Exploring Cutaneous Melanoma Patients’ Experiences with Follow-Up Radiology: A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Sample and Setting
2.3. Data Collection
2.4. Data Analysis
2.5. Reliability and Validity
2.6. Ethical Considerations
3. Results
“I feel awful because the wait is long… many thoughts are running through my mind…”(I18)
“… I’m still waiting for them to call me for the CT scan”(I22)
“… the waiting time is long… the wait has always been devastating”(I18)
“The waiting times… entering and finding out you have to wait another half hour is unbearable. That half hour feels endless.”(I2)
“…since it’s an ultrasound where I have to drink, it stresses me a little because I’m not sure if my bladder will be full or if I’ll be able to hold it.”(I17)
“… the wait creates anxiety… will I be able to do the bladder ultrasound?”(I23)
“If something negative comes up, of course, it would lead to a spiral of worries.”(I6)
“If there are significant changes in the report, I would be worried…”(I29)
“… you don’t know if there is something wrong or not, and this creates a state of fear, a constant sense of suspense… there’s no one to tell you everything is fine.”(I24)
“The fear of recurrence…”(I10)
“… So I’ll have to remove the tumor, I’ll have to go through the whole process again, and so some fear comes in…”(I15)
“… fear of what lies ahead, knowing that these melanomas can cause metastases…”(I19)
“What helps is that I’m very positive… I try to face things with a certain philosophy, always thinking of the best…”(I7)
“… I always look on the bright side…”(I8)
“And I’m optimistic, I want to stay calm…”(I9)
“The first few years were more complicated… but now, since 2014, I’ve gotten pretty calm, so I face it with peace of mind.”(I6)
“It also depends a bit on the character of the person; I tend to be rational…”(I29)
“… I’m quite calm, rational by nature…”(I15)
“… the staff I found at IFO is not only competent but much more… they are extremely professional and experienced, which makes you feel calm.”(I5)
“… there is professionalism from everyone…”(I12)
“… when I dealt with the specialists, I calmed down… a competent person can reassure you because they’ve seen thousands of cases like mine…”(I19)
“… the way they handle patients with kindness helps… it helps you relax and face the visit differently.”(I17)
“… kindness… being greeted by a caring and kind person is what we need, it makes you feel relieved…”(I27)
“… I also found kindness; they take care of people… I found reliable people, that’s it”(I19)
“… we’re followed so well that we’re calm, always informed about what’s happening and updated on every little detail… information brings peace of mind.”(I14)
“I was reassured, they explained what would happen, what the next steps would be, so I know what I’ve had, what it entails, and what the risks are…”(I22)
“… there are treatments; we’re in 2024, and fortunately, medicine is progressing, and that helps me overcome fears…”(I18)
“… I believe in science and doctors… I feel calm when I come here.”(I5)
“… and the positive thing is that research is moving forward; I follow the Facebook page and see that a lot of research is being done, which is reassuring…”(I10)
“This gives me peace of mind: seeing my children doing well, calm, and then I’m calm too.”(I8)
“… I’m happy like this, with my wife, my daughter, with my family and my daughter’s family, two families, they’re doing well, and so are we.”(I20)
“… I have the fundamental support of my daughter…”(I26)
“I’m very sociable, I have friends, I never lose heart, that helps me, this awareness helps me in society…”.(I9)
“After my husband’s death, living alone, you approach things with more anxiety because you don’t have the support of someone by your side, you feel empty…”.(I9)
“… I feel worse for my children because I’m a bother to them.”(I9)
“… I couldn’t come here alone, and that’s a discomfort because I always have to depend on someone, whereas before I was independent in everything…”(I26)
“… going shopping, running errands… that reassures me…”(I9)
“… I try not to think about it until the last moment… I focus on work, home…”(I13)
“I try to distract myself, with music in my headphones. I mustn’t think about it, I have to stay calm; otherwise, if I start thinking, I’ll feel worse”(I2)
“… I talk a lot with others, and it helps me relieve tension… encouraging others, but in encouraging others, I encourage myself, and time passes”(I7)
“… hearing testimonies, the comparison with people who are surely worse off than I am, makes me feel better”(I27)
“… I’m a believer, I believe in the creator… faith is essential… prayer… that gives me a lot of strength…”(I7)
“… well, if it is Christ’s wish, unfortunately, there’s nothing else I can do. I trust in faith, prayer, and common sense…”(I15)
“… I have a lot of trust; I believe in God…”(I24)
“… those working here should be trained differently because training them and transferring different skills from what they currently have would certainly yield better results.”(I11)
“… the presence of volunteers to help us understand the paths, how to move around… to provide support, give directions, take a number—this would certainly help a lot…”(I22)
“… someone to let you know if there’s still more waiting…”(I24)
“… communication when we’re at home, and the numbers and references when we’re home could be improved, because it’s not always possible to return in person to get an answer.”(I22)
“Maybe a psychologist would be useful… I know, in general, it can be a good approach; some people need it to cope with this anxiety, this fear.”(I3)
“… psychological support… having some comfort would be important.”(I28)
“… having a more comfortable environment with less confusion… if there are other people like me who don’t know, they start asking questions and get agitated, and that agitation tends to spread to others.”(I22)
“… I’m handling it pretty well, but it would be nicer if there were more space or a screen to show when it’s your turn.”(I12)
“… background music would not be a bad idea, for those that are a little more anxious, it could be a distraction.”(I1)
“Help them unwind, give them a chance not to think about what they’re about to do. For example, do you have TVs? Use them… background music.”(I2)
“… a television, something to distract them so they don’t think so much… the television might help reduce anxiety a bit.”(I5)
“Environmental comfort could be achieved by showing something on TV; it is a good distraction, and you stop thinking about what you have to do.”(I29)
“… they could add something to make the environment more welcoming, more like home, soften the colors in the waiting area, making it feel more welcoming and less cold.”(I12)
4. Discussion
5. Conclusions
Limitations
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Aiom. Linee Guida Melanoma. Edizione 2023. Available online: https://www.iss.it/documents/20126/8403839/LG+127_Melanoma_agg-ago2023_rev-nov.pdf/d1e6e188-6e08-8cd6-5ac7-3e1f83dce7c6?t=1702303171666 (accessed on 20 September 2023).
- Welch, H.G.; Mazer, B.L.; Adamson, A.S. The rapid rise in cutaneous melanoma diagnoses. N. Engl. J. Med. 2021, 384, 72–79. [Google Scholar] [PubMed]
- Garbe, C.; Keim, U.; Eigentler, T.; Amaral, T.; Katalinic, A.; Holleczek, B.; Martus, P.; Leiter, U. Time trends in incidence and mortality of cutaneous melanoma in Germany. J. Eur. Acad. Dermatol. Venereol. 2019, 33, 1272–1280. [Google Scholar]
- Dummer, R.; Pittelkow, M.R.; Iwatsuki, K.; Green, A.; Elwan, N.M. Skin Cancer—A World-Wide Perspective; Springer: Berlin/Heidelberg, Germany, 2011. [Google Scholar]
- Bui, K.T.; Liang, R.; Kiely, B.E.; Brown, C.; Dhillon, H.M.; Blinman, P. Scanxiety: A scoping review about scan-associated anxiety. BMJ Open 2021, 11, e043215. [Google Scholar]
- Garbe, C.; Schadendorf, D. Surveillance and follow-up examinations in cutaneous melanoma. Oncol. Res. Treat. 2003, 26, 241–246. [Google Scholar]
- Ruiz-Rodríguez, I.; Hombrados-Mendieta, I.; Melguizo-Garín, A.; Martos-Méndez, M.J. The importance of social support, optimism and resilience on the quality of life of cancer patients. Front. Psychol. 2022, 13, 833176. [Google Scholar]
- Busca, E.; Savatteri, A.; Calafato, T.L.; Mazzoleni, B.; Barisone, M.; Dal Molin, A. Barriers and facilitators to the implementation of nurse’s role in primary care settings: An integrative review. BMC Nurs. 2021, 20, 171. [Google Scholar]
- Välimäki, M.; Hu, S.; Lantta, T.; Hipp, K.; Varpula, J.; Chen, J.; Liu, G.; Tang, Y.; Chen, W.; Li, X. The impact of evidence-based nursing leadership in healthcare settings: A mixed methods systematic review. BMC Nurs. 2024, 23, 452. [Google Scholar]
- Tong, A.; Sainsbury, P.; Craig, J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int. J. Qual. Health Care 2007, 19, 349–357. [Google Scholar]
- Booth, A.; Hannes, K.; Harden, A.; Noyes, J.; Harris, J.; Tong, A. COREQ (consolidated criteria for reporting qualitative studies). In Guidelines for Reporting Health Research: A User’s Manual; Wiley: Hoboken, NJ, USA, 2014; pp. 214–226. [Google Scholar]
- Dossett, L.A.; Kaji, A.H.; Cochran, A. SRQR and COREQ reporting guidelines for qualitative studies. JAMA Surg. 2021, 156, 875–876. [Google Scholar]
- Abdel-Rahman, O. Risk of Subsequent Primary Kidney Cancer After Another Malignancy: A Population-based Study. Clin. Genitourin. Cancer 2017, 15, E747–E754. [Google Scholar] [CrossRef]
- Takona, J.P. Research design: Qualitative, quantitative, and mixed methods approaches. Qual. Quant. 2024, 58, 1011–1013. [Google Scholar]
- Trundle, C.; Gardner, J.; Phillips, T. The Ethnographic Interview: An Interdisciplinary Guide for Developing an Ethnographic Disposition in Health Research. Qual. Health Res. 2024. [Google Scholar] [CrossRef]
- Guest, G.; Namey, E.; Chen, M. A simple method to assess and report thematic saturation in qualitative research. PLoS ONE 2020, 15, e0232076. [Google Scholar]
- Bolvin, J.; Lancastle, D. Medical waiting periods: Imminence, emotions and coping. Women’s Health 2010, 6, 59–69. [Google Scholar]
- Pillastrini, P.; Ferrari, S.; Albano, A.; Beni, M.; Burbello, I.; De Cristofaro, L.; Griffoni, C.; Mattarozzi, K.; Nervuti, G.; Vanti, C. Patients’ experience on waiting for spinal arthrodesis: A qualitative study. Qual. Life Res. 2024, 34, 833–842. [Google Scholar]
- Patton, M.Q. Qualitative Research & Evaluation Methods: Integrating Theory and Practice; Sage Publications: Thousand Oaks, CA, USA, 2014. [Google Scholar]
- Turner, D.W., III; Hagstrom-Schmidt, N. Qualitative interview design. Howdy Or Hello? Technical and professional communication. Qual. Rep. 2022, 15, 154–760. [Google Scholar]
- Brinkmann, S.; Kvale, S. Doing Interviews; Sage Publications: Thousand Oaks, CA, USA, 2018. [Google Scholar]
- Miles, M.B.; Huberman, A.M.; Saldaña, J. Qualitative Data Analysis: A Methods Sourcebook, 3rd ed.; Sage Publications: Thousand Oaks, CA, USA, 2014. [Google Scholar]
- Klingberg, S.; Stalmeijer, R.E.; Varpio, L. Using framework analysis methods for qualitative research: AMEE Guide No. 164. Med. Teach. 2024, 46, 603–610. [Google Scholar]
- Lincoln, Y.S.; Guba, E.G. Naturalistic Inquiry; Sage Publications: Beverly Hills, CA, USA, 1985. [Google Scholar]
- Enworo, O.C. Application of Guba and Lincoln’s parallel criteria to assess trustworthiness of qualitative research on indigenous social protection systems. Qual. Res. J. 2023, 23, 372–384. [Google Scholar]
- Casales Morici, B.; Augustsson, H.; Hasson, H.; Ebbevi, D. Information and support to patients when the waiting time guarantee cannot be fulfilled: A qualitative study. Int. J. Equity Health 2023, 22, 130. [Google Scholar]
- Li, J.; Li, C.; Puts, M.; Wu, Y.-C.; Lyu, M.-M.; Yuan, B.; Zhang, J.-P. Effectiveness of mindfulness-based interventions on anxiety, depression, and fatigue in people with lung cancer: A systematic review and meta-analysis. Int. J. Nurs. Stud. 2023, 140, 104447. [Google Scholar]
- Gagliardi, A.R.; Yip, C.Y.; Irish, J.; Wright, F.C.; Rubin, B.; Ross, H.; Green, R.; Abbey, S.; McAndrews, M.P.; Stewart, D.E. The psychological burden of waiting for procedures and patient-centred strategies that could support the mental health of wait-listed patients and caregivers during the COVID-19 pandemic: A scoping review. Health Expect. 2021, 24, 978–990. [Google Scholar] [PubMed]
- Troy, A.S.; Willroth, E.C.; Shallcross, A.J.; Giuliani, N.R.; Gross, J.J.; Mauss, I.B. Psychological resilience: An affect-regulation framework. Annu. Rev. Psychol. 2023, 74, 547–576. [Google Scholar] [PubMed]
- Voskanyan, V.; Marzorati, C.; Sala, D.; Grasso, R.; Pietrobon, R.; van der Heijden, I.; Engelaar, M.; Bos, N.; Caraceni, A.; Couspel, N. Psychosocial factors associated with quality of life in cancer survivors: Umbrella review. J. Cancer Res. Clin. Oncol. 2024, 150, 249. [Google Scholar]
- Amin, S.M.; Khedr, M.A.; Tawfik, A.F.; Gamal Noaman Malek, M.; El-Ashry, A.M. The mediating and moderating role of social support on the relationship between psychological well-being and burdensomeness among elderly with chronic illness: Community nursing perspective. BMC Nurs. 2025, 24, 156. [Google Scholar]
- Murphy, E.R.; Wippold, G.M.; Crichlow, Z.R. Socioeconomic Status, Social Support, and Quality of Life Among Black Adults. J. Racial Ethn. Health Disparities 2024. [Google Scholar] [CrossRef]
- Cohen, S.; McKay, G. Social support, stress and the buffering hypothesis: A theoretical analysis. In Handbook of Psychology and Health; Routledge: Oxfordshire, UK, 2020; Volume IV, pp. 253–267. [Google Scholar]
- Zell, E.; Stockus, C.A. Social support and psychological adjustment: A quantitative synthesis of 60 meta-analyses. Am. Psychol. 2024, 80, 33–46. [Google Scholar]
- Trapp, M.; Trapp, E.-M.; Richtig, E.; Egger, J.W.; Zampetti, A.; Sampogna, F.; Rohrer, P.M.; Komericki, P.; Strimitzer, T.; Linder, M.D. Coping strategies in melanoma patients. Acta Derm. Venereol. 2012, 92, 598–602. [Google Scholar]
- Feng, Y.; Wang, M. Effect of music therapy on emotional resilience, well-being, and employability: A quantitative investigation of mediation and moderation. BMC Psychol. 2025, 13, 47. [Google Scholar]
- Nagy, D.S.; Isaic, A.; Motofelea, A.C.; Popovici, D.I.; Diaconescu, R.G.; Negru, S.M. The Role of Spirituality and Religion in Improving Quality of Life and Coping Mechanisms in Cancer Patients. Healthcare 2024, 12, 2349. [Google Scholar] [CrossRef]
- Kwame, A.; Petrucka, P.M. A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nurs. 2021, 20, 158. [Google Scholar]
- Burgener, A.M. Enhancing communication to improve patient safety and to increase patient satisfaction. Health Care Manag. 2020, 39, 128–132. [Google Scholar]
- Dhakal, K.; Chen, C.; Wang, P.; Mboineki, J.F.; Adhikari, B. Existing psychological supportive care interventions for cervical cancer patients: A systematic review and meta-analysis. BMC Public Health 2024, 24, 1419. [Google Scholar] [CrossRef] [PubMed]
- Lyu, X.-C.; Jiang, H.-J.; Lee, L.-H.; Yang, C.-I.; Sun, X.-Y. Oncology nurses’ experiences of providing emotional support for cancer patients: A qualitative study. BMC Nurs. 2024, 23, 58. [Google Scholar]
- Tian, Y. A review on factors related to patient comfort experience in hospitals. J. Health Popul. Nutr. 2023, 42, 125. [Google Scholar]
- King, S.; Woodley, J.; Walsh, N. A systematic review of non-pharmacologic interventions to reduce anxiety in adults in advance of diagnostic imaging procedures. Radiography 2021, 27, 688–697. [Google Scholar]
|
Codes | Categories | Themes |
---|---|---|
“I feel awful because the wait is long… there are many thoughts running through my mind…” (I18) | Negative Aspects | Waiting Affects the Emotional Experience |
“… I’m still waiting for them to call me for the CT scan” (I22) | ||
“… the waiting time is long… the wait has always been devastating” (I18) | ||
“The waiting times… entering and finding out you have to wait another half hour is un-bearable. That half hour feels endless.” (I2) | ||
“…since it’s an ultrasound where I have to drink, it stresses me a little because I’m not sure if my bladder will be full or if I’ll be able to hold it.” (I17) | Anxiety About Preparation and results | |
“… the wait creates anxiety… will I be able to do the bladder ultrasound?” (I23) | ||
“If something negative comes up, of course, it would lead to a spiral of worries.” (I6) | ||
“If there are significant changes in the report, I would be worried…” (I29) | ||
“… you don’t know if there is something wrong or not, and this creates a state of fear, a constant sense of suspense… there’s no one to tell you everything is fine.” (I24) | ||
“The fear of recurrence…” (I10) | Fear of Recurrence | |
“… So I’ll have to remove the tumor, I’ll have to go through the whole process again, and so some fear comes in…” (I15) | ||
“… fear of what lies ahead, knowing that these melanomas can cause metastases…” (I19) |
n. | % | |
---|---|---|
Age (mean) | 57.4 anni | |
Gender | ||
M | 20 | 66.67 |
F | 10 | 33.33 |
Marital status | ||
Married | 22 | 73.33 |
Single | 4 | 13.33 |
Divorced | 1 | 3.33 |
Widow/widower | 1 | 3.33 |
Data missing | 2 | 6.67 |
Education | ||
Middle school | 1 | 3.33 |
High school | 12 | 40.00 |
Degree | 17 | 56.67 |
Employment | ||
Employed | 12 | 40.00 |
Retirees | 12 | 40.00 |
Unemployed | 1 | 3.33 |
Student | 1 | 3.33 |
Data missing | 4 | 13.33 |
Previous oncological therapies | ||
Yes | 30 | 100.00 |
No | 0 | 0.00 |
Diagnostic test to be performed | ||
CT scans | 15 | 50.00 |
Ultrasound | 10 | 33.33 |
MRIs | 5 | 16.67 |
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Share and Cite
Iacorossi, L.; Molinaro, S.; Gambalunga, F.; Petrone, F.; Desiderio, F.; Piacentini, F.; Guerrisi, A.; Elia, F.; Caterino, M. Exploring Cutaneous Melanoma Patients’ Experiences with Follow-Up Radiology: A Qualitative Study. Healthcare 2025, 13, 845. https://doi.org/10.3390/healthcare13080845
Iacorossi L, Molinaro S, Gambalunga F, Petrone F, Desiderio F, Piacentini F, Guerrisi A, Elia F, Caterino M. Exploring Cutaneous Melanoma Patients’ Experiences with Follow-Up Radiology: A Qualitative Study. Healthcare. 2025; 13(8):845. https://doi.org/10.3390/healthcare13080845
Chicago/Turabian StyleIacorossi, Laura, Simona Molinaro, Francesca Gambalunga, Fabrizio Petrone, Flora Desiderio, Francesca Piacentini, Antonino Guerrisi, Fulvia Elia, and Mauro Caterino. 2025. "Exploring Cutaneous Melanoma Patients’ Experiences with Follow-Up Radiology: A Qualitative Study" Healthcare 13, no. 8: 845. https://doi.org/10.3390/healthcare13080845
APA StyleIacorossi, L., Molinaro, S., Gambalunga, F., Petrone, F., Desiderio, F., Piacentini, F., Guerrisi, A., Elia, F., & Caterino, M. (2025). Exploring Cutaneous Melanoma Patients’ Experiences with Follow-Up Radiology: A Qualitative Study. Healthcare, 13(8), 845. https://doi.org/10.3390/healthcare13080845