Rehabilitation Needs in Cancer Treatment-Related Cardiotoxicity

Psychometric Properties of the Turkish CardioToxicity Management Self-Efficacy Scale for Nurses

OBJECTIVES

This study was conducted to evaluate the validity and reliability of the CardioToxicity Management Self-Efficacy Scale (NSS-CTC) in Turkey.

METHOD

This methodological and descriptive study was undertaken with 204 oncology nurses. Information was gathered using a descriptive questionnaire and the NSS-CTC instrument. In the validity analysis of the scale, explanatory factor analysis and confirmatory factor analysis were used. In the reliability analysis, Cronbach α coefficient and Pearson correlation analysis were used to examine item-total score correlations, and Student t-test was used for test-retest analysis.

RESULTS

The scale, characterized by a two-dimensional structure confirmed through factor analysis, exhibited an explained variance rate of 60.44%. The factor loadings exceeded the threshold of 0.30, and all fitness indices surpassed the criterion of 0.90. Furthermore, the root-mean-square error of approximation (RMSEA) fell below 0.080 and demonstrated statistical significance. The scale demonstrated strong internal consistency, as indicated by the overall Cronbach α coefficient of 0.930, with its subdimensions exhibiting similarly high reliability, reflected in Cronbach α values of 0.871 and 0.912, respectively.

CONCLUSION

The NSS-CTS is a valid and reliable tool specifically developed for evaluating nurses' self-efficacy in the context of oncology wards, particularly in managing cardiotoxicity resulting from cancer treatments.

IMPLICATIONS FOR NURSING PRACTICE

This newly developed scale holds significant promise in gauging nurses' confidence levels when confronted with the intricacies of cardiotoxicity management. It responds to the growing imperative for nurses to continually enhance their knowledge and skills to effectively address the evolving challenges associated with cardiotoxicity in cancer care.

Personalizing Heart Failure Care to the Patient With Cancer

PURPOSE OF REVIEW

The current review describes the role of the cardio-oncology nurse and the need for personalized heart failure care for the patient with cancer.

RECENT FINDINGS

It is a new role whereby cardiology or heart failure nurses care for patients with cancer who develop cardiotoxicity or cardiovascular diseases, either during the cancer therapy or in a later stage. Inter-disciplinary approach is important for individualized early treatment, shortened interruptions to cancer therapy, and irreversible cardiovascular injury prevention. Nurses have a key role in early evaluation and quality control of the care provided. This is a quite new clinical area and not much evidence exists for the development of clinical guidelines and pathways to support clinicians. More trials are needed for the development of clinical recommendations.

A Cardiac Rehabilitation Program for Breast Cancer Survivors: A Feasibility Study

Purpose

The purpose of this study was to determine the feasibility and preliminary efficacy of a cardiac rehabilitation (CR) intervention in the breast cancer population.

Methods

This single-arm feasibility study evaluated a 14-week CR intervention program in breast cancer survivors. Feasibility was defined as completion of at least 30/36 sessions of the program without serious adverse events (SAE) in 80% of patients. Secondary endpoints included the change in VO2 max, cardiovascular disease (CVD) risk factors, Duke Activity Secondary Index (DASI), Brief Fatigue Inventory (BFI), and QLQ-C30. All outcomes were reported as mean change and compared using paired t-tests.

Results

A total of 25 patients were enrolled in the study. 18 patients of the 25 enrolled (72%) completed the 14 weeks program without SAE. The overall adherence to the study protocol was 60%. Of the 18 participants who did not withdraw from the program, 15 (83%) adhered to the study protocol and completed 30 or more sessions. There was a nonsignificant improvement in VO2 max (mean Δ0.5, p=0.6). The scores for DASI, BFI, and QLQ-C30 improved from baseline to posttreatment.

Conclusion

A CR intervention in breast cancer survivors had high adherence in those who were able to complete the 14-week program. The program significantly improved patient reported physical activity, fatigue, and quality of life (QoL), without significant improvement in CVD risk factors. Implications for cancer patients are that early implementation of a CR program should be considered by practitioners as it improves QoL and exercise tolerance in breast cancer survivors.