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Holmberg K, Bergkvist K, Wengström Y, Hagelin CL. Dismantle and rebuild: the importance of preparedness and self-efficacy before, during and after allogeneic haematopoietic cell transplantation. J Cancer Surviv 2024:10.1007/s11764-024-01622-2. [PMID: 38829473 DOI: 10.1007/s11764-024-01622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/23/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE The aim of this study was to explore patients' experiences of being prepared for allogenic haematopoietic cell transplantation and to explore their perceived self-efficacy and preparedness for self-care after allogenic haematopoietic cell transplantation. METHODS Nine participants, who recently underwent allo-HCT, were interviewed regarding their views on preparedness, self-efficacy and self-care. The interviews were analysed using inductive qualitative content analysis. RESULTS An overarching theme, Life is taken apart, then you have to know how to put the pieces together, and four sub-themes: Convert information into something understandable; Taking responsibility, maintaining and preparing for an uncertain time in life; Balancing vigilance with independence; and Reorientating in an altered body places new demands on self-care illustrate the dismantlement of life during treatment and how actions and approaches can build a new life. CONCLUSIONS Both participants and healthcare professionals prioritised preparing for allo-HCT in the period before admission. However, during admission, preparation decreased and the time was not used for preparatory learning. This meant that participants were well prepared for the acute phase but unprepared for life after completion of treatment. Among the participants, self-efficacy was good. They sought information about taking care of their health before and in the aftermath of allo-HCT. IMPLICATIONS FOR CANCER SURVIVORS This study provides insight into, and knowledge about, how patients prepare before, during and after treatment. This knowledge should primarily be directed towards healthcare professionals to be used for future patients who may need advice and support, as well as continued preparation for a life after transplantation.
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Affiliation(s)
- Katarina Holmberg
- Karolinska Institutet, Stockholm, Sweden.
- Sophiahemmet University, Stockholm, Sweden.
| | - Karin Bergkvist
- Karolinska Institutet, Stockholm, Sweden
- Sophiahemmet University, Stockholm, Sweden
| | - Yvonne Wengström
- Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Stockholm, Sweden
| | - Carina Lundh Hagelin
- Karolinska Institutet, Stockholm, Sweden
- Marie Cederschiöld University, Stockholm, Sweden
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Holmberg K, Bergkvist K, Adalsteinsdóttir S, Wengström Y, Lundh Hagelin C. Nursing as a balancing act in allogeneic hematopoietic cell transplantation -nurses' experiences through participation in workshops. Eur J Oncol Nurs 2023; 63:102300. [PMID: 36893569 DOI: 10.1016/j.ejon.2023.102300] [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: 06/30/2022] [Revised: 01/09/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
PURPOSE Registered nurses have a key role in supporting patients during the trajectory of allogeneic hematopoietic cell transplantation (allo-HCT). However, the circumstances for performing nursing are not previously outlined therefore the purpose of this study was to explore the conditions for nursing care in allo-HCT. METHOD An explorative design, inspired by Experienced based co-design was used to gather experiences, thoughts and visions of nursing care in allo-HCT by means of workshops. Thematic analysis was applied to analyse the data. RESULT An overarching theme that was defined from the data was nursing as a balancing act and illustrating conditions for performing nursing in a highly medical-technical environment. The theme included three sub-themes: Fragmented care vs holistic care outlining how the holistic approach to care disappeared when the care became fragmented; Proximity vs distance illuminating the balance between seeing the patient as an independent person despite illness and the need for support; Teamwork vs stand-alone demonstrating the difficulties inherent in adapting to both teamwork and independence in nursing. CONCLUSION This study shows that the conditions for RNs and nursing care in allo-HCT care is to balance tasks and approach towards the patient and themselves. RNs must weigh and balance what is most important in the moment and where something else often has to be put aside. It is difficult for RNs to find the time to plan each patient's care and to support the patient in the way they see as most optimal to prepare for discharge, self-care and rehabilitation.
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Affiliation(s)
- Katarina Holmberg
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Department of Nursing, Sophiahemmet University, Stockholm, Sweden.
| | - Karin Bergkvist
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Department of Nursing, Sophiahemmet University, Stockholm, Sweden
| | | | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Karolinska Comprehensive Cancer Centre, Karolinska University Hospital, Stockholm, Sweden; Cancer Theme, Breast Centre, Karolinska University Hospital, Stockholm, Sweden
| | - Carina Lundh Hagelin
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
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Zou G, Simons A, Toland S. An exploration of the effects of information giving and information needs of women with newly diagnosed early-stage breast cancer: A mixed-method systematic review. Nurs Open 2022; 9:2586-2601. [PMID: 34313018 PMCID: PMC9584490 DOI: 10.1002/nop2.994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/16/2021] [Accepted: 07/10/2021] [Indexed: 02/05/2023] Open
Abstract
AIM To review the information needs of women with newly diagnosed early-stage breast cancer and the effects of information giving by measuring patient-reported outcomes. DESIGN A mixed-method systematic review using PRISMA guidelines. METHODS The major electronic nursing databases were searched from inception until 31 December 2019 using key terms. Included studies were assessed using the Crowes Critical Appraisal Tool. RESULTS Four quantitative studies and two qualitative studies, comprising of 537 participants (age range from 25 to 98 years), were included for the ultimate qualitative synthesis of this review. There was high-level evidence that demonstrated the prevalence of these groups of women's information needs and their improvement in fighting spirit and decrease in helplessness/hopelessness for information giving interventions; low-level evidence of long-term adjustment and well-being improvement; and limited evidence indicating that inadequate information, including restricted information, too much information and conflicting information could cause some ramifications.
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Affiliation(s)
- Guanfa Zou
- The First Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Alison Simons
- Faculty of Health, Education and Life SciencesSchool of Nursing and MidwiferyBirmingham City UniversityBirminghamUK
| | - Samantha Toland
- Faculty of Health, Education and Life SciencesSchool of Nursing and MidwiferyBirmingham City UniversityBirminghamUK
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Kantilal K, Hardeman W, Whiteside H, Karapanagioutou E, Small M, Bhattacharya D. Facilitating healthcare practitioners to deliver self-management support in adult cancer survivors: A realist review. Res Social Adm Pharm 2022; 18:3870-3883. [DOI: 10.1016/j.sapharm.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
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Latin dance and Qigong/Tai Chi effects on physical activity and body composition in breast cancer survivors: A pilot study. Complement Ther Clin Pract 2022; 47:101554. [DOI: 10.1016/j.ctcp.2022.101554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 12/26/2022]
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Vo JB, Gillman A, Mitchell K, Nolan TS. Health Disparities: Impact of Health Disparities and Treatment Decision-Making Biases on Cancer Adverse Effects Among Black Cancer Survivors. Clin J Oncol Nurs 2021; 25:17-24. [PMID: 34533532 DOI: 10.1188/21.cjon.s1.17-24] [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: 12/23/2022]
Abstract
BACKGROUND Health disparities affect cancer incidence, treatment decisions, and adverse effects. Oncology providers may hold biases in the decision-making process, which can perpetuate health disparities. OBJECTIVES The purpose of this article is to describe health disparities across treatment decisions and adverse effects, describe decision-making biases, and provide suggestions for nurses to mitigate adverse outcomes. METHODS A scoping review of the literature was conducted. FINDINGS Factors affecting health disparities stem, in part, from structural racism and decision-making biases, such as implicit bias, which occurs when individuals have unconscious negative thoughts or feelings toward a particular group. Other decision-making biases, seemingly unrelated to race, include default bias, delay discounting bias, and availability bias. Nurses and nurse navigators can mitigate health disparities by providing culturally appropriate care, assessing health literacy, providing education regarding adverse effects, serving as patient advocates, empowering patients, evaluating personal level of disease knowledge, and monitoring and managing cancer treatment adverse effects.
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Affiliation(s)
| | | | | | - Timiya S Nolan
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
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7
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Prieto R, Ferrell B, Kim JY, Sun V. Self-Management Coaching: Promoting Postoperative Recovery and Caregiving Preparedness for Patients With Lung Cancer and Their Family Caregivers. Clin J Oncol Nurs 2021; 25:290-296. [PMID: 34019030 DOI: 10.1188/21.cjon.290-296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Quality of life (QOL) for patients undergoing lung resection and their family caregivers (FCGs) is often affected by surgical treatment for lung cancer. OBJECTIVES Patients and FCGs have a great deal of distress that affects their QOL. Introducing self-management skills soon after diagnosis improves patient and FCG outcomes. METHODS This article presents a intervention model for providing patients and FCGs with self-management skills. Patients and FCGs will learn how to identify and overcome challenges, set goals, and address unmet needs throughout the phases of surgery. The model and case examples are presented. FINDINGS Patients and FCGs gained self-efficacy. They were able to identify potential stressors that would otherwise become burdensome. Patients remained in control of their preoperative care and recovery, resulting in continued independence. FCGs achieved healthier well-being, which increased positive caregiving experiences.
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The Self-management Smartphone Application for Cancer Survivors, ReLive: Development and Usability Testing. Comput Inform Nurs 2020; 39:312-320. [PMID: 33214389 DOI: 10.1097/cin.0000000000000690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ReLive is a nursing theory-driven and evidence-based smartphone application that aims to promote self-management among cancer survivors. It has been designed to display symptom measurement results in different traffic light colors, depending on the severity of a user's symptoms (eg, severe symptoms are presented in red). Therefore, it is easy for users to draw inferences about changes in their symptoms. Further, users can simultaneously set several physical activity goals and monitor their performance. Social support, self-efficacy, and quality of life of a user can also be monitored regularly. This study investigated the usability of this application. An iterative formative test, including a cognitive walkthrough and face-to-face interviews, was conducted. Participants were seven individuals with a diagnosis of chronic myeloid leukemia. The ease of use and understanding, acceptability, and usefulness of the application were evaluated. The results revealed that the participants had evaluated ReLive positively. This program could be used as an intervention to deliver health information and manage their performance. Further research is needed to assess the application's effects on self-management among survivors of various types of cancers.
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DePasquale N, Cabacungan A, Ephraim PL, Lewis-Boyér L, Diamantidis CJ, Powe NR, Boulware LE. "I Wish Someone Had Told Me That Could Happen": A Thematic Analysis of Patients' Unexpected Experiences With End-Stage Kidney Disease Treatment. J Patient Exp 2020; 7:577-586. [PMID: 33062881 PMCID: PMC7534108 DOI: 10.1177/2374373519872088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Preparedness regarding prognosis and treatment options enables patients to cope with uncertainties, make value-based treatment decisions, and set treatment goals. Yet, little is known about the expectedness of end-stage kidney disease (ESKD) patients' treatment experiences beyond their desire for better treatment education. OBJECTIVE To describe unexpected adverse treatment experiences among ESKD patients. METHOD The authors conducted 7 focus groups with 55 dialysis patients and living-donor kidney transplantation recipients receiving medical care in Baltimore, Maryland. Data were analyzed thematically. Themes present in different treatment groups were highlighted to provide insight into common experiences. RESULTS The authors identified 5 themes: (1) psychological reactions, (2) constrained freedom of choice, (3) treatment delivery and logistics, (4) morbidity, and (5) finances. CONCLUSION Patients were unprepared for nonclinical, logistical, and clinical aspects of ESKD treatment. The need for providers' use of tailored preparatory techniques and the development of pretreatment interventions to help patients know what to expect from and feel psychologically prepared for treatment, particularly with respect to nonclinical implications, is critical. These efforts have great potential to improve patients' treatment experiences.
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Affiliation(s)
- Nicole DePasquale
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Ashley Cabacungan
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Patti L Ephraim
- Department of Epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - LaPricia Lewis-Boyér
- General Internal Medicine & Physical Medicine and Rehabilitation, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Clarissa J Diamantidis
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Neil R Powe
- School of Medicine, University of California at San Francisco, CA, USA
| | - L Ebony Boulware
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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10
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Sun V, Raz DJ, Erhunmwunsee L, Ruel N, Carranza J, Prieto R, Ferrell B, Krouse RS, McCorkle R, Kim JY. Improving family caregiver and patient outcomes in lung cancer surgery: Study protocol for a randomized trial of the multimedia self-management (MSM) intervention. Contemp Clin Trials 2019; 83:88-96. [PMID: 31279090 PMCID: PMC6661176 DOI: 10.1016/j.cct.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To describe the study protocol of the Multimedia Self-Management (MSM) intervention to prepare patients and family caregivers (FCGs) for lung cancer surgery. DESIGN The study is a five-year, single site, randomized controlled trial of 160 lung cancer surgery FCG and patient dyads (320 total participants), comparing intervention and attention control arms. SETTING One National Cancer-Institute (NCI) designated comprehensive cancer center in Southern California. PARTICIPANTS Patients who are scheduled to undergo lung cancer surgery and their FCGs are enrolled as dyads only. INTERVENTION Based on the Chronic Care Self-Management Model (CCM), the intervention is a nurse-led, caregiver-based, multimedia care program for lung cancer surgery. Its primary focus is to help FCGs develop self-management skills related to their caregiving role through goal setting, proactive planning, building problem-solving skills, and accessing family support services. The intervention also supports dyads to prepare for surgery and post-operative recovery at home. It includes videos, print, web-based, and post-discharge telephone support. MAIN OUTCOME MEASURES FCG and patient psychological distress and QOL; FCG burden and preparedness for caregiving; FCG and patient healthcare resource use (in-home nursing care, urgent care/ER visits, readmissions). ANALYSIS Repeated measures ANCOVA statistical design will be used, removing variances prior to examining mean squares for the group by occasion interactions, and co-varying the baseline scores. In addition, structured equation modeling (SEM) will assess whether mediating and moderating factors are associated with outcomes. ClinicalTrials.gov Identifier: NCT03686007.
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Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, United States of America.
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, United States of America
| | | | - Nora Ruel
- Biostatistics and Mathematical Modeling Core City of Hope, Duarte, CA, United States of America
| | - Jacqueline Carranza
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Rosemary Prieto
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Robert S Krouse
- Surgical Services, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States of America; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Ruth McCorkle
- School of Nursing, Yale University, New Haven, CT, United States of America
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, United States of America
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11
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Sawin KJ, Montgomery KE, Dupree CY, Haase JE, Phillips CR, Hendricks-Ferguson VL. Oncology Nurse Managers' Perceptions of Palliative Care and End-of-Life Communication. J Pediatr Oncol Nurs 2019; 36:178-190. [PMID: 30939966 DOI: 10.1177/1043454219835448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The purpose of this study was to describe pediatric oncology nurse managers' (NMs) perspectives of palliative care/end-of-life (PC/EOL) communication. The study, guided by group-as-a-whole theory and empirical phenomenology, was part of a larger, multisite study aimed at understanding pediatric oncology nurses' experiences of PC/EOL communication. Nurses were assigned to focus groups based on length or type of experience (i.e., nurses with <1, 2-5, or >5 years' work experience and NMs). Eleven NMs from three Midwestern pediatric hospitals with large oncology programs participated in one focus group. The participants' mean years of experience was 15.8 in nursing and 12 in pediatric oncology; 90% had a BSN or higher degree; all had supervisory responsibilities. The authors identified 2,912 meaning statements, which were then analyzed using Colaizzi's method. Findings include NMs' overall experience of "Fostering a Caring Climate," which includes three core themes: (1) Imprint of Initial Grief Experiences and Emotions; (2) Constant Vigilance: Assessing and Optimizing Family-Centered Care; and (3) Promoting a Competent, Thoughtful, and Caring Workforce. Findings indicate that pediatric oncology NMs draw on their own PC/EOL experiences and their nursing management knowledge to address the PC/EOL care learning needs of nursing staff and patient/family needs. NMs need additional resources to support nursing staff's PC/EOL communication training, including specific training in undergraduate and graduate nursing programs and national and hospital-based training programs.
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Affiliation(s)
- Kathleen J Sawin
- 1 Children's Hospital of Wisconsin, Milwaukee, WI, USA.,2 University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Muntlin Athlin Å, Brovall M, Wengström Y, Conroy T, Kitson AL. Descriptions of fundamental care needs in cancer care-An exploratory study. J Clin Nurs 2018; 27:2322-2332. [DOI: 10.1111/jocn.14251] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Åsa Muntlin Athlin
- Department of Medical Sciences; Uppsala University; Uppsala Sweden
- Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
- Adelaide Nursing School; University of Adelaide; Adelaide SA Australia
- Department of Emergency Care and Internal Medicine; Uppsala University Hospital; Uppsala Sweden
| | - Maria Brovall
- Department of Neurobiology, Care Sciences and Society; Division of Nursing; Karolinska Institutet; Huddinge Sweden
- School of Health and Education; University of Skövde; Skövde Sweden
| | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society; Division of Nursing; Karolinska Institutet; Huddinge Sweden
- Karolinska University Hospital; Radiumhemmet; Stockholm Sweden
| | - Tiffany Conroy
- Adelaide Nursing School; University of Adelaide; Adelaide SA Australia
- Faculty of Health Sciences; Centre for Evidence based Practice South Australia; Adelaide Nursing School; The University of Adelaide; Adelaide SA Australia
| | - Alison L. Kitson
- Adelaide Nursing School; University of Adelaide; Adelaide SA Australia
- College of Nursing and Health Sciences; Flinders University; Adelaide SA Australia
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13
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Liska CM, Morash R, Paquet L, Stacey D. Empowering cancer survivors to meet their physical and psychosocial needs: An implementation evaluation. Can Oncol Nurs J 2018; 28:76-81. [PMID: 31148752 DOI: 10.5737/236880762827681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Our Wellness Beyond Cancer Survivorship Program was established and evaluated as a quality improvement project. Individualized survivorship care plans for survivors and primary care providers included cancer surveillance recommendations and survivors' self-reported physical and psychosocial needs. At the discharge visit, an oncology nurse reviewed the care plan and symptom management strategies with survivors. We assessed the physical and psychosocial needs and feelings of empowerment of 70 breast and 53 colorectal cancer survivors on entry into the program and one year after discharge to primary care. Survivors were months to 10 or more years since the end of active treatment, with colorectal cancer survivors referred sooner (average 1.2 years). At baseline, colorectal cancer survivors reported little concern about their needs (scores <1.0 out of 5.0) and breast cancer survivors reported some concern about sleep disturbances, weight changes, memory/concentration changes, and fear of recurrence (scores 1.0 to 1.5 out of 5.0). All survivors reported feeling empowered (>3.0 out of 4.0). Needs and empowerment levels were mostly unchanged one year later. Colorectal cancer survivors showed a statistically significantly increased fear of recurrence at one year. In summary, cancer survivors with a survivorship care plan continued to feel empowered one year following discharge.
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15
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O'Callaghan CC, McDermott F, Reid P, Michael N, Hudson P, Zalcberg JR, Edwards J. Music's Relevance for People Affected by Cancer: A Meta-Ethnography and Implications for Music Therapists. J Music Ther 2016; 53:398-429. [PMID: 27980035 DOI: 10.1093/jmt/thw013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Evidence supports music-based oncologic support interventions including music therapy. By comparison, little is understood about music-based self-care. This meta-ethnography examined five published qualitative studies to extend understanding of music's relevance, including helpfulness, for people affected by cancer; including children, adolescents, and adults with cancer, carers, and the bereaved. OBJECTIVE To improve understanding of music's broad relevance for those affected by cancer. METHODS Meta-ethnography strategies informed the analysis. Five studies were synthesized that included 138 participants: 26 children and 28 parents of children with cancer; 12 adolescents and young adults with cancer; 52 adults with cancer; 12 carers; and 8 bereaved. Studies' category and thematic findings were compared and integrated into third-order interpretations, and a line of argument. Perspectives from the five studies that illuminated the line of argument were developed. RESULTS Music usage can remain incidental, continue normally, and/or change because of cancer's harsh effects. Music can be a lifeline, support biopsychosocial and spiritual well-being, or become elusive, that is, difficult to experience. Music helps or intrudes because it extends self-awareness and social connections, and prompts play, memories, imageries, and legacies. Music therapists may help patients and carers to recover or extend music's helpful effects. CONCLUSIONS Cancer care can be improved through offering music-based resources/services, which give cancer patients and carers opportunities to extend music usage for personal support and, for carers, to support patients. Music therapists can advocate for such resources and educate health professionals about assessing/recognizing when patients' and carers' changed music behaviors signify additional support needs.
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Affiliation(s)
- Clare C O'Callaghan
- Caritas Christi Hospice and Department of Medicine, St Vincent's Hospital, The University of Melbourne and Cabrini Health, Melbourne .,Monash University .,Department of Education and Training, Melbourne .,Notre Dame University, Sydney, and Monash University, Melbourne .,Centre for Palliative Care Education and Research, St Vincent's & University of Melbourne, and Queens University, Belfast .,Monash University .,Deakin University
| | - Fiona McDermott
- Caritas Christi Hospice and Department of Medicine, St Vincent's Hospital, The University of Melbourne and Cabrini Health, Melbourne.,Monash University.,Department of Education and Training, Melbourne.,Notre Dame University, Sydney, and Monash University, Melbourne.,Centre for Palliative Care Education and Research, St Vincent's & University of Melbourne, and Queens University, Belfast.,Monash University.,Deakin University
| | - Philippa Reid
- Caritas Christi Hospice and Department of Medicine, St Vincent's Hospital, The University of Melbourne and Cabrini Health, Melbourne.,Monash University.,Department of Education and Training, Melbourne.,Notre Dame University, Sydney, and Monash University, Melbourne.,Centre for Palliative Care Education and Research, St Vincent's & University of Melbourne, and Queens University, Belfast.,Monash University.,Deakin University
| | - Natasha Michael
- Caritas Christi Hospice and Department of Medicine, St Vincent's Hospital, The University of Melbourne and Cabrini Health, Melbourne.,Monash University.,Department of Education and Training, Melbourne.,Notre Dame University, Sydney, and Monash University, Melbourne.,Centre for Palliative Care Education and Research, St Vincent's & University of Melbourne, and Queens University, Belfast.,Monash University.,Deakin University
| | - Peter Hudson
- Caritas Christi Hospice and Department of Medicine, St Vincent's Hospital, The University of Melbourne and Cabrini Health, Melbourne.,Monash University.,Department of Education and Training, Melbourne.,Notre Dame University, Sydney, and Monash University, Melbourne.,Centre for Palliative Care Education and Research, St Vincent's & University of Melbourne, and Queens University, Belfast.,Monash University.,Deakin University
| | - John R Zalcberg
- Caritas Christi Hospice and Department of Medicine, St Vincent's Hospital, The University of Melbourne and Cabrini Health, Melbourne.,Monash University.,Department of Education and Training, Melbourne.,Notre Dame University, Sydney, and Monash University, Melbourne.,Centre for Palliative Care Education and Research, St Vincent's & University of Melbourne, and Queens University, Belfast.,Monash University.,Deakin University
| | - Jane Edwards
- Caritas Christi Hospice and Department of Medicine, St Vincent's Hospital, The University of Melbourne and Cabrini Health, Melbourne.,Monash University.,Department of Education and Training, Melbourne.,Notre Dame University, Sydney, and Monash University, Melbourne.,Centre for Palliative Care Education and Research, St Vincent's & University of Melbourne, and Queens University, Belfast.,Monash University.,Deakin University
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16
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Orr S. Demystifying cancer care in the community. Br J Community Nurs 2016; 21:497-500. [PMID: 27715266 DOI: 10.12968/bjcn.2016.21.10.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah Orr
- Lead Macmillan Head and Neck Clinical Nurse Specialist, University College London Hospital, London
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17
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Reñones Crego MDLC, Fernández Pérez D, Vena Fernández C, Zamudio Sánchez A. [Strategies for improving care of oncologic patients: SHARE Project results]. ENFERMERIA CLINICA 2016; 26:312-20. [PMID: 27237729 DOI: 10.1016/j.enfcli.2016.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 12/28/2015] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients.
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Yamamoto S, Tazumi K, Arao H. Support not corresponding to transition to a new treatment: Women's perceptions of support provided by their male partners during hormonal therapy. Int J Qual Stud Health Well-being 2015; 10:29283. [PMID: 26627115 PMCID: PMC4666895 DOI: 10.3402/qhw.v10.29283] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2015] [Indexed: 12/02/2022] Open
Abstract
Women with breast cancer receive support from their partners to deal with the side effects of therapies over the cancer trajectory. Hormonal therapy (HT) is usually given after completing other treatments, and women receiving HT reclaim their normal life. This may lead to changes in support from their partners. Therefore, we explored women's perceptions of the support provided by their male partners in managing the side effects of adjuvant HT. We conducted semi-structured interviews with 10 women who received HT and recognized their partners as a main source of support. An interview guide was used to explore their experiences of treatment side effects, the contents of support received from their partners, their need for support, and their overall relationship with their partners. Interviews were analysed by content analysis. A theme on how participants perceived support from their partners was formulated as “Support not corresponding to transition to a new treatment” with the following categories: “Shrinking support,” “Primacy of partner,” and “Solitary new treatment.” Participants felt lack of support from their partners because their partners did not understand their experience of the side effects induced by HT. Unlike the side effects of past treatments such as surgery and chemotherapy, side effects of HT cannot be observed and are highly subjective. Their partners often failed to notice these symptoms and provided little support. Nevertheless, participants aimed to accept the existing support without asking for more. They were left alone in the continuing trajectory of breast cancer. After starting HT, women entered a new treatment phase in which less understanding and support was provided by partners. Educational support for couples may enable sharing of subjective symptoms that are not obvious to partners and improve outcomes by facilitating partner engagement and support.
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Affiliation(s)
- Sena Yamamoto
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Harue Arao
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan;
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Walker R, Szanton SL, Wenzel J. Working Toward Normalcy Post-Treatment: A Qualitative Study of Older Adult Breast and Prostate Cancer Survivors. Oncol Nurs Forum 2015; 42:E358-67. [PMID: 26488842 PMCID: PMC4750471 DOI: 10.1188/15.onf.e358-e367] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To develop a better understanding of how older adult survivors of early-stage breast and prostate cancer managed the work of recovery.
. RESEARCH APPROACH Multiple case study design embedded in a larger randomized, controlled trial of a nurse-led patient navigation intervention.
. SETTING Community-based research conducted via in-home visits and by phone with participants residing in non-metropolitan areas of a mid-Atlantic state.
PARTICIPANTS Rural-dwelling adults aged 60 years or older with early-stage breast or prostate cancer and the people who support them (11 dyads).
METHODOLOGIC APPROACH An approach to grounded theory analysis was used to evaluate the fit between existing theoretical knowledge and case findings and to generate new knowledge about the cancer recovery process.
FINDINGS Working toward normalcy was a core process of cancer recovery prompted by participants' internal experiences and external interactions with their environments. This ongoing, iterative, and active process involved multiple concurrent strategies that were not necessarily medically oriented or cancer specific. Working toward normalcy resulted in movement along a continuum of self-appraisal anchored between participants experiencing life as completely disrupted by cancer to a life back to normal. A greater sense of normalcy was associated with higher engagement in valued activities and increased physical and psychological well-being.
CONCLUSIONS In addition to the core process of working toward normalcy, multiple theories from nursing, sociology, psychology, and gerontology helped to explain case findings. This knowledge could serve as a foundation on which to design survivorship care that supports the goals of cancer survivors working toward normalcy post-treatment. INTERPRETATION Post-treatment wellness goals can include a desire to reestablish or maintain a sense of normalcy. Nursing actions that promote survivors' efforts to be perceived as capable, stay engaged in valued activities and roles, maintain a sense of control over their lives and bodies, and make plans for the future may help meet this goal. Existing theories about identity, dignity, inner strength, and the work of illness can inform nursing interventions.
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Affiliation(s)
- Rachel Walker
- Assistant professor in the College of Nursing at the University of Massachusetts Amherst
| | - Sarah L. Szanton
- Associate professor in the Department of Community and Public Health, School of Nursing at Johns Hopkins University in Baltimore, MD
| | - Jennifer Wenzel
- Assistant professor in the Department of Acute and Chronic Care, School of Nursing at Johns Hopkins University in Baltimore, MD
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Abstract
OBJECTIVES To describe the goals of treatment, decision-making, incidence, and outcomes of surgical palliation in advanced cancer. DATA SOURCES Journal articles, research reports, state of the science papers, and clinical guidelines. CONCLUSION Surgical palliation is common in advanced cancer settings, and is indicated primarily in settings where the goals of treatment are focused on quality of life, symptom control, and symptom prevention. More research is needed to guide evidence-based best practices in palliative surgery. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses practicing in clinical and research settings have a responsibility to arm themselves with knowledge related to the indications and options of palliative procedures, and the impact of surgery on quality of life for patients and families facing advanced cancer.
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Dietary alterations and restrictions following surgery for upper gastrointestinal cancers: Key components of a health-related quality of life intervention. Eur J Oncol Nurs 2015; 19:343-8. [PMID: 25697545 DOI: 10.1016/j.ejon.2015.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 01/14/2015] [Accepted: 01/22/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE The surgical treatment of upper gastrointestinal (GI) cancers, specifically esophageal and gastric cancers, often result in extensive health-related quality of life (HRQOL) concerns, particularly those associated with dietary adjustments. This paper provides a review of HRQOL changes following esophagectomy and gastrectomy, and describes key components of an intervention to improve dietary adjustments following surgery. METHODS Intervention development was informed by 1) current published evidence on HRQOL changes for patients following upper GI surgery, 2) examination of usual post-operative care related to dietary restrictions to identify areas for continued education and support and 3) the inclusion of a conceptual framework (the Chronic Care Model) to guide intervention design and inform the selection of appropriate outcome measures. RESULTS Three key components of an HRQOL intervention are identified, and should focus on HRQOL concerns associated with dietary alterations and restrictions following treatment, involve family caregivers, and be tailored and flexible to patient and family caregiver's needs and preferences. CONCLUSIONS Evidence-based interventions to support long-term dietary alterations and restrictions following upper GI surgery are lacking, despite evidence confirming its impact on morbidity and mortality. Interventions are needed to support dietary adjustments, prevent malnutrition and excessive weight loss, and enhance HRQOL following surgery for upper GI cancers.
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Turkman YE, Sakibia Opong A, Harris LN, Knobf MT. Biologic, demographic, and social factors affecting triple negative breast cancer outcomes. Clin J Oncol Nurs 2015; 19:62-7. [PMID: 25689650 DOI: 10.1188/15.cjon.62-67] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Triple negative breast cancer (TNBC) is an aggressive breast cancer subtype that disproportionately affects women who are African American, younger, or carriers of the BRCA1 gene. No targeted treatments exist for the disease, which has distinct features and presents unique challenges to patients who have been diagnosed with it. OBJECTIVES TNBC is reviewed in this article according to incidence, tumor grade, stage of diagnosis, biologic and social risk factors, mortality, and treatment. METHODS Published articles pertaining to TNBC and located through online database searches were reviewed. Articles were selected either because they offered the most current information about TNBC or contributed to the understanding of TNBC. FINDINGS Biologic, demographic, and social factors present unique challenges in the treatment of women with TNBC. Knowing about the characteristics of TNBC and the populations who are most at risk for the disease might help healthcare providers better respond to their patients. It may also facilitate responsiveness to patients' needs and enhance their quality of life.
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Komatsu H, Yagasaki K. The power of nursing: guiding patients through a journey of uncertainty. Eur J Oncol Nurs 2014; 18:419-24. [PMID: 24721178 DOI: 10.1016/j.ejon.2014.03.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 03/04/2014] [Accepted: 03/13/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE The objective of this qualitative study was to understand the experiences of oncology nurses in patient counseling and support services in the ambulatory care setting. METHODS AND SAMPLE A qualitative study was conducted using grounded theory methods. Data were generated through four focus group interviews with 21 oncology nurses currently providing counseling and support services for cancer patients in Japan. The content was analyzed based on a constant comparison approach. RESULTS The power of nursing was identified through three themes: connecting with the patient (shared needs); personalized coordination (shared action); and realizing the patient's potential (reassurance). Oncology nurses should guide patients through the uncertain cancer trajectory by identifying patients' true needs based on an established relationship, providing personalized coordination, and developing their potential. Patient-centered care can be provided in non-physical care settings such as counseling and support services. CONCLUSIONS Our study describes the uniqueness and significance of nursing, and provides insights into realizing the full potential of nurses. This conceptual model can be used as a guide for practice and an educational tool to build professional identity of nurses. Oncology nurses can take a leadership role in enhancing the visibility of the nurses in multidisciplinary environments.
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Affiliation(s)
- Hiroko Komatsu
- Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Kaori Yagasaki
- Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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