Response to "Knowledge and Practice of Breast Self-Examination: A Cross-Sectional Study of Women at Selected Health Centers in Oyo State, Nigeria"

I would like to thank Faleti et al. (2023) for describing the practice patterns of breast self-examination (BSE) in Nigeria. Early identification of the symptoms of breast cancer is important in the effort to improve quality.

Knowledge and Practice of Breast Self-Examination: A Cross-Sectional Study of Women at Selected Health Centers in Oyo State, Nigeria

Breast cancer is the leading cause of death for women in sub-Saharan Africa. However, knowledge and practice of breast self-examination (BSE) remains low. This project examined if there is an association between BSE knowledge.

Relationship Between Quality of Life and Symptom Burden in Patients With Cancer With and Without HIV in Botswana

Cancer is an emerging public health concern in sub-Saharan Africa. In Botswana, the most prevalent cancers are HIV related. The symptom burden that results from cancer and HIV infection is associated with poorer quality of li.

Assessing and Implementing Nursing Standards in Pediatric Oncology Units in a Low- to Middle-Income Country

Oncology nurses are stakeholders in the global fight against childhood cancer. In low- to middle-income countries, the burden of care on nursing staff is high, and nurses face several unique challenges. To optimize pediatric.

Psychological Distress and Work-Related Quality of Life Among Oncology Nurses During the COVID-19 Pandemic: A Cross-Sectional Study

BACKGROUND

Oncology nurses are at disproportionate risk for psychological distress because they often encounter ethical challenges and deaths while providing care. Exposures to emergent suffering during the COVID-19 pandemic compound their chronic distress, which likely increased their vulnerability to psychological distress and may increase their risk for reduced work-related quality of life (WRQOL).

OBJECTIVES

This study examined the association between psychological distress and WRQOL among oncology nurses during the COVID-19 pandemic.

METHODS

A cross-sectional analysis of psychological distress and WRQOL among oncology nurses (N = 63) was conducted.

FINDINGS

The mean Depression, Anxiety and Stress Scale score was 33.4, showing low depression levels, mild anxiety, and mild stress. The mean PTSD score was 29.3, and the mean WRQOL Scale score was 78.8. Depression, anxiety, and stress were strongly correlated to PTSD, and WRQOL was negatively correlated to PTSD, depression, anxiety, and stress.

Major Publications in the Critical Care Pharmacotherapy Literature: 2020

OBJECTIVES

To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2020.

DATA SOURCES

The Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update group screened 36 journals monthly for impactful publications.

STUDY SELECTION

The group reviewed a total of 119 articles during 2020 according to relevance for practice.

DATA EXTRACTION

Articles were selected with consensus and importance to clinical practice from those included in the monthly Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update. The group reviewed articles according to Grading of Recommendations, Assessment, Development, and Evaluations criteria. Articles with a 1A grade were selected.

DATA SYNTHESIS

Several trials were summarized, including two meta-analyses and five original research trials. Original research trials evaluating vitamin C, hydrocortisone, and thiamine versus hydrocortisone in sepsis, the use of nonsedation strategies, dexmedetomidine in cardiac surgery, remdesivir for severe acute respiratory syndrome coronavirus 2, and thrombectomy in acute ischemic stroke. Two meta-analyses determining the impact of norepinephrine initiation in patients with septic shock and the use of corticosteroids in severe acute respiratory syndrome coronavirus 2 was included.

CONCLUSIONS

This clinical review provides summary and perspectives of clinical practice impact on influential critical care pharmacotherapy publications in 2020.

A systematic review and meta-analytic evaluation of psychosocial interventions in parents of children with cancer with an exploratory focus on minority outcomes

Parents of children with cancer are prone to psychosocial distress, yet little is known about intervention response among diverse parents. Our systematic review and meta-analysis evaluated the efficacy of psychosocial interventions on anxiety and depression among parents of children with cancer and explored race and/or ethnicity differences in the efficacy of these interventions. Twenty articles met inclusion. The aggregate effect size on anxiety (-0.01, 95% CI: -0.95, 0.93, p = .97) and depression (-0.56, 95% CI: -1.65, 0.54, p = .32) showed micro to medium effects, with larger negative effect sizes indicating that anxiety and depression scores after treatment were lower for parents in intervention group as compared to control group. Neither aggregate effect size was statistically significantly different from zero. Due to underrepresentation of minorities, we could not perform subgroup or moderator analyses. Several efficacious psychosocial interventions were found to reduce parental anxiety. Future studies to examine psychosocial interventions in minority parents are warranted.

Safety and Effectiveness of an Accelerated Intravenous Iron Administration Protocol in Hospitalized Patients With Heart Failure

BACKGROUND

The ACC/AHA heart failure (HF) guidelines include a class IIb recommendation for intravenous (IV) iron replacement in patients with iron deficiency and New York Heart Association class II or III to improve functional status and quality of life. Several studies have addressed the use of IV iron formulations such as ferric carboxymaltose or iron sucrose in HF population; however, few studies focused on sodium ferric gluconate complex (SFGC).

OBJECTIVES

To assess the safety and effectiveness of an IV SFGC administration protocol in patients hospitalized with HF.

METHODS

A retrospective cohort study was conducted. We included patients admitted to the HF service from September 2017 to March 2018. The primary outcome was the frequency of adverse reactions. The secondary outcome was the odds of HF readmissions between the 2 groups (IV SFGC vs. control).

RESULTS

Of the 123 patients, 70 received IV iron (SFGC group) and 53 did not receive IV iron (control group). Five (7%) patients of the 70 in the SFGC group experienced adverse events, which included hypotension (n = 2, 2.8%), fever (n = 2, 2.8%) and myalgia (n = 2, 2.8%). Nine (12.8%) and 18 (25.7%) were readmitted within 30 days and 6 months respectively. In the control arm, 5 (9.4%) and 14 (26.4%) were admitted within 30 days and 6 months respectively. The odds of HF readmission at 30 days [OR 1.4 (95% CI: 0.45, 4.5)] and at 6 months [OR 0.96 (95% CI: 0.43, 2.2)] were similar in those who did not receive IV iron compared to those who received IV iron.

CONCLUSIONS

Sodium ferric gluconate complex given at an accelerated dosing schedule appears to provide a more efficient means to prescribe IV iron in the inpatient setting and is safe with a low frequency of hypotension, fevers, and myalgias.

A Retrospective Comparison of the Effectiveness and Safety of Intravenous Olanzapine Versus Intravenous Haloperidol for Agitation in Adult Intensive Care Unit Patients

OBJECTIVE

Intravenous (IV) olanzapine could be an alternative to first-generation antipsychotics for the management of agitation in intensive care unit (ICU) patients. We compared the effectiveness and safety of IV olanzapine to IV haloperidol for agitation management in adult patients in the ICU at a tertiary academic medical center.

METHODS

A retrospective cohort study was conducted. The primary outcome was the proportion of patients who achieved a Richmond Agitation Sedation Scale (RASS) score of < +1 within 4 hours of IV olanzapine or IV haloperidol administration. Secondary outcomes included the proportion of patients who required rescue medications for agitation within 4 hours of initial IV olanzapine or IV haloperidol administration, incidence of adverse events and ICU length of stay.

RESULTS

In the 192 patient analytic cohort, there was no difference in the proportion of patients who achieved a RASS score of < +1 within 4 hours of receiving IV olanzapine or IV haloperidol (49% vs. 42%, p = 0.31). Patients in the IV haloperidol group were more likely to receive rescue medications (28% vs 55%, p < 0.01). There was no difference in the incidence of respiratory events or hypotension between IV olanzapine and IV haloperidol. Patients in the IV olanzapine group experienced more bradycardia (11% vs. 3%, p = 0.04) and somnolence (9% vs. 1%, p = 0.02) compared to the IV haloperidol group. Patients in the IV olanzapine group had a longer median ICU length of stay (7.5 days vs. 5 days, p = 0.04).

CONCLUSION

In this retrospective cohort study, there was no difference in the effectiveness of IV olanzapine compared to IV haloperidol for the management of agitation. IV olanzapine was associated with an increased incidence of bradycardia and somnolence.

An Integrative Review of Factors Associated With Symptom Burden at the End of Life in Children With Cancer

Children with cancer experience multiple symptoms at end of life (EOL) that impair their health-related quality of life. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, this integrative literature review comprehensively summarized symptom experiences of children with cancer at EOL. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Academic Premier were searched between January 2007 to September 2019 for articles published in English using the MeSH terms: symptom burden or distress AND children with cancer or pediatric cancer or cancer children or oncology and pediatrics AND EOL care or palliative care or death or dying or terminally ill. The inclusion criteria were the following: (a) study designs [randomized controlled trials, nonexperimental, secondary analysis (if aims were distinct from primary studies) and qualitative]; (b) participants <18 years old (died of cancer, had no realistic chance of cure, or had advanced cancer); and (c) focused on symptom experiences/burden at EOL. Exclusion criteria were nonresearch articles, systematic reviews, case studies, reports, and studies that focused on cancer survivors and/or those receiving curative therapies. Twenty-seven articles met inclusion criteria. The most prevalent symptoms-pain, fatigue, dyspnea, and loss of appetitewere associated with impairments in health-related quality of life. Children with brain tumors experienced higher symptom burden compared to those with hematologic/solid malignancies. Children who received cancer-directed therapies experienced disproportionate symptoms and were more likely to die in the intensive care unit compared with those who did not receive cancer-directed therapies. Most common location of death was home. This integrative review indicated that children with cancer were polysymptomatic at EOL. Strategies facilitating effective symptom management at EOL are needed.

A Literature Review of Racial Disparities in Overall Survival of Black Children With Acute Lymphoblastic Leukemia Compared With White Children With Acute Lymphoblastic Leukemia

Despite major advances in acute lymphoblastic leukemia [ALL] treatment, poorer overall survival (OS) persists for Black children with ALL compared with White children with ALL. The purpose of this literature review was to examine the racial disparities on OS in Black versus White children with ALL. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, PubMed, and Academic Search Complete databases were searched using the Medical Subject Heading (MeSH) terms: survival or mortality or outcome AND black or African-American or AA or minority AND racial disparities or race or racial/ethnic disparities AND cancer in children or pediatric cancer or children with leukemia or children with ALL for articles published in English between January 2009 and July 2019. Exclusion criteria were non-research articles, systematic reviews, conference abstracts, editorials, commentaries, correspondence, and case reports. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data were extracted, appraised, and synthesized. Sixteen articles met the inclusion criteria. Sample sizes across studies ranged from 184 to 31,866 participants. The factors most associated with disparities in OS included: age at diagnosis (e.g., <1 year and/or >10 years old), differences in clinical prognosticators (e.g., white blood cell count at diagnosis, T-cell vs. precursor B-cell immunophenotype, central nervous system disease status, cytogenetic profile) and lower socioeconomic status. Future prospective studies are needed to elucidate the role of these factors in OS of Black children with ALL.

Factors That Influence Parental Uncertainty and Health-Related Quality of Life in Children With Cancer: A Framework

The purpose of this paper is to present a conceptual-theoretical-empirical model addressing factors that influence the relation between parental uncertainty and health-related quality of life in children with cancer. The basic concepts identified and defined in the model include parental uncertainty, health-related quality of life, parental trait anxiety, parental depression, and perceived parental social support. The proposed relationships between the concepts are explained with explicit linkages to their empirical indicators. There is limited research in childhood cancer regarding the relation between parental uncertainty and health-related quality of life; therefore, the proposed model will help to better understand this relationship.

Evaluating Cultural Competence of Pediatric Oncology Nurses at a Teaching Hospital: A Pilot Study

This cross-sectional descriptive study evaluated registered nurses’ self-ratings of cultural competence on the hematology/oncology unit at a large Northeastern urban children’s hospital. The Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals was used to measure 5 constructs of cultural competence. The study findings show that there were significant correlations between the knowledge and skill subscales (ρ = .57, P < .001) and the knowledge and desire subscales (ρ = .42, P < .05). The highest mean among the 5 subscales was cultural desire (mean = 15.5), indicating that nurses were motivated to engage in the process of becoming culturally competent. The lowest mean among the 5 subscales was cultural knowledge (mean = 11.2), followed by cultural skill (mean = 11.8), indicating that nurses did not perceive themselves to be well informed in these areas. The findings from this pilot study suggest that nurses on this pediatric oncology unit are most likely to possess cultural desire and cultural awareness, but there is certainly opportunity to engage and educate the staff. Targeted interventions to improve cultural competence on this inpatient unit are being explored and a larger scale study is being planned to assess the cultural competence of nurses across the hospital.