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Harris E, Yorke J, Law K, Winter-Roach MB, Taylor S. Advanced Ovarian Cancer Patients' Experiences of Surgical Treatment: A Qualitative Analysis. Semin Oncol Nurs 2024; 40:151679. [PMID: 38890076 DOI: 10.1016/j.soncn.2024.151679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVES Recommended treatment for advanced ovarian cancer involves a combination of debulking surgery and chemotherapy. Surgery places a significant burden on a patient's physical, social, sexual, and emotional wellbeing. Existing research exploring the impact of surgery is often limited to questionnaire administration with large gaps between data collection time points, missing key aspects of the perioperative period. Little is known of the experience of ovarian cancer surgical treatment from a patient perspective. This research aims to qualitatively explore advanced ovarian cancer patients' experience of surgery and identify areas in which quality of life may be impacted. METHODS Semi-structured telephone or face-to-face interviews were conducted with patients who had undergone combined surgical and chemotherapy treatment. Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using an inductive approach to thematic analysis. RESULTS Twenty ovarian cancer patients who had undergone debulking surgery participated in interviews lasting between 33 and 68 minutes. Qualitative analysis generated five key themes: (1) care services; (2) experiences of a stoma; (3) preoperative experience; (4) impact of surgery; and (5) coping mechanisms. CONCLUSIONS Understanding the patient experience of surgical treatment for advanced ovarian cancer can help inform and improve future care. This research explored the ways in which a patient's quality of life is impacted by surgery and highlights areas in which further support may be needed. Knowledge of the patient experience may also aid decision-making for both clinicians and patients when considering different treatment pathways. IMPLICATIONS FOR NURSING PRACTICE Results highlighted two crucial points in the surgical pathway where patients' need for emotional support was significant: during pre-op and recovering from surgery as an inpatient. Nursing staff are key to providing reassurance during this time. Specialized stoma nurses were also essential for supporting patients to adapt to their stomas both physically and psychologically.
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Affiliation(s)
- Emily Harris
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Janelle Yorke
- School of Nursing, The Hong Kong Polytechnic University, Manchester, Kowloon, Hong Kong, SAR, China
| | - Kate Law
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, United Kingdom
| | - Mr Brett Winter-Roach
- Department of Gynaecology, Clinical Support and Specialist Surgery, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Sally Taylor
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, United Kingdom.
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Xu H, Xiao L, Zhang H. Impact of nursing interventions in obstetric and gynaecological surgery: A bibliometric and visual analysis. Asian J Surg 2024:S1015-9584(24)01167-9. [PMID: 38876880 DOI: 10.1016/j.asjsur.2024.05.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/31/2024] [Indexed: 06/16/2024] Open
Affiliation(s)
- Hong Xu
- Department of Gynaecology, Chongqing Rongchang District People's Hospital, Chongqin, China
| | - Lan Xiao
- Department of Gynaecology, Chongqing Rongchang District People's Hospital, Chongqin, China
| | - Huaijie Zhang
- Department of Gynaecology, Chongqing Rongchang District People's Hospital, Chongqin, China.
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Erfina E, Nurmaulid N, Hariati S, Andriani A, McKenna L. Effectiveness of a Multimodal Nursing Intervention on Quality of Sleep, Fatigue, and Level of Depression Among Indonesian Patients With Gynecological Cancer: A Pilot Study. Cancer Nurs 2024; 47:72-80. [PMID: 36076316 DOI: 10.1097/ncc.0000000000001158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The use of nonpharmacological modalities in managing symptoms experienced by patients with cancer is increasingly important in providing holistic care. However, limited studies have reported on integrating nonpharmacological interventions to improve physical and psychological symptoms of women with gynecological cancer. OBJECTIVE The aim of this study was to examine the effect of a multimodal nursing intervention (MNI) on sleep quality, fatigue, and level of depression among Indonesian women with gynecological cancer. METHODS The quasi-experimental nonequivalent group design involved 50 patients in 2 groups and used convenience sampling. An experimental group (n = 25) received MNI including progressive muscle relaxation and a counseling session; the control group received routine hospital care (n = 25). Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI), depression levels by the Beck Depression Inventory-II, and fatigue by the Piper Fatigue Scale (PFS). Pretest data were collected after 3 days of hospital admission; posttest data were gathered after the intervention. RESULTS The PSQI ( P = .000), Beck Depression Inventory-II ( P = .008), and PFS ( P = .000) changed significantly in the intervention group; the PSQI ( P = .000) and PFS ( P = .000) in the control group changed significantly. The PSQI ( P = .00) and PFS ( P = .000) scores differed significantly between the 2 groups before and after the intervention. The effect size of the MNI for difference scores before and after the intervention was medium effect size. CONCLUSIONS The role of nonpharmacological modalities in managing symptoms experienced by patients with cancer is increasingly important to providing holistic care. IMPLICATION FOR PRACTICE Gynecology nurses can lead the implementation of MNI to decrease patient fatigue and depression and to increase sleep quality.
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Affiliation(s)
- Erfina Erfina
- Author Affiliations: Maternity Nursing Department (Dr Erfina and Ms Nurmaulid), Pediatric Nursing Department (Dr Hariati), and Mental Health Nursing Department (Ms Andriani), Faculty of Nursing, Hasanuddin University, Makassar, Indonesia; and College of Science Health and Engineering, La Trobe University (Prof McKenna), Bundoora, Australia
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Zhang X, Wu K, Pan Y, Zhong W, Zhou Y, Guo T, Yin R, Chen W. Introducing activation functions into segmented regression model to address lag effects of interventions. BMC Med Res Methodol 2023; 23:277. [PMID: 38001462 PMCID: PMC10668529 DOI: 10.1186/s12874-023-02098-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
The interrupted time series (ITS) design is widely used to examine the effects of large-scale public health interventions and has the highest level of evidence validity. However, there is a notable gap regarding methods that account for lag effects of interventions.To address this, we introduced activation functions (ReLU and Sigmoid) to into the classic segmented regression (CSR) of the ITS design during the lag period. This led to the proposal of proposed an optimized segmented regression (OSR), namely, OSR-ReLU and OSR-Sig. To compare the performance of the models, we simulated data under multiple scenarios, including positive or negative impacts of interventions, linear or nonlinear lag patterns, different lag lengths, and different fluctuation degrees of the outcome time series. Based on the simulated data, we examined the bias, mean relative error (MRE), mean square error (MSE), mean width of the 95% confidence interval (CI), and coverage rate of the 95% CI for the long-term impact estimates of interventions among different models.OSR-ReLU and OSR-Sig yielded approximately unbiased estimates of the long-term impacts across all scenarios, whereas CSR did not. In terms of accuracy, OSR-ReLU and OSR-Sig outperformed CSR, exhibiting lower values in MRE and MSE. With increasing lag length, the optimized models provided robust estimates of long-term impacts. Regarding precision, OSR-ReLU and OSR-Sig surpassed CSR, demonstrating narrower mean widths of 95% CI and higher coverage rates.Our optimized models are powerful tools, as they can model the lag effects of interventions and provide more accurate and precise estimates of the long-term impact of interventions. The introduction of an activation function provides new ideas for improving of the CSR model.
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Affiliation(s)
- Xiangliang Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Kunpeng Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Yan Pan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Wenfang Zhong
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Yixiang Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Tingting Guo
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Rong Yin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.
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Maheta BJ, Singh NK, Lorenz KA, Fereydooni S, Dy SM, Wong HN, Bergman J, Leppert JT, Giannitrapani KF. Interdisciplinary interventions that improve patient-reported outcomes in perioperative cancer care: A systematic review of randomized control trials. PLoS One 2023; 18:e0294599. [PMID: 37983229 PMCID: PMC10659207 DOI: 10.1371/journal.pone.0294599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Interdisciplinary teams are often leveraged to improve quality of cancer care in the perioperative period. We aimed to identify the team structures and processes in interdisciplinary interventions that improve perioperative patient-reported outcomes for patients with cancer. METHODS We searched PubMed, EMBASE, and CINAHL for randomized control trials published at any time and screened 7,195 articles. To be included in our review, studies needed to report patient-reported outcomes, have interventions that occur in the perioperative period, include surgical cancer treatment, and include at least one non physician intervention clinical team member: advanced practice providers, including nurse practitioners and physician assistants, clinical nurse specialists, and registered nurses. We narratively synthesized intervention components, specifically roles assumed by intervention clinical team members and interdisciplinary team processes, to compare interventions that improved patient-reported outcomes, based on minimal clinically important difference and statistical significance. RESULTS We included 34 studies with a total of 4,722 participants, of which 31 reported a clinically meaningful improvement in at least one patient-reported outcome. No included studies had an overall high risk of bias. The common clinical team member roles featured patient education regarding diagnosis, treatment, coping, and pain/symptom management as well as postoperative follow up regarding problems after surgery, resource dissemination, and care planning. Other intervention components included six or more months of continuous clinical team member contact with the patient and involvement of the patient's caregiver. CONCLUSIONS Future interventions might prioritize supporting clinical team members roles to include patient education, caregiver engagement, and clinical follow-up.
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Affiliation(s)
- Bhagvat J. Maheta
- VA Center for Innovation to Implementation, Menlo Park, CA, United States of America
- California Northstate University College of Medicine, Elk Grove, CA, United States of America
| | - Nainwant K. Singh
- VA Center for Innovation to Implementation, Menlo Park, CA, United States of America
- Department of Health Policy, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Karl A. Lorenz
- VA Center for Innovation to Implementation, Menlo Park, CA, United States of America
- Department of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, United States of America
| | | | - Sydney M. Dy
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Hong-nei Wong
- Lane Medical Library, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Jonathan Bergman
- VA Los Angeles Healthcare System, Los Angeles, CA, United States of America
- Olive View UCLA Medical Center, Los Angeles, CA, United States of America
| | - John T. Leppert
- VA Center for Innovation to Implementation, Menlo Park, CA, United States of America
- Department of Urology, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Karleen F. Giannitrapani
- VA Center for Innovation to Implementation, Menlo Park, CA, United States of America
- Department of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, United States of America
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Quality of life of patients with rare cancer: a comparison with patients with colorectal cancer and the association with disease trajectory-related factors. J Cancer Surviv 2022:10.1007/s11764-022-01324-7. [PMID: 36585575 DOI: 10.1007/s11764-022-01324-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/15/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE Differences in quality of life (QoL) between patients with rare and common cancer might be explained by the specific challenges patients with rare cancer face during their disease trajectory, but research is scarce. This study aimed to (1) assess the difference in QoL between patients with rare and common cancer (i.e. colorectal cancer (CRC)) and (2) examine the association between disease trajectory-related factors and QoL in patients with rare cancer. METHODS Cross-sectional data were collected among adults with rare cancer by a nationwide online survey in the Netherlands. For comparison with patients with CRC, data from the Prospective Dutch Colorectal Cancer (PLCRC) cohort were used. Associations were assessed by linear regression analyses. RESULTS Data from 1525 patients with rare cancer and 1047 patients with CRC were analysed. Having a rare cancer was significantly associated with a lower QoL compared to having CRC (p < 0.001). Disease trajectory-related factors significantly associated with QoL in patients with rare cancer were time until diagnosis, misdiagnoses, information on best treatment options, information on late and/or long-term effects, and both satisfaction with physician and specialized nurse care (all: p < 0.05). CONCLUSION Patients with rare cancers have a lower self-reported QoL than patients with CRC, and several disease trajectory-related factors are associated with QoL in patients with rare cancer. IMPLICATIONS FOR CANCER SURVIVORS To improve QoL of patients with rare cancer, appropriate guidance and support by healthcare professionals throughout the disease trajectory are needed, as well as early diagnosis and proper referral to centres of expertise.
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Pozzar RA, Enzinger AC, Poort H, Furey A, Donovan H, Orechia M, Thompson E, Tavormina A, Fenton AT, Jaung T, Braun IM, DeMarsh A, Cooley ME, Wright AA. Developing and Field Testing BOLSTER: A Nurse-Led Care Management Intervention to Support Patients and Caregivers following Hospitalization for Gynecologic Cancer-Associated Peritoneal Carcinomatosis. J Palliat Med 2022; 25:1367-1375. [PMID: 35297744 PMCID: PMC9492907 DOI: 10.1089/jpm.2021.0618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction: Peritoneal carcinomatosis (PC) afflicts women with advanced gynecologic cancers. Patients with PC often require ostomies, gastric tubes, or catheters to palliate symptoms, yet patients and caregivers report feeling unprepared to manage these devices. The purpose of this study was to develop and field test the Building Out Lifelines for Safety, Trust, Empowerment, and Renewal (BOLSTER) intervention to support patients and their caregivers after hospitalization for PC. Materials and Methods: We adapted components of the Standard Nursing Intervention Protocol with stakeholders and topical experts. We developed educational content; built a smartphone application to assess patients' symptoms; and assessed preliminary feasibility and acceptability in two single-arm prepilot studies. Eligible participants were English-speaking adults hospitalized for gynecologic cancer-associated PC and their caregivers. Feasibility criteria were a ≥50% consent-to-approach ratio and ≥80% outcome measure completion. The acceptability criterion was ≥70% of participants recommending BOLSTER. Results: During the first prepilot, BOLSTER was a 10-week intervention. While 7/8 (87.5%) approached patients consented, we experienced high attrition to hospice. Less than half of patients (3/7) and caregivers (3/7) completed outcome measures. For the second prepilot, BOLSTER was a four-week intervention. All (7/7) approached patients consented. Two withdrew before participating in any study activity because they were "too overwhelmed." We excluded data from one caregiver who completed baseline measures with the patient's assistance. All remaining patients (5/5) and caregivers (4/4) completed outcome measures and recommended BOLSTER. Conclusion: BOLSTER is a technology-enhanced, nurse-led intervention that is feasible and acceptable to patients with gynecologic cancer-associated PC and their caregivers.
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Affiliation(s)
- Rachel A. Pozzar
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea C. Enzinger
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Hanneke Poort
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Ann Furey
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Heidi Donovan
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Meghan Orechia
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Anna Tavormina
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Anny T.H.R. Fenton
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Tim Jaung
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Ilana M. Braun
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea DeMarsh
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Mary E. Cooley
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexi A. Wright
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Ma'rifah AR, Afiyanti Y, Huda MH, Chipojola R, Putri YR, Nasution MAT. Effectiveness of psychoeducation intervention among women with gynecological cancer: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2022; 30:8271-8285. [PMID: 35821448 DOI: 10.1007/s00520-022-07277-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/03/2022] [Indexed: 12/24/2022]
Abstract
Psychoeducation interventions have been suggested to improve sexual functioning and quality of life. The aim of this study was to examine the effects of the psychoeducation intervention on quality of life, sexual function, and psychological outcomes; and to identify the critical components of psychoeducation intervention for women with gynecological cancer. This study was a systematic review and meta-analysis. Psychoeducation interventions were searched using six English databases, eligible studies were extracted, and the risk of bias was evaluated by two authors independently. A random effects model was used to examine the intervention effects. We conducted subgroup analysis and meta-regression to assess the variables underlying the heterogeneity. In total, eight trials were identified, and 1128 participants were included. Women who received the psychoeducation intervention had better quality of life (standardized mean difference (SMD) = 0.59, 95% confidence interval (CI): 0.22, 0.97), sexual functioning (SMD = 0.63, 95% CI: 0.27, 0.99), and psychological outcomes (i.e., anxiety and depression (SMD = - 0.27, 95% CI: - 0.09, - 0.44)). Interventions that combined lecture-based, skill practical, discussion, and counseling were conducted using an online format and were delivered by a team of health professionals that had higher scores of qualities of life. Additionally, involving significant others in the intervention improved sexual functioning. Psychoeducation interventions effectively improve quality of life, sexual functioning, anxiety, and depression. Incorporating lecture-based, practical skills, discussion, and counseling through an online format and involving significant others are beneficial for improving the quality of life and sexual functioning among women with gynecological cancer.
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Affiliation(s)
- Atun Raudotul Ma'rifah
- Faculty of Nursing, Universitas Indonesia, FIK UI Campus, Jl. Prof. Dr. Bahder DjohanJawa Barat, Depok, Indonesia, 16424.,Harapan Bangsa University Purwokerto, Jl. Raden Patah no 100 Ledug Kembaran Banyumas, Central Java, Indonesia
| | - Yati Afiyanti
- Faculty of Nursing, Universitas Indonesia, FIK UI Campus, Jl. Prof. Dr. Bahder DjohanJawa Barat, Depok, Indonesia, 16424.
| | - Mega Hasanul Huda
- Institute Kesehatan Prima Nusantara Bukit Tinggi, Hermina Hospital Group, Gn. Sahari Sel, Jl. Selangit, RW.10, Kec. Kemayoran, Central Jakarta, Capital Region of Jakarta, Indonesia, 10620
| | | | - Yelmi Reni Putri
- Faculty of Nursing, Universitas Indonesia, FIK UI Campus, Jl. Prof. Dr. Bahder DjohanJawa Barat, Depok, Indonesia, 16424.,Fort De Kock University, Jl. Soekarno Hatta No. 11, Manggis Ganting, Mandingin, Kota Selayan-Kota Bukit Tinggi West Sumatra, Indonesia
| | - M A Tantawi Nasution
- National Library of the Republik of Indonesia, Salemba Raya, 28 A. Kenari, Senen, Central Jakarta, Capital Region of Jakarta, Indonesia
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Monteiro MGCT, de Morais Gouveia GP. Physiotherapy in the management of gynecological cancer patient: A systematic review. J Bodyw Mov Ther 2021; 28:354-361. [PMID: 34776164 DOI: 10.1016/j.jbmt.2021.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 06/01/2021] [Accepted: 06/21/2021] [Indexed: 01/05/2023]
Abstract
AIM to evaluate the effectiveness of physiotherapy as an adjunct treatment in patients with gynecological cancer. METHOD systematic review carried out in the PubMed, MEDLINE, via VHL, Cochrane and SciELO, in the last ten years. A search strategy was based on the PICO method and the PRISMA flowchart using Boolean descriptors and operators: "gynecological cancer or neoplasms of female genital organs" and "physiotherapy or physiotherapy modalities" and "rehabilitation or quality of life" in languages Portuguese, English, and Spanish. RESULTS 405 articles were found, and after eligibility criteria, only 5 studies were selected for review. Evidence of a monitored physical exercise, photobiomodulation and pelvic floor rehabilitation program as physiotherapeutic resources in the management of gynecological cancer. CONCLUSION Physiotherapy dominates techniques and appears to be beneficial for the main complications arising from the treatment or post-treatment of gynecological cancer and has sought to accompany the knowledge and care of the patient, through scientific research.
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Guan T, Qan'ir Y, Song L. Systematic review of illness uncertainty management interventions for cancer patients and their family caregivers. Support Care Cancer 2021; 29:4623-4640. [PMID: 33495851 PMCID: PMC8236440 DOI: 10.1007/s00520-020-05931-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Illness uncertainty pervades individuals' experiences of cancer across the illness trajectory and is associated with poor psychological adjustment. This review systematically examined the characteristics and outcomes of interventions promoting illness uncertainty management among cancer patients and/or their family caregivers. METHODS PubMed, Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and Cochrane Database of Systematic Reviews were systematically searched for relevant literature. We included randomized controlled trials (RCTs) and quasi-experimental studies focusing on interventions for uncertainty management in cancer patients and/or their family caregivers. RESULTS Our database searches yielded 26 studies. Twenty interventions were only offered to cancer patients, who were mostly elder, female, and White. All interventions included informational support. Other intervention components included emotional support, appraisal support, and instrumental support. Most interventions were delivered in person and via telephone (n = 8) or exclusively in person (n = 7). Overall, 18 studies identified positive intervention effects on illness uncertainty outcomes. CONCLUSION This systematic review foregrounds the promising potential of several interventions-and especially multi-component interventions-to promote uncertainty management among cancer patients and their family caregivers. To further improve these interventions' effectiveness and expand their potential impact, future uncertainty management interventions should be tested among more diverse populations using rigorous methodologies.
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Affiliation(s)
- Ting Guan
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yousef Qan'ir
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lixin Song
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Schneider F, Kempfer SS, Backes VMS. Training of advanced practice nurses in oncology for the best care: a systematic review. Rev Esc Enferm USP 2021; 55:e03700. [PMID: 33978139 DOI: 10.1590/s1980-220x2019043403700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 10/20/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To search for evidence on the training of advanced practice nurses, through clinical practice and nursing care with cancer patients. METHOD Systematic review, searching the databases: MEDLINE-PubMed, LILACS, Web of Science, Scopus, CINAHL and Cochrane CENTRAL. A manual search of the reference list and Google Scholar was also carried out. To assess the methodological quality of the studies, the following tools were used: Cochrane Collaboration Risk of Bias Tool (RoB 1) for randomized controlled trials and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for quasi-experimental studies. RESULTS A total of 12 experimental studies were identified. The main intervention identified in the studies was educational guidance. The studies showed improvement in pain control or other symptoms related to disease and/or treatment, satisfaction and improvement in the quality of life of cancer patients. CONCLUSION It is observed that there are studies that demonstrate the value of advanced practice nursing in oncology, through differentiated clinical training and advanced professional performance. Registration number of the systematic review: CRD42018098906.
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Affiliation(s)
- Franciane Schneider
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
| | - Silvana Silveira Kempfer
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
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May JR, Jao NC, McCarter K, Klass E, Pearman T, Leone F, Schnoll RA, Hitsman B. Change in Health-Related Quality of Life Among Individuals With Cancer Undergoing Smoking Cessation Treatment Involving Varenicline. Oncol Nurs Forum 2021; 48:112-120. [PMID: 33337436 DOI: 10.1188/21.onf.112-120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine whether health-related quality of life (HRQOL) among individuals with cancer is undermined by smoking cessation treatment involving varenicline. SAMPLE & SETTING Participants (N = 103) were daily smokers with cancer (up to five years postdiagnosis) who completed a placebo-controlled trial of standard versus extended duration varenicline. METHODS & VARIABLES For this secondary study, participants were selected based on having completed the SF-12® at weeks 0, 1, 12, and 24. Using separate repeated measures multivariate analysis of variance, change in SF-12 scores was evaluated by time and by cancer treatment, varenicline duration, and quit status at week 24. RESULTS There was no change in any of the three HRQOL scores by time or by cancer treatment status, varenicline duration, or quit status. Average emotional HRQOL score across time was significantly higher for quitters versus smokers. IMPLICATIONS FOR NURSING Varenicline, including long-term treatment, does not appear to adversely affect HRQOL, which is highly relevant to oncology nurses who are well positioned to assist with the pharmacologic treatment of tobacco dependence.
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Affiliation(s)
| | | | | | | | | | - Frank Leone
- University of Pennsylvania Presbyterian Medical Center
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Alotaibi T, Al Anizi CA. The impact of advanced nurse practitioner (ANP) role on adult patients with cancer: A quantitative systematic review. Appl Nurs Res 2020; 56:151370. [PMID: 33280789 DOI: 10.1016/j.apnr.2020.151370] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 01/06/2023]
Abstract
AIM This study aims to identify how Advanced Nurse Practitioners (ANPs) can contribute to oncology care. BACKGROUND The position of ANPs has grown significantly in recent years and ANPs have been shown to make significant contributions to various areas of healthcare. Due to improvements in research and techniques elder cancer patients are living longer, as beneficial, as this is to patients it is putting a strain on the provision of care as support is required at various stages. As there have been discussions about how ANPs +. can be most effectively employed this study identifies that ANPs, due to their skills and knowledge, may be able to assist elderly patients with long-term conditions specifically oncology patients. Therefore, research has been undertaken to identify how ANPs are currently employed in oncology. METHODS A systematic review was conducted in order to gain background information into how the role of ANPs in oncology is perceived and to gain understanding of some of the issues that they face and identify the skills that they have in order to be able to make a positive contribution. This was followed by a study of quantitative Randomized Control Trials, which looked at the roles of ANPs in oncology. Thematic Analysis was conducted in order to gain a perspective of how ANPs are best currently employed with elderly oncology patients. RESULTS Five studies were reviewed which showed that ANPs provide support to elder patients which helps to alleviate stress and improve the quality of life of cancer patients. Furthermore, it was seen that ANPs can aid patients in symptom management. CONCLUSION This study has shown that ANPs are effectively used in clinical support for cancer patients. Further studies are required to verify the extent of this support and to determine if this support is effective only in the short term or can it be applied just as effectively over a period of time. ANPs have high-level knowledge and skills but more research is required to determine how they work effectively.
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Affiliation(s)
- Taghreed Alotaibi
- Princess Nourah bint Abdulrahman University, Nursing College, Community Health Nursing Department, Airport Road, Building 4, Flat 2.4, Riyadh, Saudi Arabia.
| | - Co Amira Al Anizi
- Princess Nourah bint Abdulrahman University, Nursing College, Community Health Nursing Department, Airport Road, Building 4, Flat 2.4, Riyadh, Saudi Arabia.
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Stein B, Müller MM, Meyer LK, Söllner W. Psychiatric and Psychosomatic Consultation-Liaison Services in General Hospitals: A Systematic Review and Meta-Analysis of Effects on Symptoms of Depression and Anxiety. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 89:6-16. [PMID: 31639791 DOI: 10.1159/000503177] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 09/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Psychiatric and psychosomatic consultation-liaison services (CL) are important providers of diagnosis and treatment for hospital patients with mental comorbidities and psychological burdens. OBJECTIVE To perform a systematic review and meta-analysis investigating the effects of CL on depression and anxiety. METHODS Following PRISMA guidelines, a systematic literature search was conducted until 2017. Included were published randomized controlled trials using CL interventions with adults in general hospitals, treatment as usual as control groups, and depression and/or anxiety as outcomes. Risk of bias was assessed using the Cochrane Risk of Bias Tool. Level of integration was assessed using the Standard Framework for Levels of Integrated Healthcare. Meta-analyses were performed using random effects models and meta-regression for moderator effects. RESULTS We included 38 studies (9,994 patients). Risk of bias was high in 17, unclear in 15, and low in 6 studies. Studies were grouped by type of intervention: brief interventions tailored to the patients (8), interventions based on specific treatment manuals (19), and integrated, collaborative care (11). Studies showed small to medium effects on depression and anxiety. Meta-analyses for depression yielded a small effect (d = -0.19, 95% CI: -0.30 to -0.09) in manual studies and a small effect (d = -0.33, 95% CI: -0.53 to -0.13) in integrated, collaborative care studies, the latter using mostly active control groups with the possibility of traditional consultation. CONCLUSIONS CL can provide a helpful first treatment for symptoms of depression and anxiety. Given that especially depressive symptoms in medically ill patients are long-lasting, the results underline the benefit of integrative approaches that respect the complexity of the illness.
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Affiliation(s)
- Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany,
| | - Markus M Müller
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
| | - Lisa K Meyer
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
| | - Wolfgang Söllner
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany
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Yin YN, Wang Y, Jiang NJ, Long DR. Can case management improve cancer patients quality of life?: A systematic review following PRISMA. Medicine (Baltimore) 2020; 99:e22448. [PMID: 33019431 PMCID: PMC7535784 DOI: 10.1097/md.0000000000022448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Cancer patients are associated with a series of long lasting and stressful treatments and experiencing, and case management (CM) has been widely used and developed with the aim to increase the quality of treatments and improve the patient care services. The purpose of this review is to identify and synthesize the evidence of randomized controlled trial studies to prove that case management could be one way to address the quality of life of cancer patients. METHODS We performed a literature search in 4 electronic bibliographic databases and snowball searches were performed to ensure a complete collection. Two review authors independently extracted and analyzed data. A data extraction form was used to collect the characteristics of case management intervention, report outcomes, and quality assessment. RESULTS Our searches identified 3080 articles, of which 7 randomized controlled trials met the inclusion criteria. The intervention was varied from the target population, measurement tools, duration of intervention, and so on, and 5 studies consistently showed improvement in the intervention group compared with control groups, no significant difference was found between health care costs of case management care services and the routine care services. CONCLUSION There is some evidence that case management can be effective in cancer patients quality of life. However, due to the heterogeneity in the target population, measurement tools, and results applied, no conclusion can be made from a meta-analysis on the present bias. More rigorously multi-centered randomized controlled studies should be provided with detailed information about intervention in future research.
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Affiliation(s)
- Ya-nan Yin
- Department of Gynecology and Obstetrics Nursing, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education
- West China Nursing School, Sichuan University, Chengdu, Sichuan, China
| | - Yun Wang
- Department of Gynecology and Obstetrics Nursing, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education
- West China Nursing School, Sichuan University, Chengdu, Sichuan, China
| | - Ni-jie Jiang
- Department of Gynecology and Obstetrics Nursing, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education
- West China Nursing School, Sichuan University, Chengdu, Sichuan, China
| | - De-rong Long
- Department of Gynecology and Obstetrics Nursing, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education
- West China Nursing School, Sichuan University, Chengdu, Sichuan, China
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Hong MS, Park HS, Cho YS. Effects of a video education program for patients with benign uterine tumors receiving high-intensity focused ultrasound treatment. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2020; 26:151-160. [PMID: 36310579 PMCID: PMC9328596 DOI: 10.4069/kjwhn.2020.03.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/29/2020] [Accepted: 03/31/2020] [Indexed: 11/22/2022] Open
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Ream E, Hughes AE, Cox A, Skarparis K, Richardson A, Pedersen VH, Wiseman T, Forbes A, Bryant A. Telephone interventions for symptom management in adults with cancer. Cochrane Database Syst Rev 2020; 6:CD007568. [PMID: 32483832 PMCID: PMC7264015 DOI: 10.1002/14651858.cd007568.pub2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND People with cancer experience a variety of symptoms as a result of their disease and the therapies involved in its management. Inadequate symptom management has implications for patient outcomes including functioning, psychological well-being, and quality of life (QoL). Attempts to reduce the incidence and severity of cancer symptoms have involved the development and testing of psycho-educational interventions to enhance patients' symptom self-management. With the trend for care to be provided nearer patients' homes, telephone-delivered psycho-educational interventions have evolved to provide support for the management of a range of cancer symptoms. Early indications suggest that these can reduce symptom severity and distress through enhanced symptom self-management. OBJECTIVES To assess the effectiveness of telephone-delivered interventions for reducing symptoms associated with cancer and its treatment. To determine which symptoms are most responsive to telephone interventions. To determine whether certain configurations (e.g. with/without additional support such as face-to-face, printed or electronic resources) and duration/frequency of intervention calls mediate observed cancer symptom outcome effects. SEARCH METHODS We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 1); MEDLINE via OVID (1946 to January 2019); Embase via OVID (1980 to January 2019); (CINAHL) via Athens (1982 to January 2019); British Nursing Index (1984 to January 2019); and PsycINFO (1989 to January 2019). We searched conference proceedings to identify published abstracts, as well as SIGLE and trial registers for unpublished studies. We searched the reference lists of all included articles for additional relevant studies. Finally, we handsearched the following journals: Cancer, Journal of Clinical Oncology, Psycho-oncology, Cancer Practice, Cancer Nursing, Oncology Nursing Forum, Journal of Pain and Symptom Management, and Palliative Medicine. We restricted our search to publications published in English. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs that compared one or more telephone interventions with one other, or with other types of interventions (e.g. a face-to-face intervention) and/or usual care, with the stated aim of addressing any physical or psychological symptoms of cancer and its treatment, which recruited adults (over 18 years) with a clinical diagnosis of cancer, regardless of tumour type, stage of cancer, type of treatment, and time of recruitment (e.g. before, during, or after treatment). DATA COLLECTION AND ANALYSIS We used Cochrane methods for trial selection, data extraction and analysis. When possible, anxiety, depressive symptoms, fatigue, emotional distress, pain, uncertainty, sexually-related and lung cancer symptoms as well as secondary outcomes are reported as standardised mean differences (SMDs) with 95% confidence intervals (CIs), and we presented a descriptive synthesis of study findings. We reported on findings according to symptoms addressed and intervention types (e.g. telephone only, telephone combined with other elements). As many studies included small samples, and because baseline scores for study outcomes often varied for intervention and control groups, we used change scores and associated standard deviations. The certainty of the evidence for each outcome was interpreted using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS Thirty-two studies were eligible for inclusion; most had moderate risk of bias,often related to blinding. Collectively, researchers recruited 6250 people and studied interventions in people with a variety of cancer types and across the disease trajectory, although many participants had breast cancer or early-stage cancer and/or were starting treatment. Studies measured symptoms of anxiety, depression, emotional distress, uncertainty, fatigue, and pain, as well as sexually-related symptoms and general symptom intensity and/or distress. Interventions were primarily delivered by nurses (n = 24), most of whom (n = 16) had a background in oncology, research, or psychiatry. Ten interventions were delivered solely by telephone; the rest combined telephone with additional elements (i.e. face-to-face consultations and digital/online/printed resources). The number of calls delivered ranged from 1 to 18; most interventions provided three or four calls. Twenty-one studies provided evidence on effectiveness of telephone-delivered interventions and the majority appeared to reduce symptoms of depression compared to control. Nine studies contributed quantitative change scores (CSs) and associated standard deviation results (or these could be calculated). Likewise, many telephone interventions appeared effective when compared to control in reducing anxiety (16 studies; 5 contributed quantitative CS results); fatigue (9 studies; 6 contributed to quantitative CS results); and emotional distress (7 studies; 5 contributed quantitative CS results). Due to significant clinical heterogeneity with regards to interventions introduced, study participants recruited, and outcomes measured, meta-analysis was not conducted. For other symptoms (uncertainty, pain, sexually-related symptoms, dyspnoea, and general symptom experience), evidence was limited; similarly meta-analysis was not possible, and results from individual studies were largely conflicting, making conclusions about their management through telephone-delivered interventions difficult to draw. Heterogeneity was considerable across all trials for all outcomes. Overall, the certainty of evidence was very low for all outcomes in the review. Outcomes were all downgraded due to concerns about overall risk of bias profiles being frequently unclear, uncertainty in effect estimates and due to some inconsistencies in results and general heterogeneity. Unsubstantiated evidence suggests that telephone interventions in some capacity may have a place in symptom management for adults with cancer. However, in the absence of reliable and homogeneous evidence, caution is needed in interpreting the narrative synthesis. Further, there were no clear patterns across studies regarding which forms of interventions (telephone alone versus augmented with other elements) are most effective. It is impossible to conclude with any certainty which forms of telephone intervention are most effective in managing the range of cancer-related symptoms that people with cancer experience. AUTHORS' CONCLUSIONS Telephone interventions provide a convenient way of supporting self-management of cancer-related symptoms for adults with cancer. These interventions are becoming more important with the shift of care closer to patients' homes, the need for resource/cost containment, and the potential for voluntary sector providers to deliver healthcare interventions. Some evidence supports the use of telephone-delivered interventions for symptom management for adults with cancer; most evidence relates to four commonly experienced symptoms - depression, anxiety, emotional distress, and fatigue. Some telephone-delivered interventions were augmented by combining them with face-to-face meetings and provision of printed or digital materials. Review authors were unable to determine whether telephone alone or in combination with other elements provides optimal reduction in symptoms; it appears most likely that this will vary by symptom. It is noteworthy that, despite the potential for telephone interventions to deliver cost savings, none of the studies reviewed included any form of health economic evaluation. Further robust and adequately reported trials are needed across all cancer-related symptoms, as the certainty of evidence generated in studies within this review was very low, and reporting was of variable quality. Researchers must strive to reduce variability between studies in the future. Studies in this review are characterised by clinical and methodological diversity; the level of this diversity hindered comparison across studies. At the very least, efforts should be made to standardise outcome measures. Finally, studies were compromised by inclusion of small samples, inadequate concealment of group allocation, lack of observer blinding, and short length of follow-up. Consequently, conclusions related to symptoms most amenable to management by telephone-delivered interventions are tentative.
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Affiliation(s)
- Emma Ream
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Anna Cox
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Katy Skarparis
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle, UK
| | - Alison Richardson
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Vibe H Pedersen
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
| | - Theresa Wiseman
- Health Services Research, The Royal Marsden NHS Foundation Trust, London, UK
| | - Angus Forbes
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
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Abstract
Patients with frailty experience substantial physical and emotional distress related to their condition and face increased morbidity and mortality compared with their nonfrail peers. Palliative care is an interdisciplinary medical specialty focused on improving quality of life for patients with serious illness, including those with frailty, throughout their disease course. Anesthesiology providers will frequently encounter frail patients in the perioperative period and in the intensive care unit (ICU) and can contribute to improving the quality of life for these patients through the provision of palliative care. We highlight the opportunities to incorporate primary palliative care, including basic symptom management and straightforward goals-of-care discussions, provided by the primary clinicians, and when necessary, timely consultation by a specialty palliative care team to assist with complex symptom management and goals-of-care discussions in the face of team and/or family conflict. In this review, we apply the principles of palliative care to patients with frailty and synthesize the evidence regarding methods to integrate palliative care into the perioperative and ICU settings.
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Affiliation(s)
- Rita C. Crooms
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Laura P. Gelfman
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
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19
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Chow KM, Chan CWH, Choi KC, Siu KY, Fung HKS, Sum WM. A theory-driven psycho-educational intervention programme for gynaecological cancer patients during treatment trajectory: A randomised controlled trial. Psychooncology 2019; 29:437-443. [PMID: 31705591 DOI: 10.1002/pon.5284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/28/2019] [Accepted: 11/04/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aims to evaluate the effects of a theory-driven psycho-educational intervention programme on uncertainty in illness, anxiety, and sexual functioning in a cohort of Chinese patients with gynaecological cancer. METHODS Women with newly diagnosed gynaecological cancer (n = 202) received either a four-session, 12-week-long, culturally appropriate psycho-educational intervention programme (n = 102) or attention from intervener (n = 100) in a two-group randomised controlled trial. Patient-reported measures included Chinese version of Mishel's Uncertainty in Illness Scale (C-MUIS), Hospital Anxiety and Depression Scale (HADS)-Anxiety subscale, and Sexual Function-Vaginal Changes Questionnaire (SVQ). Data regarding uncertainty in illness and anxiety were collected at baseline and postintervention, while data on sexual functioning were collected postintervention. RESULTS Patients receiving psycho-educational intervention reported significantly greater reductions in ambiguity, inconsistency, and overall uncertainty in illness, as measured by C-MUIS (P < .01). They were also more likely to be sexually active (P = .037), report their partners having greater sexual interest (P = .008), and perceive a significantly greater level of intimacy (P = .001) in the SVQ. CONCLUSIONS Given the growing population of gynaecological cancer survivors and the universal side effects of the disease and its related treatments, the established design and content of the psycho-educational intervention programme should be incorporated into routine clinical practice.
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Affiliation(s)
- Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Carmen W H Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Ka Yi Siu
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hospital Authority, Hong Kong
| | - Hedy K S Fung
- Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hospital Authority, Hong Kong
| | - Wai Man Sum
- Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hospital Authority, Hong Kong
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Amo-Setién FJ, Abajas-Bustillo R, Torres-Manrique B, Martín-Melón R, Sarabia-Cobo C, Molina-Mula J, Ortego-Mate C. Characteristics of nursing interventions that improve the quality of life of people with chronic diseases. A systematic review with meta-analysis. PLoS One 2019; 14:e0218903. [PMID: 31233569 PMCID: PMC6590814 DOI: 10.1371/journal.pone.0218903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/11/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The objective of this systematic review was to determine the characteristics of the interventions conducted by nurses that attempt to improve the health related quality of life (HRQoL) of people over 18 years of age with chronic diseases. METHODS This systematic review with meta-analysis summarizes 24 studies, conducted in 10 countries, that evaluated HRQoL through the Short-Form Health Survey (SF). Five databases were accessed to find the available studies from December 31st, 2000 to May 22sd, 2017. Selected studies were coded according to the characteristics of the sample and the intervention. A model of random effects was adopted for the overall estimation and to explain the heterogeneity. RESULTS Twenty-four studies were included in the systematic review and meta-analysis providing a sample of 4324 chronic patients aged 63.4 years. Among the 8 subscales and two summary measures that comprise the SF-36, only an overall significant effect size (ES) index was found in the Mental Health Component summary score (ES = 0.14; 95% CI:0.03 - 0.26; I2 = 44.6, p = 0.042) and the Mental Health subscale. This improvement on HRQoL was associated to interventions on "Case Management" and "Treatments and Procedures", which were based on a theory, were of shorter duration, and had a follow-up period. CONCLUSIONS Interventions targeting people with chronic diseases resulted in a slight increase in the HRQoL that was not always significant, which suggests that there is a need for their continuous improvement.
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Affiliation(s)
| | | | | | | | - Carmen Sarabia-Cobo
- Faculty of Nursing, University of Cantabria, IDIVAL Nursing Group, Santander, Spain
| | - Jesús Molina-Mula
- Nursing and Physiotherapy Department, University of Illes Balears, Palma, Spain
| | - Carmen Ortego-Mate
- Faculty of Nursing, University of Cantabria, IDIVAL Nursing Group, Santander, Spain
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21
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Amo-Setién FJ, Abajas-Bustillo R, Torres-Manrique B, Martín-Melón R, Sarabia-Cobo C, Molina-Mula J, Ortego-Mate C. Characteristics of nursing interventions that improve the quality of life of people with chronic diseases. A systematic review with meta-analysis. PLoS One 2019. [DOI: https://doi.org/10.1371/journal.pone.0218903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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23
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Monterosso L, Platt V, Bulsara M, Berg M. Systematic review and meta-analysis of patient reported outcomes for nurse-led models of survivorship care for adult cancer patients. Cancer Treat Rev 2019; 73:62-72. [DOI: 10.1016/j.ctrv.2018.12.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 12/21/2018] [Accepted: 12/31/2018] [Indexed: 11/26/2022]
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Budhwani S, Wodchis WP, Zimmermann C, Moineddin R, Howell D. Self-management, self-management support needs and interventions in advanced cancer: a scoping review. BMJ Support Palliat Care 2018; 9:12-25. [PMID: 30121581 DOI: 10.1136/bmjspcare-2018-001529] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/29/2018] [Accepted: 07/11/2018] [Indexed: 12/25/2022]
Abstract
Patients with advanced cancer can experience illness trajectories similar to other progressive chronic disease conditions where undertaking self-management (SM) and provision of self-management support (SMS) becomes important. The main objectives of this study were to map the literature of SM strategies and SMS needs of patients with advanced cancer and to describe SMS interventions tested in this patient population. A scoping review of all literature published between 2002 and 2016 was conducted. A total of 11 094 articles were generated for screening from MEDLINE, Embase, PsychINFO, CINAHL and Cochrane Library databases. A final 55 articles were extracted for inclusion in the review. Included studies identified a wide variety of SM behaviours used by patients with advanced cancer including controlling and coping with the physical components of the disease and facilitating emotional and psychosocial adjustments to a life-limiting illness. Studies also described a wide range of SMS needs, SMS interventions and their effectiveness in this patient population. Findings suggest that SMS interventions addressing SMS needs should be based on a sound understanding of the core skills required for effective SM and theoretical and conceptual frameworks. Future research should examine how a patient-oriented SMS approach can be incorporated into existing models of care delivery and the effects of SMS on quality of life and health system utilisation in this population.
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Affiliation(s)
- Suman Budhwani
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada.,Health System Performance Research Network, University of Toronto, Toronto, ON, Canada
| | - Walter P Wodchis
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada.,Health System Performance Research Network, University of Toronto, Toronto, ON, Canada
| | - Camilla Zimmermann
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Doris Howell
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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Fisher AV, Campbell-Flohr SA, Sell L, Osterhaus E, Acher AW, Leahy-Gross K, Brenny-Fitzpatrick M, Kind AJH, Carayon P, Abbott DE, Winslow ER, Greenberg CC, Fernandes-Taylor S, Weber SM. Adaptation and Implementation of a Transitional Care Protocol for Patients Undergoing Complex Abdominal Surgery. Jt Comm J Qual Patient Saf 2018; 44:741-750. [PMID: 30097384 DOI: 10.1016/j.jcjq.2018.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Transitional care protocols are effective at reducing readmission for medical patients, yet no evidence-based protocols exist for surgical patients. A transitional care protocol was adapted to meet the needs of patients discharged to home after major abdominal surgery. APPROACH The Coordinated-Transitional Care (C-TraC) protocol, initially designed for medical patients, was used as the initial framework for the development of a surgery-specific protocol (sC-TraC). Adaptation was accomplished using a modification of the Replicating Effective Programs (REP) model, which has four phases: (1) preconditions, (2) preimplementation, (3) implementation, and (4) maintenance and evolution. A random sample of five patients each month was selected to complete a phone survey regarding patient satisfaction. Preimplementation planning allowed for integration with current systems, avoided duplication of processes, and defined goals for the protocol. The adapted protocol specifically addressed surgical issues such as nutrition, fever, ostomy output, dehydration, drain character/output, and wound appearance. After protocol launch, the rapid iterative adaptation process led to changes in phone call timing, inclusion and exclusion criteria, and discharge instructions. OUTCOMES Survey responders reported 100% overall satisfaction with the transitional care program. KEY INSIGHTS The adaptable nature of sC-TraC may allow for low-resource hospitals, such as rural or inner-city medical centers, to use the methodology provided in this study for implementation of local phone-based transitional care protocols. In addition, as the C-TraC program has begun to disseminate nationally across US Department of Veterans Affairs (VA) hospitals and rural health settings, sC-TraC may be implemented using the existing transitional care infrastructure in place at these hospitals.
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Bail JR, Traeger L, Pirl WF, Bakitas MA. Psychological Symptoms in Advanced Cancer. Semin Oncol Nurs 2018; 34:241-251. [DOI: 10.1016/j.soncn.2018.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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28
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Ghodraty Jabloo V, Alibhai SMH, Fitch M, Tourangeau AE, Ayala AP, Puts MTE. Antecedents and Outcomes of Uncertainty in Older Adults With Cancer: A Scoping Review of the Literature. Oncol Nurs Forum 2018. [PMID: 28632247 DOI: 10.1188/17.onf.e152-e167] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Uncertainty is a major source of distress for cancer survivors. Because cancer is primarily a disease of older adults, a comprehensive understanding of the antecedents and outcomes of uncertainty in older adults with cancer is essential.
. LITERATURE SEARCH MEDLINE®, PsycINFO®, Scopus, and CINAHL® were searched from inception to December 2015. Medical Subject Headings (MeSH) terms and free text words were used for the search concepts, including neoplasms, uncertainty, and aging.
. DATA EVALUATION Extracted data included research aims; research design or analysis approach; sample size; mean age; type, stage, and duration of cancer; type and duration of treatment; uncertainty scale; and major results.
. SYNTHESIS Of 2,584 articles initially identified, 44 studies (30 qualitative, 12 quantitative, and 2 mixed-methods) were included. Evidence tables were developed to organize quantitative and qualitative data. Descriptive numeric and thematic analyses were used to analyze quantitative results and qualitative findings, respectively. Outcomes were reported under four main categories. CONCLUSIONS Uncertainty is an enduring and common experience in cancer survivorship. Uncertainty is affected by a number of demographic and clinical factors and affects quality of life (QOL) and psychological well-being.
. IMPLICATIONS FOR PRACTICE Uncertainty should be considered a contributing factor to psychological well-being and QOL in older adults with cancer. Nurses are in a unique position to assess negative effects of uncertainty and manage these consequences by providing patients with information and emotional support.
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XUE F, HUANG F. The Effect of Psychological Intervention on Nutrient Status of Perioperative Patients with Lung Cancer. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:531-537. [PMID: 29900137 PMCID: PMC5996330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND To investigate the effect of psychological intervention on nutrient status of perioperative patients with lung cancer. METHODS Overall, 176 lung cancer patients admitted to Shanghai Pulmonary Hospital, Shanghai China from 2015 to 2016 were divided into control group (n=88) and study group (n=88). Conventional nursing strategy was adopted for patients in control group, while psychological nursing strategy was implemented for those in the study group, and the specific nursing efficiency was compared between the two groups. In addition to the assessment with Symptom Checklist 90 (SCL-90) and Quality of Life Questionnaire-Core 36 (QLQ-C30), patients were required to fulfill the evaluations with nutrition risk screening 2002 (NRS2002) and Patient-Generated Subjective Global Assessment (PG-SGA). RESULTS After nursing care, significant amelioration in scores of SCL-90 and QLQ-C30 of patients were seen in the study group (P<0.05). In the study group, the scores of NRS2002 and PG-SGA were all lower than those in the control group (P<0.001). Besides, PG-SGA score was also significantly correlated with the levels of serum total proteins, serum albumin, hemoglobin, reduction in diet and weight (P<0.01), while only reduction in diet and weight was obviously correlated with the score of NRS2002 (P<0.01). Moreover, a significant correlation was identified between the scores of PG-SGA and NRS2002 (P<0.01). CONCLUSION Psychological intervention could effectively alleviate the psychological stress response and ameliorate the nutrient status of lung cancer patients in perioperative period, thereby reducing the negative feelings and increasing the life quality of patients.
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Kinner EM, Armer JS, McGregor BA, Duffecy J, Leighton S, Corden ME, Gauthier Mullady J, Penedo FJ, Lutgendorf SK. Internet-Based Group Intervention for Ovarian Cancer Survivors: Feasibility and Preliminary Results. JMIR Cancer 2018; 4:e1. [PMID: 29335233 PMCID: PMC5789163 DOI: 10.2196/cancer.8430] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/16/2017] [Accepted: 11/25/2017] [Indexed: 12/29/2022] Open
Abstract
Background Development of psychosocial group interventions for ovarian cancer survivors has been limited. Drawing from elements of cognitive-behavioral stress management (CBSM), mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT), we developed and conducted preliminary testing of an Internet-based group intervention tailored specifically to meet the needs of ovarian cancer survivors. The Internet-based platform facilitated home delivery of the psychosocial intervention to a group of cancer survivors for whom attending face-to-face programs could be difficult given their physical limitations and the small number of ovarian cancer survivors at any one treatment site. Objective The aim of this study was to develop, optimize, and assess the usability, acceptability, feasibility, and preliminary intended effects of an Internet-based group stress management intervention for ovarian cancer survivors delivered via a tablet or laptop. Methods In total, 9 ovarian cancer survivors provided feedback during usability testing. Subsequently, 19 survivors participated in 5 waves of field testing of the 10-week group intervention led by 2 psychologists. The group met weekly for 2 hours via an Internet-based videoconference platform. Structured interviews and weekly evaluations were used to elicit feedback on the website and intervention content. Before and after the intervention, measures of mood, quality of life (QOL), perceived stress, sleep, and social support were administered. Paired t tests were used to examine changes in psychosocial measures over time. Results Usability results indicated that participants (n=9) performed basic tablet functions quickly with no errors and performed website functions easily with a low frequency of errors. In the field trial (n=19), across 5 groups, the 10-week intervention was well attended. Perceived stress (P=.03) and ovarian cancer-specific QOL (P=.01) both improved significantly during the course of the intervention. Trends toward decreased distress (P=.18) and greater physical (P=.05) and functional well-being (P=.06) were also observed. Qualitative interviews revealed that the most common obstacles participants experienced were technical issues and the time commitment for practicing the techniques taught in the program. Participants reported that the intervention helped them to overcome a sense of isolation and that they appreciated the ability to participate at home. Conclusions An Internet-based group intervention tailored specifically for ovarian cancer survivors is highly usable and acceptable with moderate levels of feasibility. Preliminary psychosocial outcomes indicate decreases in perceived stress and improvements in ovarian cancer-specific QOL following the intervention. A randomized clinical trial is needed to demonstrate the efficacy of this promising intervention for ovarian cancer survivors.
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Affiliation(s)
- Ellen M Kinner
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Jessica S Armer
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States
| | | | - Jennifer Duffecy
- Department of Clinical Psychiatry and Center on Depression and Resilience, University of Illinois at Chicago, Chicago, IL, United States
| | - Susan Leighton
- Ovarian Cancer Research Fund Alliance, Washington, DC, United States
| | - Marya E Corden
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | | | - Frank J Penedo
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Susan K Lutgendorf
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, United States.,Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Iowa, Iowa City, IA, United States.,Department of Urology, University of Iowa, Iowa City, IA, United States.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States
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Abstract
OBJECTIVE To describe the existing science of palliative care in surgery within three priority areas and expose specific gaps within the field. BACKGROUND Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care. METHODS The National Institutes of Health and the National Palliative Care Research Center convened researchers from several medical subspecialties to develop a national agenda for palliative care research. The surgeon work group reviewed the existing surgical literature to identify critical knowledge gaps. RESULTS To date, evidence to support the role of palliative care in surgical practice is sparse and palliative care research in surgery is encumbered by methodological challenges and entrenched cultural norms that impede appropriate provision of palliative care. Priorities for future research on palliative care in surgery include: 1) measuring outcomes that matter to patients, 2) communication and decision making, and 3) delivery of palliative care to surgical patients. CONCLUSIONS Surgical patients would likely benefit from early palliative care delivered alongside surgical treatment to promote goal-concordant decision making and to improve patients' physical, emotional, social and spiritual well-being and quality of life. We propose a research agenda to address major gaps in the literature and provide a road map for future investigation.
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Kobleder A, Mayer H, Gehrig L, Senn B. “Promoting continuity of care”-Specialist nurses’ role experiences in gynaecological oncology: A qualitative study. J Clin Nurs 2017; 26:4890-4898. [DOI: 10.1111/jocn.13966] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Andrea Kobleder
- Institute of Applied Nursing Sciences IPW-FHS; FHS St. Gallen, University of Applied Sciences; St. Gallen Switzerland
- Department of Nursing Science; University of Vienna; Vienna Austria
| | - Hanna Mayer
- Department of Nursing Science; University of Vienna; Vienna Austria
| | | | - Beate Senn
- Institute of Applied Nursing Sciences IPW-FHS; FHS St. Gallen, University of Applied Sciences; St. Gallen Switzerland
- Sydney Nursing School; University of Sydney; Sydney NSW Australia
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Sandsund C, Towers R, Thomas K, Tigue R, Lalji A, Fernandes A, Doyle N, Jordan J, Gage H, Shaw C. Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods. BMJ Support Palliat Care 2017; 10:e16. [PMID: 28847853 PMCID: PMC7286034 DOI: 10.1136/bmjspcare-2016-001207] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 01/09/2017] [Accepted: 04/01/2017] [Indexed: 12/20/2022]
Abstract
Objectives Holistic needs assessment (HNA) and care planning are proposed to address unmet needs of people treated for cancer. We tested whether HNA and care planning by an allied health professional improved cancer-specific quality of life for women following curative treatment for stage I–III gynaecological cancer. Methods Consecutive women were invited to participate in a randomised controlled study (HNA and care planning vs usual care) at a UK cancer centre. Data were collected by questionnaire at baseline, 3 and 6 months. The outcomes were 6-month change in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (version 3), global score (primary) and, in EORTC subscales, generic quality of life and self-efficacy (secondary). The study was blinded for data management and analysis. Differences in outcomes were compared between groups. Health service utilisation and quality-adjusted life years (QALY) (from Short Form-6) were gathered for a cost-effectiveness analysis. Thematic analysis was used to interpret data from an exit interview. Results 150 women consented (75 per group); 10 undertook interviews. For 124 participants (61 intervention, 63 controls) with complete data, no statistically significant differences were seen between groups in the primary endpoint. The majority of those interviewed reported important personal gains they attributed to the intervention, which reflected trends to improvement seen in EORTC functional and symptom scales. Economic analysis suggests a 62% probability of cost-effectiveness at a £30 000/QALY threshold. Conclusion Care plan development with an allied health professional is cost-effective, acceptable and useful for some women treated for stage I–III gynaecological cancer. We recommend its introduction early in the pathway to support person-centred care.
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Affiliation(s)
- Catherine Sandsund
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Richard Towers
- Lead Nurse Counsellor, Psychological Support Services, The Royal Marsden NHS Foundation Trust, London, UK
| | - Karen Thomas
- Senior Statistician Research Data Management and Statistics Unit, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Ruth Tigue
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Amyn Lalji
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Andreia Fernandes
- Gynaeoncology Unit, Clinical Services Division, The Royal Marsden NHS Foundation Trust, London, UK
| | - Natalie Doyle
- Nurse Consultant in Living With and Beyond Cancer, The Royal Marsden NHS Foundation Trust, London, UK
| | - Jake Jordan
- Surrey Health Economics Centre, School of Economics, University of Surrey, Guildford, UK
| | - Heather Gage
- Surrey Health Economics Centre, School of Economics, University of Surrey, Guildford, UK
| | - Clare Shaw
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
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Raphaelis S, Kobleder A, Mayer H, Senn B. Effectiveness, structure, and content of nurse counseling in gynecologic oncology: a systematic review. BMC Nurs 2017; 16:43. [PMID: 28785169 PMCID: PMC5543445 DOI: 10.1186/s12912-017-0237-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/31/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Gynecological pre-cancer and gynecological cancers are considerable diseases in women throughout the world. The disease and treatment lead to numerous biopsychosocial issues. To improve the outcomes of affected women, several counseling interventions have been tested thus far in nursing research. These interventions target different endpoints and are composed of various structural and content components. The purpose of this research was to systematically review the effectiveness of nurse counseling on any patient outcomes tested so far in gynecologic oncology before, during and after treatment and to explore structure and content components. METHODS Experimental, quasi-experimental, and pre-experimental studies assessing the effectiveness of nurse counseling in women with gynecological neoplasia were searched for in PubMed®, CINAHL®, PsychINFO®, Cochrane®, and EMBASE®. Reference lists were hand-searched and relevant authors were contacted. Moreover, the evidence level and methodological quality of the included studies were assessed. Afterwards, the effect of nurse counseling on each identified patient outcome was narratively analyzed. To identify the structural and content components of the included interventions, a structured content analysis was performed. Finally, it was determined which components were associated with favorable outcomes within the included studies. RESULTS Seven experimental and three pre-experimental studies, reporting the effects of 11 interventions on a total of 588 participants, were eligible. No study investigated women with pre-cancer. Three studies had a high, five a moderate, and two a low methodological quality. Positive effects were found on quality of life, symptoms, and healthcare utilization. Eight structural components and four content components composed of various sub-components were identified and linked to specific effects. CONCLUSIONS The current evidence base is fragmented and inconsistent. More well-designed, large-scale studies including women with pre-cancer are warranted. Most convincing evidence indicates that nurse counseling can improve symptom distress. Components associated with the most trustworthy effects include nurses with an academic education; repeated and individual consultations during and after active treatment; structured, tailored, interdisciplinary orientated, and theoretically based counseling concepts; specific materials; comprehensive symptom management; and utilization of healthcare services. Healthcare providers and researchers can use the findings of this review for the systematic development of nurse counseling in gynecologic oncology.
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Affiliation(s)
- Silvia Raphaelis
- Department of Nursing Science, University of Vienna, Alser Strasse 23, 1080 Vienna, Austria
| | - Andrea Kobleder
- Institute for Applied Nursing Sciences IPW-FHS, University of Applied Sciences FHS St. Gallen, Rosenbergstrasse 59, 9001 St. Gallen, Switzerland
| | - Hanna Mayer
- Department of Nursing Science, University of Vienna, Alser Strasse 23, 1080 Vienna, Austria
| | - Beate Senn
- Institute for Applied Nursing Sciences IPW-FHS, University of Applied Sciences FHS St. Gallen, Rosenbergstrasse 59, 9001 St. Gallen, Switzerland
- Sydney Nursing School, The University of Sydney, Mallett Street 88, Camperdown, NSW 2050 Australia
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Hagell P, Westergren A, Årestedt K. Beware of the origin of numbers: Standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations. Res Nurs Health 2017; 40:378-386. [DOI: 10.1002/nur.21806] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/16/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Hagell
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Albert Westergren
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences; Department of Research; Linnaeus University; Kalmar County Hospital; Kalmar Sweden
- Department of Medical and Health Sciences; Linköping University; Linköping Sweden
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Kyriacou J, Black A, Drummond N, Power J, Maheu C. Peur de la récidive: Étude de l’expérience vécue par les survivantes du cancer des ovaires. Can Oncol Nurs J 2017; 27:243-250. [PMID: 31148805 PMCID: PMC6516391 DOI: 10.5737/23688076273243250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectif L’objectif de la présente étude est de mieux comprendre la peur de la récidive à la lumière de l’expérience vécue par des survivantes du cancer des ovaires et des trompes de Fallope. Méthodologie L’étude fait appel à un devis descriptif qualitatif. Douze participantes en rémission d’un cancer des ovaires ou des trompes de Fallope ont été recrutées. Les chercheuses ont d’abord procédé à des entrevues semi-structurées en personne puis analysé le contenu et les retranscriptions textuelles des entretiens. Résultats La peur de la récidive est une préoccupation non négligeable chez les femmes en rémission d’un cancer des ovaires. Quatre thèmes ressortent de l’expérience vécue par les participantes à cet égard: a) incertitude entourant la récidive; b) croyances et sources d’inquiétude variées; c) risque de récidive perçu; d) gestion de la peur de la récidive. Implications Les infirmières peuvent optimiser le soutien apporté aux survivantes en restant à l’affût de cette peur de la récidive, en offrant de l’aide psychosociale aux femmes risquant de vivre cette peur, ainsi qu’en enseignant et en renforçant les stratégies d’adaptation.
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Affiliation(s)
- Jamie Kyriacou
- École des sciences infirmières Ingram, Université McGill, Montréal, QC
| | - Alexandra Black
- École des sciences infirmières Ingram, Université McGill, Montréal, QC
| | - Nancy Drummond
- Infirmière clinicienne spécialisée, oncologie gynécologique, Hôpital général juif - SMBD, Montréal, QC
| | - Joanne Power
- Infirmière clinicienne spécialisée, oncologie gynécologique | Centre universitaire de santé McGil, Montréal, QC
| | - Christine Maheu
- Professeure agrégée, École des sciences infirmières Ingram, Université McGill, Montréal, QC
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Kyriacou J, Black A, Drummond N, Power J, Maheu C. Fear of cancer recurrence: A study of the experience of survivors of ovarian cancer. Can Oncol Nurs J 2017; 27:236-242. [PMID: 31148762 PMCID: PMC6516398 DOI: 10.5737/23688076273236242] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE The purpose of this study is to better understand fear of cancer (FCR) through the experience of ovarian and fallopian tube cancer survivors. METHODS This study used a descriptive qualitative design. Twelve participants in remission from ovarian or fallopian tube cancer were recruited. Researchers conducted face-to-face, semi-structured interviews and the content, transcribed verbatim, underwent content analysis. RESULTS FCR has been identified as a significant concern for women in remission from ovarian cancer. Four themes emerged from the participants' FCR experience: (a) uncertainty surrounding recurrence; (b) varied beliefs and sources of worry; (c) perceived risk of recurrence; (d) management of FCR. IMPLICATIONS Survivorship support can be optimized by nurses by screening for FCR, offering psychosocial support for women at risk for FCR, teaching and reinforcing adaptive coping strategies.
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Affiliation(s)
- Jamie Kyriacou
- Ingram School of Nursing, McGill University. Montréal, QC,
| | | | - Nancy Drummond
- Clinical Nurse Specialist, Gynecologic Oncology, SMBD Jewish General Hospital, Montréal, QC,
| | - Joanne Power
- Clinical Nurse Specialist, Gynecologic Oncology, McGill University Health Centre, Montréal, QC,
| | - Christine Maheu
- Associate Professor, Ingram School of Nursing, McGill University, Montréal, QC,
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Abstract
BACKGROUND The 13-item Symptom Distress Scale (SDS) is a widely used symptom measurement tool, yet a systematic review summarizing the symptom knowledge generated from its use in patients with advanced cancer is nonexistent. OBJECTIVES This was a systematic review of the research literature in which investigators utilized the SDS as the measure of symptoms in patients with advanced cancer. METHODS We searched PubMed, CINAHL, EMBASE, and Web of Science for primary research studies published between 1978 and 2013 that utilized the SDS as the measurement tool in patients with advanced cancer. Nine hundred eighteen documents were found. Applying inclusion/exclusion criteria, 21 articles and 2 dissertations were included. RESULTS The majority of investigators utilized descriptive, cross-sectional research designs conducted with convenience samples. Inconsistent reporting of SDS total scores, individual item scores, age ranges and means, gender distributions, cancer types, cancer stages, and psychometric properties made comparisons difficult. Available mean SDS scores ranged from 17.6 to 38.8. Reports of internal consistency ranged from 0.67 to 0.88. Weighted means indicated fatigue to be the most prevalent and distressing symptom. Appetite ranked higher than pain intensity and pain frequency. CONCLUSIONS The SDS captures the patient's symptom experience in a manner that informs the researcher or clinician about the severity of the respondents' reported symptom distress. IMPLICATIONS FOR PRACTICE The SDS is widely used in a variety of cancer diagnoses. The SDS is a tool clinicians can use to assess 11 symptoms experienced by patients with advanced cancer.
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Lai XB, Ching SSY, Wong FKY. A qualitative exploration of the experiences of patients with breast cancer receiving outpatient-based chemotherapy. J Adv Nurs 2017; 73:2339-2350. [DOI: 10.1111/jan.13309] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Xiao Bin Lai
- School of Nursing; Fudan University; Shanghai China
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Raphaelis S, Mayer H, Ott S, Mueller MD, Steiner E, Joura E, Senn B. The impact of written information and counseling (WOMAN-PRO II Program) on symptom outcomes in women with vulvar neoplasia: A multicenter randomized controlled phase II study. Gynecol Oncol 2017; 146:114-122. [PMID: 28483270 DOI: 10.1016/j.ygyno.2017.04.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 04/28/2017] [Accepted: 04/30/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine whether written information and/or counseling based on the WOMAN-PRO II Program decreases symptom prevalence in women with vulvar neoplasia by a clinically relevant degree, and to explore the differences between the 2 interventions in symptom prevalence, symptom distress prevalence, and symptom experience. METHODS A multicenter randomized controlled parallel-group phase II trial with 2 interventions provided to patients after the initial diagnosis was performed in Austria and Switzerland. Women randomized to written information received a predefined set of leaflets concerning wound care and available healthcare services. Women allocated to counseling were additionally provided with 5 consultations by an Advanced Practice Nurse (APN) between the initial diagnosis and 6months post-surgery that focused on symptom management, utilization of healthcare services, and health-related decision-making. Symptom outcomes were simultaneously measured 5 times to the counseling time points. RESULTS A total of 49 women with vulvar neoplasia participated in the study. Symptom prevalence decreased in women with counseling by a clinically relevant degree, but not in women with written information. Sporadically, significant differences between the 2 interventions could be observed in individual items, but not in the total scales or subscales of the symptom outcomes. CONCLUSIONS The results indicate that counseling may reduce symptom prevalence in women with vulvar neoplasia by a clinically relevant extent. The observed group differences between the 2 interventions slightly favor counseling over written information. The results justify testing the benefit of counseling thoroughly in a comparative phase III trial.
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Affiliation(s)
- Silvia Raphaelis
- Department of Nursing Science, University of Vienna, Alser Strasse 23, 1080 Vienna, Austria.
| | - Hanna Mayer
- Department of Nursing Science, University of Vienna, Alser Strasse 23, 1080 Vienna, Austria
| | - Stefan Ott
- Lecturer for Business Mathematics and Statistics, University of Applied Sciences FHS St. Gallen, Rosenbergstrasse 59, 9001 St. Gallen, Switzerland
| | - Michael D Mueller
- Department of Obstetrics and Gynecology, Inselspital, University Hospital Bern, Effingerstrasse 102, 3010 Berne, Switzerland
| | - Enikö Steiner
- Department of Obstetrics and Gynecology, Vienna General University Hospital, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Elmar Joura
- Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Beate Senn
- Institute for Applied Nursing Sciences IPW-FHS, University of Applied Sciences FHS St. Gallen, Rosenbergstrasse 59, 9001 St. Gallen, Switzerland; Sydney Nursing School, The University of Sydney, Mallett Street 88, 2050 Camperdown, NSW, Australia
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Lai XB, Ching SSY, Wong FKY. Nurse-led cancer care: A scope review of the past years (2003-2016). Int J Nurs Sci 2017; 4:184-195. [PMID: 31406741 PMCID: PMC6626125 DOI: 10.1016/j.ijnss.2017.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/23/2017] [Accepted: 02/21/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Xiao Bin Lai
- School of Nursing, Fudan University, Shanghai, China
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Lilley EJ, Cooper Z, Schwarze ML, Mosenthal AC. Palliative Care in Surgery: Defining the Research Priorities. J Palliat Med 2017; 20:702-709. [PMID: 28339313 DOI: 10.1089/jpm.2017.0079] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet, these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care. Surgical patients would likely benefit from early palliative care delivered alongside surgical treatment to promote goal-concordant decision making and to improve patients' physical, emotional, social, and spiritual well-being and quality of life. To date, evidence to support the role of palliative care in surgical practice is sparse and palliative care research in surgery is encumbered by methodological challenges and entrenched cultural norms that impede appropriate provision of palliative care. The objective of this article was to describe the existing science of palliative care in surgery within three priority areas and expose specific gaps within the field. We propose a research agenda to address these gaps and provide a road map for future investigation.
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Affiliation(s)
- Elizabeth J Lilley
- 1 The Center for Surgery and Public Health at Brigham and Women's Hospital , Boston, Massachusetts
| | - Zara Cooper
- 1 The Center for Surgery and Public Health at Brigham and Women's Hospital , Boston, Massachusetts.,2 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts
| | - Margaret L Schwarze
- 3 Department of Surgery, University of Wisconsin , Madison, Wisconsin.,4 Department of Medical History and Bioethics, University of Wisconsin , Madison, Wisconsin
| | - Anne C Mosenthal
- 5 Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
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Sipples R, Taylor R, Kirk-Walker D, Bagcivan G, Dionne-Odom JN, Bakitas M. Perioperative Palliative Care Considerations for Surgical Oncology Nurses. Semin Oncol Nurs 2017; 33:9-22. [DOI: 10.1016/j.soncn.2016.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
OBJECTIVES To describe psychosocial concerns associated with the postoperative cancer patient and to discuss current psychosocial evidence-based approaches to manage these psychosocial concerns. DATA SOURCES Published peer-reviewed literature. CONCLUSION The postoperative phase of cancer care may be associated with a range of overlapping acute and chronic psychosocial concerns related to the surgery itself, the cancer diagnosis, and the need for ongoing cancer treatments. The postoperative period of cancer care represents an essential time to detect unmet psychosocial concerns and begin timely interventions for these concerns. IMPLICATIONS FOR NURSING PRACTICE Nurses are in a key position to detect, triage, refer, or manage psychosocial concerns in the postoperative patient with cancer. Current psychosocial evidence-based approaches may be used by surgical oncology nurses or other nurses who care for cancer patients during postoperative recovery.
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Self-management education interventions for patients with cancer: a systematic review. Support Care Cancer 2017; 25:1323-1355. [PMID: 28058570 DOI: 10.1007/s00520-016-3500-z] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 11/14/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE This systematic review was intended to identify the effectiveness and inclusion of essential components of self-management education interventions to support patients with cancer in developing the skills needed for effective self-management of their disease and the acute or immediate, long-term, and late harmful effects of treatments. METHODS Self-management education interventions were included if they were randomized controlled trials (RCTs) containing at least one of the eight core elements outlined by the research team. A systematic search was conducted in Ovid MEDLINE (2005 through April 2015), Embase (2005 to 2015, week 15), the Cochrane Database of Systematic Reviews (Issue 4, April 2015), CINAHL (2005 to 2015) and PsychINFO (2005 to 2015). Keywords searched include 'self-management patient education' or 'patient education'. RESULTS Forty-two RCTs examining self-management education interventions for patients with cancer were identified. Heterogeneity of interventions precluded meta-analysis, but narrative qualitative synthesis suggested that self-management education interventions improve symptoms of fatigue, pain, depression, anxiety, emotional distress and quality of life. Results for specific combinations of core elements were inconclusive. Very few studies used the same combinations of core elements, and among those that did, results were conflicting. Thus, conclusions as to the components or elements of self-management education interventions associated with the strength of the effects could not be assessed by this review. CONCLUSION Defining the core components of cancer self-management education and the fundamental elements for inclusion in supporting effective self-management will be critical to ensure consistent and effective provision of self-management support in the cancer system.
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Lanceley A, Berzuini C, Burnell M, Gessler S, Morris S, Ryan A, Ledermann JA, Jacobs I. Ovarian Cancer Follow-up: A Preliminary Comparison of 2 Approaches. Int J Gynecol Cancer 2017; 27:59-68. [PMID: 28002208 DOI: 10.1097/igc.0000000000000877] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of the study was to perform a preliminary comparison of quality of life (QoL) and patient satisfaction in individualized nurse-led follow-up versus conventional medical follow-up in ovarian cancer. METHODS One hundred twelve women who received a diagnosis of ovarian, fallopian tube, or peritoneal cancer, completed primary treatment by surgery alone or with chemotherapy, irrespective of outcome with regard to remission, and expected survival of more than 3 months. Fifty-seven participants were randomized to individualized follow-up and 55 patients to conventional follow-up. Well-being was measured at baseline and at 3, 6, 12, and 24 months after randomization for QoL (QLQ-C30 [European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire], QLQ-Ov28), the Hospital Anxiety and Depression Scale (HADS), and a Patient Satisfaction Questionnaire (PSQ-III). The primary endpoints were the effects of follow-up on each of the scores (via hierarchical mixed-effects model) and on relapse-free time (via Cox model). The total cost of follow-up was compared between each group. RESULTS There was evidence for a QoL and patient satisfaction benefit for individualized versus standard follow-up (QLQ-C30, P = 0.013; 95% confidence interval, -0.03 to -0.001; PSQ-III P = 0.002; 95% confidence interval, -0.003 to -0.015; QLQ-Ov28, P = 0.14). Hospital Anxiety and Depression Scale data provided no evidence in favor of either treatment (P = 0.42). Delivered to protocol individualized follow-up resulted in a delay in the presentation of symptomatic relapse (P = 0.04), although the effect on survival in this study is unknown. Cost was £700 lower on average for the individualized follow-up group, but the difference was not statistically significant at the 5% level (P = 0.07). CONCLUSIONS Individualized follow-up was superior to conventional follow-up in 3 of the 4 QoL and patient satisfaction surveys in this preliminary study. Further prospective studies are needed in a larger population.Trial registration number is ISRCTN59149551.
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Affiliation(s)
- Anne Lanceley
- *Department of Women's Cancer, The UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London; †Centre for Biostatistics, The University of Manchester, Manchester; ‡University College London Hospitals (UCLH) Gynaecological Cancer Centre; §Department of Applied Health Research, University College London; ‖Cancer Research UK and UCL Cancer Trials Centre, University College London, London, United Kingdom; and ¶University of New South Wales, Sydney, New South Wales, Australia
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Development and Assessment of the Feasibility of a Nurse-Led Care Program for Cancer Patients in a Chemotherapy Day Center: Results of the Pilot Study. Cancer Nurs 2016; 38:E1-12. [PMID: 25254408 DOI: 10.1097/ncc.0000000000000192] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The increasing number of cancer patients and inadequate communication in clinics are posing challenges to cancer patients receiving outpatient-based chemotherapy and healthcare providers. A nurse-led care program was proposed as one way of dealing with at least some of these challenges. OBJECTIVE The objectives of the pilot study were to assess the feasibility of the subject recruitment, care, and data collection procedures and to explore the acceptability of this program. METHODS A pilot study with a 1-group pretest-posttest design was conducted. Five cancer patients receiving chemotherapy in a chemotherapy day center participated. Each patient had a nurse consultation before chemotherapy and received 2 telephone calls after the first and second cycles of chemotherapy. Four questionnaires were adopted to evaluate the subjects' quality of life, self-efficacy, symptom experiences, and satisfaction with care. Questionnaires were completed before the chemotherapy and after the second cycle. The subjects were also interviewed to understand their comments on the service. RESULTS The recruitment, care, and data collection procedures were completed smoothly. Slight changes were observed in quality of life and self-efficacy. All 5 subjects were highly satisfied with the care. CONCLUSIONS The nurse-led care program is feasible and acceptable. IMPLICATIONS FOR PRACTICE The effect of the nurse-led care program will be evaluated in a single-center, open, randomized controlled trial. If the encouraging results can be confirmed, it may be an effective approach to improving the quality of ambulatory chemotherapy care. It would also shed light on the development of nurse-led care in other areas.
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Abstract
BACKGROUND The investigation of the real density of care by a consultation-liaison service (CLS) as a function of patient groups, settings and diagnoses makes sense with respect to a better allocation of resources. OBJECTIVE Are there differences concerning the density of care by a CLS in a general hospital depending on patient groups and on the psychiatric diagnosis? METHOD A retrospective (2012-2015) survey of all consultations (n = 7081 corresponding to 4080 patients) was carried out based on the CLS documentation for quality assurance. Bivariate tests (i.e. χ2-test and ANOVA) and multivariate linear and logistic models were used to investigate group differences and associations. RESULTS The number of consultations achieved corresponded to 3.2 % of the total admissions to hospital, especially internal medicine (22.3 %), surgery (26.1 %) as well as gynecology and obstetrics (21.1 %). A suicide attempt was the reason for treatment in 3.3 %. Each patient received on average 1.7 consultations lasting 75 min but only 25 % received 2 or more consultations. Patients with psychiatric comorbidities, non-oncology patients as well as female and young patients received a more intensive care by CLS. Patients with depressive and somatoform disorders received a higher density of treatment. DISCUSSION The psychotherapeutic interventions performed did not follow the expected diagnostic patterns in other settings. Systemic interventions with indirect treatment should be given priority in older patients and especially in patients with organic mental disorders.
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Lindsey S, Astroth K, Kumar P. Improving Awareness, Identification, and Management of Sarcopenic Obesity in Cancer Survivors: An Evidence-Based Toolbox. Clin J Oncol Nurs 2016; 20:E132-8. [PMID: 27668384 DOI: 10.1188/16.cjon.e132-e138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sarcopenic obesity, the dual condition of decreased muscle mass with increased fat mass, can affect morbidity, mortality, and quality of life in adult cancer survivors. OBJECTIVES The purpose of this project was to determine the effects of the use of an educational toolbox on advanced practice nurses' (APNs') confidence in identifying and managing adult cancer survivors at risk for sarcopenic obesity. METHODS APNs in an outpatient practice who care for adult cancer survivors received an educational toolbox with strategies to identify and manage adult cancer survivors at risk for sarcopenic obesity. FINDINGS APNs reported being more confident in their ability to identify adult patients with cancer at risk for sarcopenic obesity and in their ability to manage these patients compared to prior to the intervention. Educational resources provided an effective tool for identifying and managing patients at risk for sarcopenic obesity.
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Fung YL, Chan ZCY, Chien WT. We are different: the voices of psychiatric advanced practice nurses on the performance of their roles. Contemp Nurse 2016; 52:13-29. [PMID: 27241032 DOI: 10.1080/10376178.2016.1194724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Many studies have affirmed that psychiatric advanced practice nurses (APNs) perform multifaceted roles. However, only a limited amount of research has been conducted on their perceptions of the performance of their roles. AIM To explore the lived experiences of psychiatric APNs concerning the performance of their roles. DESIGN Data were collected from individual semi-structured interviews and analysed using the interpretative phenomenological analysis method. METHODS The study was conducted in a hospital cluster in Hong Kong. Thirteen psychiatric APNs were purposively recruited. RESULTS Three themes were discerned, namely, 'We are different', 'Who am I?', and 'I am who I am'. CONCLUSIONS The findings can help psychiatric APNs and nurse administrators to better understand the needs of the role-bearers (APNs) and to develop strategies to support the development of advanced psychiatric nursing practices in Hong Kong and worldwide.
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Affiliation(s)
- Yuen-Ling Fung
- a Department of Child and Adolescent Psychiatry , Castle Peak Hospital , 15 Tsing Chung Koon Road, Tuen Mun , New Territories , Hong Kong
| | - Zenobia C Y Chan
- b School of Nursing , The Hong Kong Polytechnic University , Hung Hom, Kowloon , Hong Kong
| | - Wai-Tong Chien
- b School of Nursing , The Hong Kong Polytechnic University , Hung Hom, Kowloon , Hong Kong
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