal incontinence specific QOL, and bowel dysfunction needs. Six randomly selected participants were interviewed to further explore unmet needs. Quantitative data were summarized using descriptive statistics for all subscales and individual items. Qualitative data were interpreted through content analysis methods. Results: The mean number of daily bowel movements was 5.5 (range 2-10). Many survivors reported incomplete bowel evacuation (66%) and increased urgency/frequency (75%). More problems were reported on the impact of diet on function (X=12, SD=3.2) and urgency/soilage (X=13.5, SD=4.5). Lower QOL scores were observed for the impact of dysfunction on lifestyle (X=2.7, SD=1.0) and coping behavior (X=2.7, SD=0.9). Survivors reported unmet information needs for the following: 1) managing bowel dysfunction in an emergency; 2) type of foods that are helpful or not helpful with bowel function; and 3) talking to others who share the same experience. The majority (75%) desired to participate in a rehabilitation program, and preferred to receive content before treatments or discharge from hospital following surgery. Conclusions: CRC survivors report unmet bowel dysfunction related needs, and desire more information and strategies to help with managing changes to their bowel patterns. Evidence-based interventions that are timely and personalized are needed to support long-term, positive adjustments following treatment.