Florida nurse practitioners’ attitudes and practices regarding oral cancer prevention and early detection

Knowledge, attitudes, practice and related factors of oral cancer prevention among public health nurses in Taiwan

OBJECTIVES

Public health nurses (PHNs) in Taiwan act as individual/family-based primary care providers and as population-based community care providers. A little information is currently available on the ability of PHNs to prevent oral cancer. We surveyed knowledge, attitudes and behaviour of oral cancer prevention among PHNs.

METHODS

This study recruited 400 PHNs through the Taiwan Public Health Center. A structured electronic questionnaire was used to collect PHNs' demographics and scale scores for oral cancer knowledge, attitudes and preventive behaviour.

RESULTS

Providing PHNs with oral cancer prevention education, having the supervisor's support for preventive work and receiving in-service education would improve PHNs' knowledge, attitude and behaviour for oral cancer prevention. Attitude, oral cancer-related courses arranged by current employer (major factor), supervisor's support for work and having responsibility for oral cancer prevention were associated with the oral cancer preventive behaviour of PHNs, and explain 41.1% of total variance.

CONCLUSIONS

We established a linear regression model for understanding the role of PHNs in the practice of preventing oral cancer. It may be useful for the government in improving school-based and in-service oral cancer prevention education programmes for PHNs as well as developing programmes for increasing public awareness and education of oral cancer prevention.

Understanding primary care nurses' contribution to cancer early diagnosis: A systematic review

PURPOSE

Primary care nurses can contribute to cancer early diagnosis. The objective of this systematic review was to identify, appraise and synthesise evidence on primary care nurses' contribution towards cancer early diagnosis in developed countries.

METHOD

The following databases were searched in September 2017: MEDLINE, PsychINFO, CINAHL, SCOPUS, and EMBASE. Data were extracted on nurses': knowledge of cancer; frequency of 'cancer early diagnosis-related discussions' with patients; and perceived factors influencing these discussions. Studies were appraised using the Mixed Methods Appraisal Tool.

RESULTS

Twenty-one studies were included from: United States, United Kingdom, Ireland, Spain, Turkey, Australia, Brazil and Middle East. Studies were mostly of low quality (one did not meet any appraisal criteria, 15 met one, four met two, and one met three). Nurses' knowledge of cancer, and their frequency of 'cancer early diagnosis-related discussions', varied across countries. This may be due to measurement bias or nurses' divergent roles across healthcare systems. Commonly perceived barriers to having screening discussions included: lack of time, insufficient knowledge and communication skills, and believing that patients react negatively to this topic being raised.

CONCLUSIONS

Findings suggest a need for nurses to be adequately informed about, and have the confidence and skills to discuss, the topic of cancer early diagnosis. Further high-quality research is required to understand international variation in primary care nurses' contribution to this field, and to develop and evaluate optimal methods for preparing them for, and supporting them in, this.

Results of a large-scale head and neck cancer screening of an at-risk population

OBJECTIVE/HYPOTHESIS

To determine whether a community-based head and neck cancer screening could be an effective method to detect positive findings of head and neck cancer in at-risk populations.

STUDY DESIGN

Survey-based study with a nonexperimental intervention component.

METHODS

Five hundred sixty-eight adults were screened for oral and laryngeal cancers by otolaryngologists and oral and maxillofacial surgeons during three National Association of Stock Car Auto Racing race weekend events. A prescreening survey collected demographic information, relevant medical history, and information regarding risk factors for head and neck cancers, including current or past tobacco use, alcohol consumption, and chemical exposures. Signs and symptoms of head and neck cancer were documented during the screening.

RESULTS

Forty-three percent of participants with a history of smoking had abnormal findings. A Pearson chi-square indicated that the proportion of males who evidenced positive findings was significantly (P<0.05) higher than the proportion of females who evidenced positive findings. For every pack of cigarettes smoked per day, an individual was 1.95 times more likely to evidence abnormal findings even after controlling for alcohol use, family history of cancer, personal history of head and neck cancers, sex, age, and occupation.

CONCLUSIONS

This study is the first to document the results of a large-scale head and neck cancer screening of a population of people known to be at risk of head and neck cancers. The study demonstrates the feasibility of developing and implementing large-scale community-based head and neck cancer screenings, as are often seen in the early diagnosis and education of signs, symptoms, and risks for other cancers.

Oral cancer awareness amongst hospital nursing staff: a pilot study

Background

Oral cancer is as prevalent as cervical and testicular cancer in the United Kingdom. Nursing staff provide the oral health care for the patient population in hospital. Admission to hospital provides a 'window of opportunity' for oral cancer 'screening' via an oral health check during nursing clerking. This study aimed to investigate whether nursing staff are aware of risk factors for oral cancer, its clinical signs, and could therefore provide a 'screening' service for oral cancer.

Method

Through the use of a questionnaire we assessed 121 nursing staff on oral health check behaviour and attitudes; their knowledge of risk factors for oral cancer; their understanding of common clinical signs of oral cancer; and their undergraduate and postgraduate training in oral health and oral cancer.

Results

Over 80% thought oral health checks were important although only 49% performed this task regularly; approximately 70% identified smoking as a risk factor but less than 30% identified alcohol. Awareness of the clinical signs of oral cancer was low with 21% identifying white patches, 15% identifying ulceration and only 2% identifying red patches despite their malignant potential. Nurses within 3 years of qualification were significantly better at recognising risk factors for oral cancer than their colleagues, identifying a need for continuing postgraduate education on oral health and oral cancer. Sixty-one percent of nursing staff received oral healthcare as an undergraduate with 34 percent receiving postgraduate training.

Conclusion

An oral health check upon admission to hospital provides an opportunity for nurses to 'screen' for oral diseases including oral cancer and allows nurses a greater role in total patient care. Nurses' awareness of oral cancer risk factors and clinical signs was, however, poor. This study highlights a need for improved education of nurses on oral cancer to make the oral health check on admission viable for oral cancer screening.