Identification and management of mental health distress in Moroccan patients with cancer: Strategies adopted by oncology nurses and barriers to practice

BACKGROUND

Adressing mental distress among cancer patients presents a substantial challenge in the delivery of oncology care.

AIMS

This present study aims to explore the nursing strategies for identifying and managing distress in cancer patients as well as the concomitant barriers that prevent them from achieving this task.

METHODS

This qualitative study is based on a semi-structured interview with 25 practicing nurses in oncology.

RESULTS

Strategies used by nurses to identify mental distress in their patients include: receiving information, mobilizing interpersonal skills, and identifying causes of distress. When asked about the barriers that hinder the practice of identifying and responding to patients' distress, nurses reported facing several barriers that can be classified into three categories: health care system-related barriers, patient-related barriers, and nurse-related barriers.

CONCLUSION

Oncology nurses should benefit from specific training on the systematic assessment of mental distress in cancer patients, in order to improve the overall management of oncology patients.

Psychometric properties of the Chinese version of the oncology nurses health behaviors determinants scale: a cross-sectional study

Objective

To test the validity and reliability of the Oncology Nurses Health Behaviors Determinants Scale (HBDS-ON) in oncology nurses, the Chinese version was developed.

Methods

The Brislin double translation-back translation approach was employed to forward translation, back translation, synthesis, cross-cultural adaptation, and pre-survey, resulting in the first Chinese version of the Oncology Nurses Health Behaviors Determinants Scale (HBDS-ON). A convenience sample technique was used to select 350 study participants in Liaoning, Shandong, and Jiangsu, China, who satisfied the inclusion and exclusion criteria, to assess the validity and reliability of the scale.

Results

The Chinese version of the Oncology Nurses Health Behaviors Determinants Scale (HBDS-ON) had six subscales (perceived threat, perceived benefits, perceived barriers, self-efficacy, cues to action, and personal protective equipment availability and accessibility), including 29 items. The average scale level was 0.931, and the content validity level of the items varied from 0.857 to 1.000. Each Cronbach's α coefficient had an acceptable internal consistency reliability range of 0.806 to 0.902. X2/df = 1.667, RMSEA = 0.044, RMR = 0.018, CFI = 0.959, NFI = 0.905, TLI = 0.954, and IFI = 0.960 were the model fit outcomes in the validation factor analysis. All of the model fit markers fell within reasonable bounds.

Conclusion

The Chinese version of the Oncology Nurses Health Behaviors Determinants Scale (HBDS-ON) has good reliability and validity and can be used as a tool to assess the influencing factors of chemotherapy exposure for oncology nurses in China.

Patient safety culture predictors and outcomes for sustainable oncology nursing practice: A cross-sectional correlational study

AIMS AND OBJECTIVES

To examine the predictors and outcomes of patient safety culture (PSC) among oncology nurses working in public Saudi hospitals according to participant characteristics and evaluate the relationship between PSC domains.

BACKGROUND

PSC is crucial in healthcare systems, particularly in oncology and chemotherapy units, and its assessment can enhance the standard service provided and cancer care quality. There is currently limited research on the status, predictors and outcomes of PSC in cancer care settings in developing countries, including Saudi Arabia.

DESIGN

A cross-sectional correlational study.

METHODS

A convenience sample of 101 oncology nurses working in two large Saudi tertiary care hospitals participated in this study. The Hospital Survey on Patient Safety Culture validated instrument and demographic and work surveys were completed by the participants. The study methods were compliant with the STROBE checklist. Descriptive statistics and multiple linear regressions were used to analyse the data.

RESULTS

The areas of PSC strength were related to organizational learning-constant improvement, feedback and communication about errors, and transitions and handoffs. Manager/supervisor actions and expectations, hospital management support, communication openness, experience in the current unit and oncology unit/area were the predictors of PSC. In terms of PSC outcomes, the oncology nurses reported either no or one to two adverse events and a substantially good patient safety rating.

CONCLUSION

The level of PSC was lower than expected. Communication openness, experience in the current unit and oncology unit/area were the strongest predictors of PSC. Investing in oncology nursing practice that addresses these concerns and prioritizes patient safety is critical in Saudi cancer care settings to increase patient safety.

RELEVANCE TO CLINICAL PRACTICE

The findings contribute to a better understanding of the predictors and outcomes of PSC, which should be considered when establishing effective nursing interventions or strategies for PSC in cancer care settings.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

How Can Gaps in Oncology Sexual Health Care Be Addressed With the Independent Practice of Nurses?

Over the years, I have embraced various roles ascending the ladder of healthcare leadership, shouldering immense responsibilities and persistently seeking opportunities for professional development. This drive for continuous.

An intervention to manage compassion fatigue in oncology nurses in Durban, South Africa

Background

Oncology nurses are involved through the often protracted and potentially traumatic continuum of diagnosis and treatment of their patients, which places them at high risk of developing compassion fatigue.

Aim

The aim of the study was to develop and implement an in-facility intervention to manage compassion fatigue among oncology nurses in Durban, South Africa.

Setting

The study was conducted with oncology nurses at state, private (private health insurance) and non-governmental oncology facilities (Hospice).

Methods

The Self-Care Intervention for Oncology Nurses was developed and implemented using action research with a mixed methods sequential explanatory design. It involved an integrative review, Professional Quality of Life (ProQOL) v 5 questionnaires (n = 83) and in-depth individual interviews (n = 8).

Results

Developed from the findings of the integrative review, quantitative and qualitative data, the Self-Care Intervention for Oncology Nurses comprised three components, namely psycho-education on risks (booklet), practices of remembrance (remembrance tree) and support structures (support group and follow-up family call). Overall, the participants enjoyed reading the booklet and engaging in the support group. There were varied responses to the remembrance tree and hesitancy to partaking in the follow-up phone call.

Conclusion

The developed intervention could encourage awareness of compassion fatigue amongst oncology nurses' engagement in self-care practices such as symbolic remembrance of patients and recognition of the value of support structures.

Contribution

The intervention may assist oncology nurses in the provision of compassionate caring for their patients and potentially minimise compassion fatigue.

Change-of-Shift Report

This is my final editorial as editor of the Clinical Journal of Oncology Nursing (CJON). And, as with any change of shift, I give this report to the next CJON editor, who will cover this assignment.

Navigating Contradictions in Cancer Screening: Headlines Versus Personalized Approach for Patients and Families

Recently, there have been several seemingly contradictory headlines in the national news regarding cancer incidence and intervals for screening practices. Most recently, a major study questioned whether cancer screening saves.

Diversity, Equity, Inclusion, and Accessibility in Cancer Care: A Synopsis of Literature From 2021 Through April 2023

Contemporary interest in the phenomenon of diversity, equity, inclusion, and accessibility (DEIA) has resulted in a plethora of literature on this topic specific to cancer. Oncology nurses need to be informed of these issues.

Death Anxiety and Associated Factors Among Oncology Nurses and Physicians

Background: Providing care for dying patients is a stress-inducing, complicated, as well as essential responsibility for health care providers. Furthermore, end-of-life care is associated with intense personal emotions such as grief, anxiety, depression, frustration, and guilt. Moreover, caring for terminally ill patients is a challenging task that confronts physicians and nurses with the psychological concerns of dealing with death, which is accompanied by a high level of physical and psychological discomfort.Objective: This study was aimed to measure the level of death anxiety among oncology nurses and physicians and to determine the associated factors that influence their level of death anxiety.Method: A cross-sectional descriptive design was used to guide this study, a non-probability convenience sampling method was used to recruit 200 oncology nurses and physicians from one specialized cancer center in Jordan. Data were collected using an electronic self-reported questionnaire include demographic data sheet and Collett-Lester fear of death scale, as well as all participants were invited via email for voluntary participation in this study.Result: The results revealed that the oncology nurses and physicians exhibited a moderate levels of death anxiety (CLDFODS = 91.07), furthermore, the result showed that female nurses and physicians exhibited a higher level of anxiety than male. Further, there were statistically significant differences in nurses' and physicians' level of death anxiety according to years of experience, receiving previous education on death and dying, and religious beliefs. On the other hand, there is no statistically significant differences in nurses' and physicians' level of death anxiety based on present or previous experience with loss of someone close to them.Conclusion: Jordanian oncology Nurses and physicians exhibited a moderate levels of death anxiety and fear of death, therefore, they have to address the inevitability of mortality since they are caring for dying patients frequently. They have to understand and acknowledge their thoughts regarding death and dying, as well as their death anxiety level before interacting with dying patients.

Implementing Physical Activity Recommendations in Clinical Practice: A Survey of Oncology Nurses' Perspectives

PROBLEM STATEMENT

Better understanding of oncology nurses' perspectives about how interventions should be designed can promote physical activity (PA) in clinical settings.

DESIGN

75 oncology nurses completed online surveys.

DATA SOURCES

A published survey, guided by the Consolidated Framework for Implementation Research, was used to assess multilevel factors that influence implementation of evidence-based interventions.

ANALYSIS

Descriptive statistics were applied to quantitative data; directed content analyses were applied to qualitative data.

FINDINGS

Participants believed it was important to discuss PA with patients; however, they had limited self-efficacy and resources to provide PA counseling. Barriers to providing counseling included competing clinical demands and a lack of education about PA for cancer survivors and resources.

IMPLICATIONS FOR PRACTICE

Findings inform how interventions can be designed for implementation and sustained practice change in clinical settings. Integration of PA education in routine clinical practice will lead to increased PA and, ultimately, improved quality of life among cancer survivors.

Evidence Generation of Standard Nursing Protocol on Chemotherapy-Induced Neutropenia Among Oncology Nurses

Background Chemotherapy uses anti-neoplastic agents, the drugs used to treat malignancies. Neutropenia is associated with cytotoxic therapy. Anti-neoplastic agents are poisonous to the cells, affecting the synthesis of folic acid and damaging the DNA, RNA, and protein that damage the bone marrow. Destruction of bone marrow decreases absolute neutrophil count in the blood. To assess the baseline data and practice of oncology nurses, develop and implement the evidence-based standard nursing protocol, assess the satisfaction level of the patients for the utility of the standard nursing protocol, find out the correlation between knowledge and practice and to associate the knowledge and practice score with selected demographic variables. Material And Method In the study quasi-experimental design was utilized. The study was conducted at Siddharth Gupta Memorial Cancer Hospital, Sawangi (Meghe), Wardha city, between June to Aug 2022 Result The result of the study shows the mean value per existing knowledge is 7.59 and practices is 37.95, post knowledge is 14.23, and post practices is 71.15. The standard deviation values of per exiting knowledge are 2.67 and, practice 3.09 and, post knowledge is 2.32, post practices are 1.32. The calculated t-value of knowledge is 46.57and the p-value is 0001. The calculated t-value of practice is 12.03, and the p-value is 0.0001. Conclusion The present research concluded that the knowledge and skills of oncology nurses are enhanced after implementing the standard nursing protocol.

Determinants Affecting the Rationing of Nursing Care and Professional Burnout among Oncology Nurses

Rationing of nursing care (RNC) is characterized by the omission of any aspect of the required patient care, resulting in incomplete or delayed nursing activities. Oncology nurses are exposed to a very high psychological burden, which can lead to the development of professional burnout syndrome (PBS). The level of PBS might be related to life and job satisfaction. This study aimed to identify determinants affecting RNC and reveal the relationship between RNC, life and job satisfaction, and the PBS levels among oncology nurses. The sample was a hundred oncology nurses from four hospitals in Poland with a mean age of 43.26 ± 10.69 years. The study was conducted from March 2019 to February 2020. The self-administered sociodemographic questionnaire and validated scales determining missed nursing care, job and life satisfaction, and life orientation were used: Basel Extent of Rationing of Nursing Care-Revised (BERNCA-R), Satisfaction with Job Scale (SWJS), Satisfaction with Life Scale (SWLS), Life Orientation Test-Revised (LOT-R), and Maslach Burnout Inventory (MBI). The mean BERNCA score was 1.55 ± 0.15, which indicates the frequency of RNC was between “never” and “rarely”. The mean SWJS score was 11.71 ± 5.97, which showed that nurses were “dissatisfied” and “rather dissatisfied” with their job. A low SWLS score was reported by 59% of nurses, which means that more than half of the respondents described their life satisfaction as low. In LOT-R, 66% of nurses reported pessimistic and 31% neutral life orientation. The mean overall MBI score was 49.27 ± 19.76 points (EE = 63.56 ± 25.37, DEP = 37.2 ± 24.95, and lack of PA = 47.05 ± 22.04), which means that half of the nurses perceived burnout and half did not. Additionally, the higher the job satisfaction (SWJS), the more frequent the RNC (BERNCA) (p < 0.05). The greater the EE, the stronger the sense of lack of PA, and the higher the PBS (MBI) level, the less frequent the RNC (BERNCA). In conclusion, there is a phenomenon of omission of some aspects of care among oncology nurses, but it is not frequent and concerns areas not directly related to therapeutic tasks, but requiring effort and not resulting in quick noticeable effects. It depends only little on life satisfaction and more on job satisfaction and PBS level. The results may indicate the professionalism of Polish nurses, their responsibility towards their patients’ life and health, and the sense of mission that enables them to perform their duties regardless of the external and internal difficulties. The presence of the PBS phenomenon in oncology nurses highlights the need for continued research in this area.

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.

Genetic and genomic learning needs of oncologists and oncology nurses in the era of precision medicine: a scoping review

Genetic and genomic data are increasingly guiding clinical care for cancer patients. To meet the growing demand for precision medicine, patient-facing oncology staff will be a part of leading the provision of genomic testing. A scoping review was undertaken to identify the range of genetic and genomic learning needs of oncologists and oncology nurses. Learning needs were reported relating to interpretation of genomic data, clinical decision-making, patient communication and counseling, and fundamentals of genetics and genomics. There was a lack of empirical research specific to oncology nurses and their learning needs in tumor sequencing. Our findings suggest that oncologists and oncology nurses need tailored support, education and training to improve their confidence and skills in adopting genomic testing into clinical practice.

Impact of a web-based educational program on Japanese nurses tobacco cessation practice and attitudes in oncology settings

PURPOSE

To evaluate the effects of a short web-based educational program on Japanese nurses' self-reported attitudes toward tobacco cessation and their use of interventions to help smokers to quit.

DESIGN

Prospective, single-group design with a pre-educational survey, a short web-based educational program, and a follow-up survey at 3 months.

METHODS

Clinical nurses were asked to view two prerecorded webcasts about helping smokers quit. They completed two online surveys, one at baseline and one at a 3-month follow-up. Generalized linear models were used to determine changes in nurses' self-reported routine practice after the study intervention.

FINDINGS

A total of 1401 nurses responded to the baseline survey, 678 of whom completed the follow-up survey. Compared with baseline, nurses at follow-up were more likely to advise smokers to quit (odds ratio [OR] = 1.45, 95% confidence interval [CI: 1.15, 1.82]), assess patients' interest in quitting (OR = 1.46, 95% CI [1.01, 1.04]), and assist patients with smoking cessation (OR = 1.34, 95% CI [1.04, 1.72]). However, the proportion of nurses who consistently recommended resources for tobacco cessation did not significantly improve at follow-up.

CONCLUSIONS

This study provides preliminary evidence that a web-based educational program can increase nurses' implementation of tobacco dependence interventions in cancer care practice. Sustaining these educational efforts could increase nurses' involvement in providing these interventions, encourage nurses to refer patients to cessation resources, and support nurses' attitudes towards their role in smoking cessation.

CLINICAL RELEVANCE

Our short web-based educational program can increase nurses' use of tobacco-dependence interventions in cancer care practice. This role can be enhanced with additional information about existing cessation resources that nurses could use to refer patients for support post-discharge. Japanese nurses, when properly educated, are willing and significant contributors to promote tobacco use cessation for cancer patients. The contribution can be facilitated through nursing care protocol that integrate tobacco use cessation interventions within evidence-based cancer care approaches.

Bearing Witness in Oncology Nursing: Sharing in Suffering Across the Cancer Care Trajectory

Bearing witness in oncology nursing is a critical practice for supporting patients with cancer, and yet it is an understudied phenomenon most described at the end of life. A literature review was performed to better understand the importance of bearing witness across the cancer care trajectory and to elucidate how the practicing oncology nurse can operationalize this skill in the clinical setting. Studies suggest that oncology nurses who successfully bear witness in their practice not only assist patients and families in meaning-finding, but also sustain themselves for the difficult work of oncology through the deeply gratifying gift they receive from the experience.

Caregiver Education and Training: Learning Preferences of Informal Caregivers of Adult Care Recipients

Oncology nurses play a key role in supporting caregivers through education and training in both inpatient and outpatient settings. This article describes the learning preferences of informal caregivers of adult care recipients. Caregiver respondents preferred multiple training methods, with most endorsing in-person instruction, online video instruction, and reading materials.

Knowledge and attitudes regarding cancer pain management among oncology nurses in China

Objective

There are limited studies examining knowledge and attitudes among Chinese oncology nurses regarding cancer pain management.

Methods

We conducted a cross-sectional survey among oncology nurses from 26 hospitals in China. The nurses completed the Knowledge and Attitudes Survey Regarding Pain (KASRP) questionnaire. Multivariate models were used to identify factors associated with nurses’ KASRP score.

Results

A total of 982 nurses completed the KASRP (mean score = 21.56 ± 4.00), and 8 (0.81%) nurses had a passing score. The results of multivariate regression indicated that clinical rank and experience in cancer pain management were associated with good knowledge and attitudes regarding cancer pain management.

Conclusion

The Chinese nurses in our study did not have adequate knowledge of or positive attitudes related to cancer pain management. Clinical rank and experience caring for patients with cancer could be used to help identify nurses with inadequate knowledge and attitudes regarding treating cancer pain.

Factors associated with self-management practices and self-efficacy among adults with cancer under treatment in Saudi Arabia

AIMS AND OBJECTIVES

To discover the current state of self-management practices and levels of self-efficacy among adults with cancer under treatment in Jeddah City, Saudi Arabia, and to identify their associated factors.

BACKGROUND

The prevalence of cancer and cancer treatment-related problems is increasing in Saudi Arabia. However, effective cancer care programmes are not provided in this country.

DESIGN

Cross-sectional correlational study.

METHODS

This study was conducted with a convenience sample of 130 adults with cancer under treatment from May 2020-August 2020 at the largest tertiary care hospital providing cancer care in the western region, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Self-Care Inventory, Strategies Used by People to Promote Health, and sociodemographic and clinical surveys. Descriptive statistics and stepwise linear regression analysis were performed.

RESULTS

The total score for self-management practices was 84.38 (SD = 13.66) and self-efficacy, as a strong associated factor of self-management, earned a total score of 104.24 (SD = 15.87). Stepwise regression analysis identified self-efficacy, age and education level as important associated variables, explaining 57.6% of the total variance in self-management practices. Significant effects of age, gender, marital status and duration of cancer on patients' self-efficacy were also found.

CONCLUSIONS

The levels of self-management practices and self-efficacy to manage cancer treatment-related problems demonstrated by patients with cancer in this study were rated as a medium. Self-efficacy, age and education level were the significant factors associated with self-management practices of patients in Saudi Arabia. Age, gender, marital status and duration of cancer were identified as associated factors of self-efficacy.

RELEVANCE TO CLINICAL PRACTICE

Enhancing patient's adherence to self-management practices and increase patient's self-efficacy through adopting educational intervention programmes, considering patient's sociodemographic and disease-related characteristics, and continuous patient education must be taken into consideration in the cancer management plan.

Knowledge and Practices on the Safe Handling of Cytotoxic Drugs Among Oncology Nurses Working at Tertiary Teaching Hospitals in Addis Ababa, Ethiopia

Background

Cytotoxic drugs (CDs) administration and occupational exposure is a worldwide concern. Inappropriate handling may cause toxic residues to infiltrate hospital environments and patient care areas, and can even be traced to patients’ homes. Hence, the study sought to assess knowledge and practices on the safe handling of cytotoxic drugs Among Oncology Nurses at Tertiary Teaching Hospitals in Addis Ababa, Ethiopia.

Methods

The researchers conducted a hospital-based cross-sectional study among 77 nurses from April 1–30, 2019. Purposive sampling was used in recruiting the respondents. Structured questionnaires were filled through self-administered interviewing. Data were analyzed using SPSS version 23 software. Multiple linear regression was performed to see the association between dependent variables and independent variables at a p-value of less than 0.05.

Results

Mean score of knowledge and practice of nurses was 7.82±2.22 out of 15 and 22.1±5.50 out of 40 respectively. Nearly 69% of nurses reported the lack of training program on the handling of CDs at their workplaces and the use of Personal Protective Equipment (PPE) remains suboptimal as none used all of PPE. Nurses who had not heard about CDs had an average knowledge score of 0.33 points lower than nurses who had heard about CDs (p ≤ 0.01). Nurses who have scored higher knowledge points had 0.33 points more practice score of safe CD handling than those who had lower knowledge score (p < 0.05) and also married nurses had average safe CDs handling practice score 0.27 points lower than their counterparts (p < 0.05).

Conclusion

Nurses’ knowledge and practice of safe handling of cytotoxic drugs are inadequate. Nurses who have scored higher knowledge points and are married were more likely to practice safe CD handling. Provision of proper PPE and training regarding the handling of CDs for Oncology Nurses are recommended and chemotherapy safety protocol and guidelines should be established.

COVID-19 Pandemic: What Have We Learned?

This issue of the Clinical Journal of Oncology Nursing&nbsp;presents foundational content about clinical oncology care in the environment of a virulent pandemic, particularly the COVID-19 pandemic, which continues to overwhelm global health and healthcare delivery systems.

Clinical Nurse Educator Mentorship: Implementation at an Oncology Program in Rwanda

A long-term partnership among the Butaro Cancer Center of Excellence (BCCOE) in Rwanda, Partners in Health (PIH)/Inshuti Mu Buzima, and Dana-Farber Cancer Institute (DFCI) supports the development of oncology nurses through a clinical nurse educator role. Two senior Rwandan oncology nurses at BCCOE were hired as nurse educators and were mentored by a PIH/DFCI oncology nurse educator using the accompaniment approach. The formalized mentorship process included long-term accompaniment for all educator projects spanning staff training, quality improvement, research, and clinical practice, as well as development of nurse educator competencies and creation of a repository of resources.

The levels, prevalence and related factors of compassion fatigue among oncology nurses: a systematic review and meta-analysis

BACKGROUND

Compassion fatigue is described as the phenomenon of exhaustion and dysfunction in healthcare workers resulting from prolonged exposure to work-related stress and compassion stress. Oncology nurses are at high risk for compassion fatigue.

AIMS

Our study aims to estimate the levels, prevalence and related factors of compassion fatigue dimension in oncology nurses.

DESIGN

Systematic review and meta-analysis.

METHOD

Ten electronic databases were conducted in the systematic review and meta-analysis. Time frame of the searches is from inception up to 31 January 2020. The research team independently conducted study selection, quality assessments, data extractions and analysis of all included studies. The means, standard deviations and prevalence of three dimensions of compassion fatigue were pooled using random-effects meta-analysis. The PRISMA guideline was used to report the systematic review and meta-analysis. PROSPERO registration number: CRD42020205521.

RESULTS

The systematic review included 21 studies, involving 6533 oncology nurses across 6 different countries. In our studies, the pooled mean scores of compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS) were 35.47 (95% CI: 33.54-37.41), 24.94 (95% CI: 23.47-26.41) and 24.48 (95% CI: 23.36-25.60), respectively; the pooled prevalence of "low" rates of CS, "high" rates of BO and STS were 20% (CI 13%-28%), 22% (CI 18%-26%) and 22% (CI 17%-28%), respectively; furthermore, geographical regions (Asia) significantly affect the prevalence of compassion fatigue among oncology nurses. The compassion fatigue variables considered were demographic (age, marital status, education background, health condition and gender), work-related (job satisfaction, income satisfaction, years of working experience, professional title, position and work environment) and other variables (social support, coping strategy, self-compassion, professional cognition and psychological training).

CONCLUSION

Oncology nurses were at "moderate" level of compassion satisfaction, burnout and secondary traumatic stress, and 22% of oncology nurses suffered from "high" risk of compassion fatigue. Hospital administrators should develop interventions to address compassion fatigue phenomenon, and enhance the mental health of oncology nurses and nursing care results.

RELEVANCE TO CLINICAL PRACTICE

Oncology unit warrants special attention, and oncology nurses are at high risk for compassion fatigue. However, the reported prevalence rates and oncology nurses with different characteristics vary considerably. The review provides a preliminary framework for nursing administrators to develop interventions to address compassion fatigue phenomenon, and enhance the psychological health of oncology nurses.

Predictors of Chemotherapy Safe-Handling Precautions and Knowledge Among a Sample of Jordanian Oncology Nurses: A Model-Building Approach

BACKGROUND

There are adverse side effects associated with handling chemotherapy; however, using safe-handling precautions can minimize or prevent these potential effects. Despite availability of international guidelines for chemotherapy handling, adherence to precautions is below expectations. This study examined knowledge of safe-handling precautions among a sample of oncology nurses in Jordon.

METHODS

A cross-sectional study was employed that included a convenience sample of 153 oncology nurses. Oncology nurses from two hospitals completed the Chemotherapy Handling Questionnaire. Descriptive analysis, Spearman rank correlation coefficients, and regression analyses were performed to determine the predictors of precaution use when handling hazardous drugs among participants.

FINDINGS

We observed that age, number of patients for whom the worker administered chemotherapy per day, the number of patients receiving chemotherapy per day in the participant's work unit, nurses' knowledge about safe-handling precautions, perceived risk, perceived barriers, self-efficacy, organization influence/workplace safety climate, conflict of interest, and interpersonal influences were predictors of use of safe-handling precautions (adjusted R² = .66, p < .001).

CONCLUSION/APPLICATION FOR PRACTICE

Several predictors for using safe-handling precautions were identified. Clinically, chemotherapy handling procedures should be evaluated frequently to identify barriers to safe practices and to improve worker safety.

Determination of the working conditions of oncology nurses as professional risks: A qualitative study

BACKGROUND

Nurses often face professional risks in their work. Most research in Russia dedicated to professional risks of nurses are quantitative studies and deal with a limited range of issues. There is an apparent lack of qualitative studies on this problem.

OBJECTIVE

The aim of this research is to study opinions of oncology nurses concerning their working conditions from the point of view of their professional risks assessment and their minimization.

METHOD

The research was conducted by an independent researcher using a method of semi-structured interview. The content-analysis with inductive approach was used for the data analysis.

RESULTS

According to the data analysis there was singled out five main topics, in particular, professional risks that are appreciated by nurses, assessment of professional risks as employment obstacles, permitted ways of psychoemotional risks mastering, permitted ways of physical exertion mastering, effective external mechanisms of risks mastering. In general, nurses do not consider their professional risks as employment obstacles. They lay special emphasis on psychosocial risks, which are the core of all other professional risks.

CONCLUSION

This research shows the opinion of the nursing service heads of oncology departments about professional risks arising in the process of their staff performing the duties. The results of the research demonstrate that the main perceived dangers are psychosocial, biological and chemical risks specific to the work with oncology patients. Possible ways to reduce the impact of professional risks on nurses can be both external institutional mechanisms and internal personal resources. Determining the working conditions of oncological nurses allows to manage occupational risks, to form a valuable attitude to health, as well as to identify indicators that form a social perception of the profession. The study of the working conditions of oncological nurses allows to manage professional risks, form a value-based attitude to health, and also identify indicators that form a social idea of the profession.

The Year of I Don't Know

The year 2020 will go down in various online archives as unbelievable, unreal, seemingly unending, and brimming with unknowns. Let's face it. How many times this year have you said, "I don't know" to yourself or to others? Let me offer a litany of situations.

How Do You Provide Humanistic Care During a Pandemic?

Because of the COVID-19 pandemic, we are at an unprecedented time in history. We practice at Monter Cancer Center in Lake Success, New York, which is part of Northwell Health, the largest health system in New York state, located in the initial epicenter of COVID-19 in the United States.

Immunotherapy Summit: Proceedings and Identified Priorities for Safe Administration and Care

BACKGROUND

Oncology nurses play a significant role in ensuring optimal care coordination for patients receiving immunotherapies.

OBJECTIVES

The Oncology Nursing Society hosted an immunotherapy summit in March 2018. Summit attendees identified and prioritized several critical resource needs to best support oncology nurses administering immunotherapies and caring for patients receiving these therapies.

METHODS

Priorities address care coordination; immunotherapy-specific education for healthcare professionals, patients, and their caregivers; and appropriate assessment, intervention, and documentation to contribute to the science of immunotherapies.

FINDINGS

This article summarizes summit proceedings and priorities for safe administration and care related to immunotherapies.

Effective Cost Conversations: Addressing Financial Toxicity and Cost-Related Health Literacy

Cancer survivors have greater risk of experiencing financial toxicity, or the undue financial burden and stress that patients face related to the costs of cancer care. Cost-related health literacy promotion should begin at the point of care with effective cost-of-care conversations that help to identify and manage patient financial needs. Nurses are uniquely positioned and often sought out as trusted sources of cost-of-care information and play a key role in engaging in effective cost conversations that help consumers to understand and manage their costs of care.

Describing compassion fatigue from the perspective of oncology nurses in Durban, South Africa

Background

Caring for cancer patients can take a toll on the emotional health of oncology nurses, which may lead to compassion fatigue, resulting in decreased quality of nursing care, absenteeism and decreased retention of staff.

Aim

The aim of this study was to describe compassion fatigue from the perspective of oncology nurses. This study is part of a larger mixed-methods action research study to develop an in-facility intervention to manage compassion fatigue in oncology nurses.

Setting

This study was conducted at Durban, KwaZulu-Natal, South Africa.

Methods

The research setting comprised one state hospital (with oncology clinics and wards), a private hospital (with oncology wards) and a hospice in Durban, KwaZulu-Natal, South Africa. Semi-structured individual interviews (guided by Figley’s Compassion Fatigue Process, 2005) were conducted with eight participants. Data were analysed using manifest content analysis.

Results

Five categories emerged from the data, namely, emotional connection, emotional fatigue, emotional loss, blurring boundaries and acceptance.

Conclusion

The findings revealed that oncology nurses are affected emotionally in caring for their patients, thus making them prone to compassion fatigue. Oncology nurses need to acknowledge compassion fatigue and be able to self-reflect on how they are managing (both positively and negatively) with the stressors encountered in the oncology wards or units.

Challenges facing oncology nurses in Jordan: A qualitative study

BACKGROUND

The literature shows that oncology nurses have more stressors than nurses in other units. They face many challenges both within and outside the work environment that affect them negatively. Most of the reviewed studies concerning these challenges were conducted in developed countries.

AIM

The purpose of this study was to explore the challenges experienced by oncology nurses in Jordan during their daily practice.

METHOD

A qualitative descriptive approach was adopted. Semistructured individual face-to-face interviews were conducted with 24 nurses. Participants were selected from oncology departments in one of the biggest governmental hospitals in Jordan.

RESULTS

Two main themes were drawn from the data analysis. The first discussed the personal challenges that oncology nurses encountered. These included emotional attachment to patients and difficulties in separating work and personal life. The second related to organizational challenges in the work environment, which included the nurses' lack of authority to inform patients about their diseases, nursing staff and supply shortages, and a lack of orientation programs. All of these factors affected the psychological status of the nurses.

CONCLUSIONS

The results of this study indicated that the working environment for oncology nurses is highly stressful and demanding and these nurses face many challenges in their work. The understanding and consideration of these challenges by stakeholders, managers, and organizational leaders would lead to improvements in the nurses' psychological state, thereby enhancing the quality of care in these units and helping with staff retention.

Oncology nurses' perceptions of work stress and its sources in a university-teaching hospital: A qualitative study

AIM

To explore and understand work stress and its sources among oncology nurses in a Saudi university-teaching hospital.

DESIGN

Qualitative descriptive study using semistructured interviews.

METHODS

Fourteen oncology nurses working in a university-teaching hospital were interviewed between October - December 2016. Qualitative content analysis according to the Krippendorff method was used to explore work-related stressors among oncology nurses in Saudi Arabia.

RESULTS

Two categories were emerged including "extent of work stress" and "work-related stressors". The second category included the following subcategories of workload and staff shortage, emotional demands, lack of social support, language barriers, and lack of respect from patients and family members and cultural differences.

Ethical decision-making levels of oncology nurses

AIM

This study was carried out in order to determine ethical decision-making levels of oncology nurses.

ETHICAL CONSIDERATION

Research Ethics Committee's approval was obtained prior to the data collection. Permission to use the Turkish version of the Nursing Dilemma Test was received from Birgül Cerit. Written approval was taken from school administrators to conduct the study confirming that there were no invasive procedures planned for human beings during the study period. The study was conducted in accordance with the Helsinki Declaration. Verbal consent was obtained from each of the nurses who agreed to participate after they were informed about the study content.

METHOD

The population of this study conducted in a descriptive way consisted of a total of 96 nurses working at the oncology units and outpatient chemotherapy units of four different hospitals between September 2017 and March 2018. The study sample included 60 nurses who responded to the question form. The data of the study were collected using "Nurses Information Questionnaire" and "Nursing Dilemma Test" developed by Crisham in 1981.

RESULTS

Oncology nurses' mean scores in Principled Thinking (49.00 ± 6.46) and those in Practical Considerations (18.35 ± 4.47) were found to be above the moderate level. It was determined that the oncology nurses participated in the study were familiar with situations similar to the dilemmas included in the Nursing Dilemma Test (15.00 ± 4.20).

CONCLUSION

It was concluded that oncology nurses try to take ethical principles into consideration but are also affected by environmental factors while making decisions concerning ethical dilemmas. The most frequently encountered ethical dilemmas by oncology nurses include the following: deciding not to perform cardiopulmonary resuscitation, telling the truth to the patient, studies being carried out without the patient's content, and patient's refusal of treatment. In order to improve oncology nurses' critical thinking and ethical decision-making skills, it is important to determine ethical dilemmas encountered by oncology nurses, and nurses should be encouraged to be involved in ethical decision-making process through cooperation with the other healthcare personnel.

Evaluation of Online Learning Modules for Improving Physical Activity Counseling Skills, Practices, and Knowledge of Oncology Nurses

PURPOSE/OBJECTIVES

To examine the effectiveness of online learning modules for improving physical activity counseling practices among oncology nurses. 
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DESIGN

Randomized, controlled trial.
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SETTING

Online.
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SAMPLE

54 oncology nurses.
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METHODS

Oncology nurses were randomly assigned to the learning modules group or control group. The learning modules group completed six online learning modules and quizzes focused on physical activity for cancer survivors, general physical activity principles, and motivational interviewing.
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MAIN RESEARCH VARIABLES

Percentage of cancer survivors counseled, self-efficacy for physical activity counseling, knowledge of physical activity, and perceived barriers and benefits of physical activity counseling.
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FINDINGS

Analyses of covariance revealed no significant difference between the learning modules and control groups in the percentage of cancer survivors that oncology nurses counseled. Significant differences were found in self-efficacy for physical activity counseling and perceived barriers to physical activity counseling at postintervention. 
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CONCLUSIONS

The online learning intervention tested in this study improved some parameters of physical activity counseling but did not increase the percentage of cancer survivors that oncology nurses counseled. Additional pilot work is needed to refine the intervention.
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IMPLICATIONS FOR NURSING

This study suggests the potential utility of an evidence-based online learning strategy for oncology nurses that includes information on physical activity and its benefits in cancer survivorship. The findings offer a framework on how to implement physical activity counseling skills in oncology nursing practice.

Health Care Professionals' Perception of Contraindications for Physical Activity During Cancer Treatment

Introduction

Suggested medical contraindications for physical activity (PA) during cancer therapy might have an influence on PA recommendation behavior of Health Care Professionals (HCP). The purpose of the present study was to examine perceptions of physicians and oncology nurses (ON) toward specific medical conditions as contraindications for PA during cancer treatment.

Materials and methods

A total of 539 physicians and 386 ON were enrolled in this cross-sectional survey. HCP judged 13 medical conditions as to whether they are contraindications for PA during cancer treatment. Answering format was "no contraindication"/"potentially a contraindication"/"yes, a contraindication."

Results

χ² analyses revealed significant differences between general practitioners, specialized physicians, and ON in their perception of 10 medical conditions. Approximately half of the medical conditions were answered cautiously, showing high numbers on the response option potentially (36-72%). Moreover, physicians' ratings differed significantly depending on their practical experience with particular medical conditions. Those being familiar with a specific medical condition was more permissive to PA during treatment, with effect sizes (Cramer's V) ranging from 0.13 to 0.27.

Conclusion

Results indicate high cautiousness among HCP in judging medical conditions and their impact on PA during cancer treatment. However, group comparisons show that familiarity and clinical experience with potential contraindications facilitate a confident handling of safety issues, which at best leads to higher levels of PA recommendations during cancer treatment.

In Remission: A Patient's Experience of Continued Care After Chronic Lymphocytic Leukemia

Being a patient with chronic lymphocytic leukemia and now in the midst of infusion treatment after a 17-year remission, I cannot praise oncology nurses enough. I am overwhelmed by their professionalism and warmth and I am delighted to share my perspective as a patient.

Suggesting a Practical Theory to Oncology Nurses: Case Report of a Child in Discomfort

PURPOSE

Children with cancer are faced with many challenges related to their disease that disturbs their comfort. The aim of this study was to apply Kolcaba's comfort theory for a child with cancer.

DESIGN

A case study design was used.

METHODS

We applied Kolcaba's comfort theory for a young boy with cancer who was sad and in discomfort because of intravenous access procedures. Following Kolcaba's taxonomy of needs for comfort in the spiritual and mental level, we designed a new intervention.

FINDINGS

Kolcaba's comfort theory is an appropriate approach which not only helps to assess and evaluate comfort holistically but also assists in performing innovative interventions to provide comfort for children with cancer.

CONCLUSIONS

Kolcaba's comfort theory is a practical theory for oncology nurses.

CLINICAL RELEVANCE

Nursing theories can improve the quality of clinical care.

Establishing Priorities for Oncology Nursing Research: Nurse and Patient Collaboration

PURPOSE/OBJECTIVES

To obtain consensus on priorities for oncology nursing research in the United Kingdom.
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DESIGN

A three-round online Delphi survey.
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SETTING

Oncology nurses were invited via the United Kingdom Oncology Nursing Society (UKONS) database. Patient participation was invited through patient organizations.
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SAMPLE

50 oncology nurses and 18 patients.
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METHODS

Eligible and consenting individuals reported five priorities for oncology nursing research (round 1), rated their level of agreement with them (round 2), and restated and revised their responses in light of the group's responses (round 3). Consensus was defined as 80% agreement.
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MAIN RESEARCH VARIABLES

Research priorities for oncology nursing as reported by oncology nurses and patients. 
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FINDINGS

Consensus was reached on 50 of 107 research priorities. These priorities reflected the entire cancer pathway, from diagnosis to palliative care. Highest agreement was reached within and across groups on the need for research relating to prevention, screening, early diagnosis, and psychological care across the cancer trajectory. Little consensus was reached regarding symptoms and side effects. Some evident divergence existed.

CONCLUSIONS

Oncology nurses and patients do not necessarily prioritize the same research areas. Prevention, screening, and early diagnosis are of the highest priority for future research among oncology nurses and patients. 
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IMPLICATIONS FOR NURSING

Patients usually play little part in priority setting for research. This study provided the opportunity for meaningful patient and nurse involvement in setting a research agenda for oncology nursing that is relevant and beneficial to oncology nurses and patients.

Oncology Nurses' Attitudes Toward the Edmonton Symptom Assessment System: Results From a Large Cancer Care Ontario Study

PURPOSE/OBJECTIVES

To examine oncology nurses' attitudes toward and reported use of the Edmonton Symptom Assessment System (ESAS) and to determine whether the length of work experience and presence of oncology certification are associated with their attitudes and reported usage.
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DESIGN

Exploratory, mixed-methods study employing a questionnaire approach.
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SETTING

14 regional cancer centers (RCCs) in Ontario, Canada.
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SAMPLE

Oncology nurses who took part in a larger province-wide study that surveyed 960 interdisciplinary providers in oncology care settings at all of Ontario's 14 RCCs.
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METHODS

Oncology nurses' attitudes and use of ESAS were measured using a 21-item investigator-developed questionnaire. Descriptive statistics and Kendall's tau-b or tau-c test were used for data analyses. Qualitative responses were analyzed using content analysis.
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MAIN RESEARCH VARIABLES

Attitudes toward and self-reported use of standardized symptom screening and ESAS.
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FINDINGS

More than half of the participants agreed that ESAS improves symptom screening, most said they would encourage their patients to complete ESAS, and most felt that managing symptoms is within their scope of practice and clinical responsibilities. Qualitative comments provided additional information elucidating the quantitative responses. Statistical analyses revealed that oncology nurses who have 10 years or less of work experience were more likely to agree that the use of standardized, valid instruments to screen for and assess symptoms should be considered best practice, ESAS improves symptom screening, and ESAS enables them to better manage patients' symptoms. No statistically significant difference was found between oncology-certified RNs and noncertified RNs on attitudes or reported use of ESAS.
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CONCLUSIONS

Implementing a population-based symptom screening approach is a major undertaking. The current study found that oncology nurses recognize the value of standardized screening, as demonstrated by their attitudes toward ESAS.
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IMPLICATIONS FOR NURSING

Oncology nurses are integral to providing high-quality person-centered care. Using standardized approaches that enable patients to self-report symptoms and understanding barriers and enablers to optimal use of patient-reported outcome tools can improve the quality of patient care.

Central Line-Associated Bloodstream Infection Prevention: Standardizing Practice Focused on Evidence-Based Guidelines

Central venous access devices (CVADs) are integral to the treatment and provision of supportive care for many patients with cancer. Central venous catheters are the most frequent cause of healthcare-associated bloodstream infections. Healthcare-associated bloodstream infections can be prevented when evidence-based practices are followed consistently over time. Establishing nursing best practice with CVADs in the ambulatory setting presents additional challenges because of multiple providers, caregivers, and policies. This article identifies evidence-based practice strategies implemented at a comprehensive ambulatory cancer center to standardize best nursing practice for central lines.
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Providing Palliative Care to Patients with Cancer: Addressing the Needs in Kenya

Cancer is the third highest cause of death in Kenya, preceded by infectious and cardiovascular diseases, and in most cases, diagnosed in later stages. Nurses are the primary caregivers, assessing and managing these patients in the clinic, in inpatient settings, and in rural and remote communities. While cancer rates remain high, the burden to the patient, the caregiver, and society as a whole continues to rise. Kenya's poverty complicates cancer even further. Many Kenyans are unaware of cancer's signs and symptoms, and limited diagnostic and treatment centers are available. Despite these barriers, there is still hope and help for those in Kenya, who suffer from cancer. The World Health Organization has stated that palliative care is a basic human right and nurses providing this care in Kenya are making efforts to support cancer patients' ongoing needs, in order to promote compassionate palliative care and prevent suffering. The purpose of this paper is to address the palliative care needs of patients with cancer in Kenya by providing education to nurses and influencing health-care policy and education at micro and macro levels. A case study weaved throughout will highlight these issues.

Fertility preservation counselling in Dutch Oncology Practice: Are nurses ready to assist physicians?

Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation (FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had "sufficient" knowledge of FP. Twenty-eight per cent of participants reported that they "never/hardly ever" discussed FP; 32.2% "almost always/always." FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a "lack of knowledge" (25.2%), "poor prognosis" (16.4%) and "lack of time" (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended.

Development and Implementation of Evidence-Based Practice in Cancer Care: Challenges and Opportunities

The cancer burden is a global problem, and oncology nurses should be accountable for delivering safe and effective cancer care and providing the best possible experience for patients. The development and application of evidence-based practice in cancer care is an effective strategy in achieving this goal; however, the journey in which such practice involves may encounter various challenges. In this article, the author discusses her own experience, successful and unsuccessful of such a journey. Both challenges and opportunities are identified, and suggestions put forward for making collaborative efforts.

Celebrating ONS's 40th anniversary and its commitment to cultural competency, diversity, and inclusiveness

Today, we all have been taught that cultural competence is a valuable tool in providing patient-centered care. However, this concept was not considered a standard of oncology nursing practice when the Oncology Nursing Society (ONS) began. It was not regarded as a critical component of patient safety, satisfaction, or quality care. In fact, in the 1970s, the importance of providing culturally competent care was virtually nonexistent in our nation's government policies, regulatory standards, academic curriculum, or professional practice. 
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Factors Influencing Nurses' Use of Hazardous Drug Safe-Handling Precautions

PURPOSE/OBJECTIVES

To identify factors associated with oncology nurses' use of hazardous drug (HD) safe-handling precautions in inpatient clinical research units.
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DESIGN

Descriptive, cross-sectional.
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SETTING

The National Institutes of Health Clinical Center in Bethesda, Maryland.
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SAMPLE

115 RNs working on high-volume HD administration units. 
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METHODS

Survey data were collected online using the Hazardous Drug Handling Questionnaire. Data were analyzed using descriptive statistics and multiple regression analysis.
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MAIN RESEARCH VARIABLES

Exposure knowledge, self-efficacy, barriers to personal protective equipment use, perceived risk, conflict of interest, interpersonal influences, workplace safety climate, and total mean HD precaution use.
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FINDINGS

Participants demonstrated high exposure knowledge, self-efficacy, perceived risk, interpersonal influences, and workplace safety climate. Participants demonstrated moderate barriers and conflict of interest. Total mean HD precaution use proved highest during HD administration and lowest for handling excreta at 48 hours. Average patients per day significantly influenced total HD precaution.

CONCLUSIONS

Despite high exposure knowledge, barriers to personal protective equipment use and conflict of interest may contribute to reduced adoption of personal protective practices among oncology nurses.
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IMPLICATIONS FOR NURSING

Hospital and unit-specific factors captured by the predictor variables could contribute to institutional HD policy.

The Oncology Nurse Prescribing: A Catalonian Survey

Objective:

This study identifies the capability, knowledge, and satisfaction of oncology nurses in Spain after approval of the nurse prescribing law in 2006.

Methods:

A descriptive cross-sectional study was conducted among 140 nurses in three cancer centers in Catalonia, Spain, by using convenience sampling method. The principal variables of this study were nurse satisfaction, knowledge about what products nurses are allowed to prescribe, the nurses’ perception of their own prescribing ability, and their opinion on education and training needs with regard to the new approved law. The secondary variables included years of professional experience, place of work, and sociodemographic variables. Data were collected during a 3 months period by using a piloted 29-item self-assessment questionnaire.

Results:

Analyses of univariate and bivariate data showed that 82.2% of the nurses were aware of the approved law, but 94.2% indicated that they lack information about it. The mean satisfaction with the approval of the law was 6.64 ± 1.76 (numerical scale 0-10). In addition, 68.1% and 55.1% of the nurses were prepared to prescribe medical devices and drugs, respectively. To date, 61.1% of the nurses prescribe medical devices and 66% prescribe pharmacological products daily.

Conclusions:

Nurses expressed general satisfaction with the approval of the Law 29/2006. Nurses currently provide prescriptions, but widespread knowledge of the allowed prescriptions is lacking.

Success is not final: onward to the future of evidence-based practice

The Oncology Nursing Society (ONS) is celebrating its 40th anniversary, so it seems only fitting that this column focuses on how evidence-based practice (EBP) has evolved for oncology nurses and ONS during the past 40 years. EBP has been around for a very long time. In the famous Notes on Nursing published in 1860, Florence Nightingale noted that, "The most important practical lesson that can be given to nurses is to teach them what to observe-how to observe-what symptoms can indicate improvement-what the reverse-which are important-which are of none" (p. 5). This quote seems pertinent given that a large part of what oncology nurses do is related to the management of symptoms, either from cancer or its treatment (e.g., chemotherapy, radiation). In addition, during the past 10-15 years, nurses have been immersed in providing symptom management interventions that are based on evidence, not just in hearsay or ritual. 
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A report on the first Asian Oncology Nursing Society conference

The first Asian Oncology Nursing Society (AONS) conference was held in Thailand from November 22 to 24 2013. It was a significant milestone in the journey of the development of the AONS. The objectives of the conference were to facilitate opportunities for networking, collaboration and exchange of ideas with renowned leaders in Oncology Nursing, to facilitate sharing and collaboration of oncology nursing in Asia and to explore innovative strategies to strengthen the implementation of evidence-based practice in oncology nursing.

Establishment of the Asia Oncology Nursing Society (AONS)

Over the past several years, whenever an informal group of Asian oncology nurses gathered, they talked about their mutual desire to create an organization closer to their homes that would be similar to the European Oncology Nursing Society (EONS). They saw this as a means for more of their colleagues to learn about the latest in cancer nursing and to have a time and place to network among themselves. This message continued to gain strength whenever these nurses met at other international meetings such as the International Conference on Cancer Nursing (ICCN), the Multinational Association of Supportive Care in Cancer (MASCC) and the Oncology Nursing Society in US. A definite and planned step toward forming an Asian organization as the first meeting was taken on June 24 2011 when several Asian nurses were attending a MASCC meeting in Greece. The second meeting was held in Prague, Czech Republic, in conjunction with the 17^th ICCN meeting on September 10 2012, where the participants of the meeting included 21 oncology nurses from Asian countries. Finally, the first official meeting of the board directors from nine countries was held on November 21 2013 in Bangkok, Thailand. Now, and in the future, sharing and collaborating in the practice, education and research for oncology nursing in Asia is needed.

Improving cancer survivorship care: oncology nurses' educational needs and preferred methods of learning

Oncology nurses are essential in all phases of cancer care; however, their role in survivorship care is unclear. To better understand the self-reported knowledge and educational needs on topics of survivorship care and oncology nurses' learning preferences, an online survey was conducted. Respondents self-reported knowledge level for 31 care topics, identified areas of most interest, topics needed to assist patients and address patient questions, and reported participation in continuing education and preferred learning methods. Knowledge was rated highest for topics of fatigue, anxiety, and fear of recurrence and lowest for issues related to finance, employment, and insurance. Nurses were most interested in late and long-term physical effects of cancer or treatment, managing emotional issues, cancer screening and surveillance, and complementary and alternative therapies. Study findings suggest that online learning methods would be feasible and well accepted by nurses to meet continuing education needs related to cancer survivorship.