Oncology Nurses' Experiences With Patients Who Choose to Discontinue Cancer Chemotherapy

Osteosarcoma in Pediatric and Adult Populations: Are Adults Just Big Kids?

Malignant bone tumors are commonly classified as pediatric or adolescent malignancies, and clinical trials for these diseases have generally focused on these populations. Of primary bone cancers, osteosarcoma is among the most common. Osteosarcoma has a bimodal age distribution, with the first peak occurring in patients from 10 to 14 years old, and the second peak occurring in patients older than 65, with about 25% of cases occurring in adults between 20 and 59 years old. Notably, adult osteosarcoma patients have worse outcomes than their pediatric counterparts. It remains unclear whether age itself is a poor prognostic factor, or if inherent differences in tumor biology exist between age groups. Despite these unknowns, current treatment strategies for adults are largely extrapolated from pediatric studies since the majority of clinical trials for osteosarcoma treatments are based on younger patient populations. In light of the different prognoses observed in pediatric and adult osteosarcoma, we summarize the current understanding of the molecular etiology of osteosarcoma and how it may differ between age groups, hypothesizing why adult patients have worse outcomes compared to children.

Hermeneutic phenomenological human science research method in clinical practice settings: An integrative literature review

Researchers conduct phenomenological studies to better understand the experiences of phenomena. Researchers conducting phenomenological studies use different research methods grounded in philosophical underpinnings. Van Manen's hermeneutic phenomenological human science method is used in understanding phenomena in diverse disciplines. The purpose of the integrative review was to explore and synthesize research to address two questions about the human science method in clinical practice settings. Wittemore and Knafi (2005)'s method for integrative review was used to explore current literature and summarize the use of human science method. A database search of keywords in peer-reviewed articles published from 2009 to 2019 was reviewed. Eleven key research studies were selected for the integrative literature review. The key studies met the inclusion criteria of phenomenology, nurses, human science method, clinical practice, and van Manen. Researchers used van Manen's human science method as guidelines for collecting and analyzing data about the lived experience of diverse phenomena in clinical practice settings. An understanding of the human science method will guide researchers who conduct research studies using van Manen's approach to phenomenology.

Calcium-Dependent Calpain Activation-Mediated Mitochondrial Dysfunction and Oxidative Stress Are Required for Cytotoxicity of Epinecidin-1 in Human Synovial Sarcoma SW982 Cells

Synovial sarcoma is a rare but highly malignant and metastatic disease. Despite its relative sensitivity to chemotherapies, the high recurrence and low 5-year survival rate for this disease suggest that new effective therapeutic agents are urgently needed. Marine antimicrobial peptide epinecidin-1 (epi-1), which was identified from orange-spotted grouper (Epinephelus coioides), exhibits multiple biological effects, including bactericidal, immunomodulatory, and anticancer activities. However, the cytotoxic effects and mechanisms of epi-1 on human synovial sarcoma cells are still unclear. In this study, we report that epi-1 exhibits prominent antisynovial sarcoma activity in vitro and in a human SW982 synovial sarcoma xenograft model. Furthermore, we determined that calcium overload-induced calpain activation and subsequent oxidative stress and mitochondrial dysfunction are required for epi-1-mediated cytotoxicity. Interestingly, reactive oxygen species (ROS)-mediated activation of extracellular signal-regulated kinase (ERK) plays a protective role against epi-1-induced cytotoxicity. Our results provide insight into the molecular mechanisms underlying epi-1-induced cell death in human SW982 cells.

Altered nursing student perspectives: Impact of a pre-clinical observation experience at an outpatient oncology setting

This study examined the influence of an observation experience at an outpatient oncology setting on first-year nursing students. This experiential learning opportunity occurred prior to any formal clinical practice course. A hermeneutic phenomenology approach was used to uncover pre-licensure nursing students' perspectives about cancer, as well as their understanding of the roles and responsibilities of registered nurses in cancer care both before and following their experience. A total of 10 nursing students agreed to participate in the study. Data were collected through semi-structured interviews following which data were analyzed and interpreted to understand the meaning in the experience. Two overarching themes were identified including circles of relationships, and the many sides of outpatient oncology. This study reveals that experiential learning in the form of a low-risk, observation-only experience may be an opportunity for pre-licensure students to gain new perspectives about cancer care and nurses roles in caring for individuals and families who are impacted by cancer.

Private Rooms, Semi-Open Areas, or Open Areas for Chemotherapy Care: Perspectives of Cancer Patients, Families, and Nursing Staff

OBJECTIVE

This research aims to better understand the needs and preferences of cancer outpatients, their families, and nursing staff with regard to private rooms, semi-open areas, or open areas for ambulatory cancer care.

BACKGROUND

Environments for cancer chemotherapy care are outpatient settings, and recommendations based on findings regarding inpatient settings may not be appropriate. Users of chemotherapy treatment environments include cancer patients, their families, and nursing staff.

METHOD

A questionnaire survey was conducted in an academic cancer center in Louisiana. The participants included 171 cancer patients, 145 family members, and 16 nursing staff members. Both quantitative and qualitative methods were used to analyze the data. Participants' environmental preferences were compared using analysis of variance. Reasons for preferences were analyzed through key word and content analysis.

RESULTS

Semi-open areas were preferred by the staff, whereas the three types of treatment environments were equally popular among both patients and families (preferred by 29%/28%/27% of the participants). Female patients and patients receiving longer periods of treatment per occurrence were more likely to prefer private rooms ( p < .05). Three common reasons for preferences were needs for privacy, social interaction, and patient-nurse access. Additional reasons for patient and family preferences included needs for sleep, openness, and access to nature. A shared environment of chemotherapy care was suggested to be appropriate for four to seven patients to occupy.

CONCLUSION

Multiple types of treatment environments should be provided in chemotherapy care to incorporate varied user needs. Privacy, social interaction, patient-nurse access, and access to nature should be considered during the design of environments for cancer chemotherapy.

An integrative Tai Chi program for patients with breast cancer undergoing cancer therapy: study protocol for a randomized controlled feasibility study

BACKGROUND

Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evaluated. Improved patient education and support has been suggested as a priority for breast cancer care. This pilot study assesses the feasibility of a randomized controlled trial (RCT) to evaluate the effectiveness of "an integrative Tai Chi" (ANITA) program for breast cancer patients undergoing cancer therapy.

METHODS/DESIGN

This is a single-centre, two-arm feasibility RCT. Twenty-four patients with breast cancer who have undergone surgical treatment will be recruited from the Dunedin Hospital (New Zealand) over a 12-month period (from August 2017 to July 2018). Subject to informed consent, patients will be randomized to receive standard cancer treatment alone or standard cancer treatment plus the ANITA program, consisting of peer support, health education, and Tai Chi Ruler exercise. The program runs alongside the patient's adjuvant cancer therapy, which may include chemotherapy, radiation therapy, antibody treatment, and/or antihormonal therapy. Analysis in this study will focus on process evaluation of participant recruitment, retention, treatment fidelity, acceptability of the program, and occurrence of adverse events. Clinical outcomes (i.e., fatigue, sleep quality, anxiety and depression and quality of life) will be assessed at baseline, and at 12 weeks and 24 weeks post-randomization.

DISCUSSION

Outcomes from this study will inform the feasibility and methodology for a future fully-powered RCT.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry with the identifier ACTRN12617000975392.

Daily diary study of hope, stigma, and functioning in lung cancer patients

OBJECTIVE

Given its lethality, associated stigma, and symptom burden, a lung cancer diagnosis poses a substantial challenge for patients. The goal of this study was to examine how daily hope, defined as goal-directed effort and planning to meet goals, and daily stigma were related to same- and next-day functioning in lung cancer patients receiving cancer treatment.

METHODS

Fifty lung cancer patients (39 non-small-cell stages IIIa-IV; 11 limited and extensive small cell) completed a baseline questionnaire and 21 daily diaries (n = 1,042) assessing hope, stigma, physical symptoms, treatment factors, and functioning. Hypotheses were tested in same- and next-day models with multilevel modeling.

RESULTS

Patients who reported more daily hope reported higher social and role functioning in same- and next-day models. On days that patients reported more hope than usual (compared with their own across-day average), they had higher social, role, and physical functioning; this effect did not carry into the next day. Treatment days were associated with lower social and role functioning when patients reported lower hope and associated with higher functioning when patients reported higher hope. Within-person hope was not predicted by disease symptoms. On days that patients reported more stigma than usual, they reported lower social and role functioning.

CONCLUSIONS

Hope is associated with functioning in lung cancer patients, regardless of physical symptoms from disease and treatment. Hope and stigma may therefore be appropriate intervention targets to support daily social and role functioning during lung cancer treatment. (PsycINFO Database Record