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Srithumsuk W, Prachusilpa G, Thunyawan S, Somkome T. Identification of Nursing Outcomes and Quality Indicators for Home Health Care in Older Adults with End-Stage Cancer. Asian Pac J Cancer Prev 2024; 25:1189-1193. [PMID: 38679977 DOI: 10.31557/apjcp.2024.25.4.1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Indexed: 05/01/2024] Open
Abstract
OBJECTIVE This study aimed to identify nursing outcomes and quality indicators for older adults with end-stage cancer receiving home health care. METHODS Nineteen experts and professional caregivers, including palliative doctors, nursing faculty, advanced practice nurses, and registered nurses, participated in the Delphi technique. Final medians and interquartile ranges were calculated. RESULT Seven components with 43 nursing outcomes and quality indicators for older adults with end-stage cancer were developed, encompassing physical pain relief, symptom management, physical well-being, complication prevention, psychosocial support, caregiver and family roles in end-of-life care, and advance care planning. CONCLUSION The caregiver and family's role in end-of-life care had the most indicators, reflecting the significance of family involvement in Thailand's cultural context. Consistent implementation of these indicators is crucial, and correlational analysis of indicator scores can enhance their validity.
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Affiliation(s)
- Werayuth Srithumsuk
- Faculty of Nursing Sciences and Allied Health, Phetchaburi Rajabhat University, Thailand
| | | | | | - Thunyasiri Somkome
- Department of Pediatric Nursing, Boromarajonani College of Nursing Chagwat Nonthaburi, Nonthaburi, Thailand
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Cloyes KG, Mansfield KJ, Wawrzynski SE, Vega M, Kent-Marvick J, Guo JW. Cancer Survivors' and Care Partners' Audio Diaries on Stress and Social Support Resources During the COVID-19 Pandemic. Semin Oncol Nurs 2024; 40:151623. [PMID: 38538507 PMCID: PMC11045306 DOI: 10.1016/j.soncn.2024.151623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES To describe cancer survivors' and care partners' perceived stress and social support during the COVID-19 pandemic and assess the feasibility of audio diaries for assessing role-related needs and resources. METHODS Participants (N = 51; n = 28 survivors, n = 23 care partners) recorded three monthly audio diaries reporting stress and support experiences. Diaries were transcribed and content-analyzed using a hybrid approach. Stress-related content was inductively coded, and social support content was deductively coded by type (instrumental, information, emotional, companionship, appraisal; κ = 0.75) then inductively coded. Descriptive statistics summarized sociodemographic data and compared coding frequencies by role. We developed narrative summaries of stress and support categories and selected quotes for contextual detail. RESULTS Cancer-related stressors were most prevalent (28.8%), followed by work (26.8%), family (23.1%), social isolation (13.4%), and finances (8.0%). While no significant difference in reporting frequency was observed between roles, cancer-related stress was more prevalent for survivors while work-related stress was mentioned more by care partners. Emotional support was the most prevalent support type (32.1%), followed by companionship (25.3%), appraisal (17.9%), instrumental (16.67%), and informational support (8%). Survivors reported more appraisal support than care partners (χ2 = 6.48, df = 1, P = .011) and more support for self-care, while care partners expressed more other-oriented concerns and focused more on managing responsibilities and interactions outside the household. CONCLUSIONS The pandemic complicated and intensified role-based stressors already present in the survivorship context. Our findings highlight the importance of informal social support networks, particularly when access to formal services is limited, and suggest that audio diaries can be an effective tool for assessing support needs and resources. IMPLICATIONS FOR NURSING PRACTICE Nurses and healthcare providers should tailor social support assessments to address the distinct support needs and individual resources of cancer survivors and their care partners. This is especially critical in contexts that limit access to care and formal services.
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Affiliation(s)
- Kristin G Cloyes
- School of Nursing, Oregon Health & Science University, Portland, OR.
| | - Kelly J Mansfield
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
| | - Sarah E Wawrzynski
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE
| | - Marilisa Vega
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
| | | | - Jia-Wen Guo
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
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Raiber L, Raff C, Thiele J, Kramer K. Integrative Nursing Interventions for Cancer-Related Symptoms in Oncology Inpatients: Results of a Descriptive Pilot Study. Integr Cancer Ther 2024; 23:15347354241239930. [PMID: 38680047 PMCID: PMC11057344 DOI: 10.1177/15347354241239930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/05/2024] [Accepted: 03/01/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND Integrative nursing (IN) is an essential component of integrative medicine and integrative oncology. IN includes a range of external naturopathic, integrative nursing interventions, such as compresses, embrocation, and foot/hand baths, aimed at alleviating symptoms and side effects of conventional treatment. The project IMPLEMENT-UKU ("Implementation of IN at the University Hospital Ulm") was accompanied by a descriptive pilot study on the use of IN interventions on cancer-related symptoms in oncology inpatients, the characterization of these patients and the evaluation of the impact. METHODS A single-arm study was conducted using a paper-based questionnaire administered before the IN interventions (t0) and 24 hours after the IN interventions (t1). Topics included sociodemographic data, symptoms, quality of life, health status, psychological burden, attitudes, and experience and satisfaction with the IN interventions. Analyses were descriptive using absolute and relative frequencies. RESULTS During the 6-month study period out of 66 patients recommended for IN consultation by medical and nursing staff on 2 wards, 62 (93.9%) accepted the offer. Of those patients who received IN, 21 patients (33.9%) participated in the study. The number of IN interventions received per patient ranged from 1 to 3 during the 24-hour survey period. And a total of 36 IN interventions were performed: The most treated body region was the feet/legs (50.0%), followed by the back (25.0%), using oils such as solum oil (41.7%) and lavender oil (13.9%). Embrocation (77.8%) was the predominant type of IN intervention. For patients, the mean FACIT-F score was 29.2 ± 12.5. The mean PHQ-4 score was 3.0 ± 1.9. Regarding sleep quality in the last 4 weeks, 13 participants (61.9%) described it as rather or very poor. Satisfaction with the IN was high, with a large proportion of participants evaluating the IN interventions very positively. CONCLUSION The study's findings suggest that there is a great need for IN among oncology inpatients. These patients are open to and interested in IN interventions and evaluate them positively. IN provides a promising opportunity to provide non-pharmacological support to inpatients. The integration of IN in conventional oncology care settings may enhance patient-centered care and contribute to improved patient wellbeing.
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Affiliation(s)
- Lea Raiber
- University Hospital Ulm, Ulm, Germany
- Interprofessional Graduate School for Integrative Medicine and Health, Witten/Herdecke University, Germany
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Hou X, Li X, Guo R, Wang Y, He S, Yang H, Bai D, Lu Y. Knowledge and Practice Behaviors Toward the Care of the Dying Among Chinese Oncology Nurses: A Cross-Sectional Survey. J Hosp Palliat Nurs 2023; 25:E94-E101. [PMID: 37525347 DOI: 10.1097/njh.0000000000000967] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
The quality of care provided to patients with cancer at the end of their lives remains unsatisfactory, especially during their last days and hours of life. This study aimed to investigate knowledge and practice behaviors of oncology nurses in relation to the care of the dying and to analyze the influencing factors. A convenience sample of 222 oncology nurses was recruited from 14 hospitals in Beijing, China, in January 2022. These nurses completed an online survey that included a demographic and work characteristics questionnaire and knowledge and practice behavior questionnaires regarding the care needs of dying cancer patients. The self-perceived knowledge and practice behavior of oncology nurses toward the care of the dying were found to be moderate. However, their understanding of airway management, restlessness, and delirium management was insufficient. In addition, their ability to effectively communicate recommendations for discontinuing unnecessary procedures, medications, treatments, and monitoring was inadequate. Nurses' previous end-of-life care education and experience of caring for dying patients influenced their knowledge. Nurses' practice settings, experience of caring for dying patients, and their knowledge were key factors in shaping their behaviors. Providing targeted continuing education for nurses in hospital settings and exploring the nursing pathway may be important ways to bridge their knowledge gap and enhance their practice behaviors toward caring for dying patients.
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Kohara I, Fujiwara N, Tamaki S, Nakahama H, Nosaki A, Hosoya M, Yabuki M, Yamamoto M, Kojima C, Fujiwara K. Development of a Japanese Scale that Evaluates the Level of Nursing Support Provided to Patients for Decision-Making in Cancer Clinical Trials. J Cancer Educ 2023; 38:1548-1556. [PMID: 37024607 DOI: 10.1007/s13187-023-02297-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
Clinical nurses need learning programs that are useful in nursing support for patients' decision-making (NSPDM) regarding cancer clinical trials (CCTs). The usefulness of the learning program can be evaluated if the practices of NSPDM before and after participation in the learning program can be compared. We developed a scale to measure the level of self-assessed NSPDM regarding participation in a CCT. Thirty-two items of scale were developed in Japanese based on previous literature. Based on the results of a pilot study, items with similar meanings were removed and the validity of the 26 scale items was statistically examined in terms of construct validity and reliability. The study population was clinical nurses and included clinical research nurses. We received 102 valid responses from clinical nurses. Based on the bias of the boxplot distribution and the ceiling and floor effects for the items analysis of the 26-item draft scale, 17 items remained. Exploratory factor analysis (EFA) revealed that the scale consisted of three subscales and 17 items. Regarding fit indices of the model, the goodness-of-fit index (GFI), adjusted GFI (AGFI), comparative fit index (CFI), and root mean square error of application (RMSEA) were 0.775, 0.704, 0.477, and 0.081, respectively. The Cronbach's alpha coefficient for the overall scale was 0.951, with subscales ranging from 0.820 to 0.942. The validity and reliability of this scale were acceptable. This scale may be helpful to evaluate the usefulness of learning programs, i.e., the practice level of NSPDM.
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Affiliation(s)
- Izumi Kohara
- School of Nursing, Jichi Medical University, Tochigi, Japan.
| | - Noriko Fujiwara
- Department of Palliative Medicine and Advanced Clinical Oncology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Shuko Tamaki
- Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroko Nakahama
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Akiko Nosaki
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Miki Hosoya
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Midori Yabuki
- Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
| | - Mayumi Yamamoto
- Department of Nursing, Jichi Medical University Hospital, Tochigi, Japan
| | - Chiemi Kojima
- Department of Nursing National Cancer Center Hospital, Tokyo, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
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Yimmee S. Learning From Cancer Patients Who Push on With Tenacity. Nurs Sci Q 2023; 36:174-180. [PMID: 36994955 DOI: 10.1177/08943184221150267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Cancer survivors have unique life challenges that threaten their well-being. Concept building has identified fearless tenacity as a process that is critical to meaningful survival, by expanding understanding of how cancer survivors get along day by day as they transcend the course of cancer treatment and move beyond to pursue life purpose. This work establishes a foundation for nurses wishing to promote self-worth through fostering fearless tenacity. It sets a direction for research and practice grounded in the discipline through a specific nursing theory and solid footing from both extant literature and the real life experiences.
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Affiliation(s)
- Suchawadee Yimmee
- Assistant Professor, Orvis School of Nursing, University of Nevada Reno, Reno, NV, USA
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Koleck TA, Topaz M, Tatonetti NP, George M, Miaskowski C, Smaldone A, Bakken S. Characterizing shared and distinct symptom clusters in common chronic conditions through natural language processing of nursing notes. Res Nurs Health 2021; 44:906-919. [PMID: 34637147 PMCID: PMC8641786 DOI: 10.1002/nur.22190] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 01/08/2023]
Abstract
Data-driven characterization of symptom clusters in chronic conditions is essential for shared cluster detection and physiological mechanism discovery. This study aims to computationally describe symptom documentation from electronic nursing notes and compare symptom clusters among patients diagnosed with four chronic conditions-chronic obstructive pulmonary disease (COPD), heart failure, type 2 diabetes mellitus, and cancer. Nursing notes (N = 504,395; 133,977 patients) were obtained for the 2016 calendar year from a single medical center. We used NimbleMiner, a natural language processing application, to identify the presence of 56 symptoms. We calculated symptom documentation prevalence by note and patient for the corpus. Then, we visually compared documentation for a subset of patients (N = 22,657) diagnosed with COPD (n = 3339), heart failure (n = 6587), diabetes (n = 12,139), and cancer (n = 7269) and conducted multiple correspondence analysis and hierarchical clustering to discover underlying groups of patients who have similar symptom profiles (i.e., symptom clusters) for each condition. As expected, pain was the most frequently documented symptom. All conditions had a group of patients characterized by no symptoms. Shared clusters included cardiovascular symptoms for heart failure and diabetes; pain and other symptoms for COPD, diabetes, and cancer; and a newly-identified cognitive and neurological symptom cluster for heart failure, diabetes, and cancer. Cancer (gastrointestinal symptoms and fatigue) and COPD (mental health symptoms) each contained a unique cluster. In summary, we report both shared and distinct, as well as established and novel, symptom clusters across chronic conditions. Findings support the use of electronic health record-derived notes and NLP methods to study symptoms and symptom clusters to advance symptom science.
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Affiliation(s)
- Theresa A. Koleck
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maxim Topaz
- School of Nursing, Columbia University, New York, New York
- Data Science Institute, Columbia University, New York, New York
| | - Nicholas P. Tatonetti
- Data Science Institute, Columbia University, New York, New York
- Department of Biomedical Informatics, Columbia University, New York, New York
- Department of Systems Biology, Columbia University, New York, New York
- Department of Medicine, Columbia University, New York, New York
- Institute for Genomic Medicine, Columbia University, New York, New York
| | - Maureen George
- School of Nursing, Columbia University, New York, New York
| | - Christine Miaskowski
- School of Nursing, University of California San Francisco, San Francisco, California
| | - Arlene Smaldone
- School of Nursing, Columbia University, New York, New York
- College of Dental Medicine, Columbia University, New York, New York
| | - Suzanne Bakken
- School of Nursing, Columbia University, New York, New York
- Data Science Institute, Columbia University, New York, New York
- Department of Biomedical Informatics, Columbia University, New York, New York
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Tay DL, Thompson C, Jones M, Gettens C, Cloyes KG, Reblin M, Thomas Hebdon MC, Beck AC, Mooney K, Ellington L. "I Feel All Alone Out Here": Analysis of Audio Diaries of Bereaved Hospice Family Caregivers During the COVID-19 Pandemic. J Hosp Palliat Nurs 2021; 23:346-353. [PMID: 33660671 PMCID: PMC8243771 DOI: 10.1097/njh.0000000000000763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The COVID-19 pandemic has dramatically changed social life. This secondary qualitative analysis aimed to better understand the impact of the pandemic on bereaved hospice family caregivers' experiences of social connection and isolation in a time of social distancing and general anxiety. Six caregivers in 3 states recorded audio diaries (N = 59) between March 13 and May 15, 2020. Caregivers were, on average, 56.80 years old (SD, 14.22; range, 32-67 years old) and consisted of spouses (n = 2), adult children (n = 3), and a sibling (n = 1). Using NVIVO 12, caregiver diaries were coded for (1) "social connection" (n = 23), defined as being able to access or seeking informal or formal social support networks; (2) "isolation" (n = 17), defined as being unable or reluctant to access informal or formal social support networks, or feeling alone; and (3) "bereavement processes" (n = 147), informed by the dual process model of bereavement (restoration and loss-oriented stressors). Content analysis revealed that caregivers were able to connect with others despite physical distancing expectations, expressed loneliness and grief while in isolation, and described moving on in the face of uncertainty. Findings provide insight into how caregivers experienced bereavement during the initial period of the pandemic and highlight implications for hospice bereavement services.
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Bargoin M, Rey P, Maffre N, Hudde T, Sérange E, Chalard N, Guérin B, Moluçon Chabrot C, Collombet-Migeon F, Bay JO, Bahadoor MRK. [Place of coordination of complex pathways in oncology by coordinating private nurses]. Bull Cancer 2021; 108:686-695. [PMID: 34049669 DOI: 10.1016/j.bulcan.2021.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The complexity of the hospital-city care pathway is a real challenge because of the lack of coordination and communication between many stakeholders. As part of a call for projects from the General Directorate of Healthcare Provision, an experiment involving private oncology coordinating nurses was developed to address this issue. To our knowledge, there is no evaluation so far of such a protocol . METHODS This single-center retrospective study focused on data from the ONC'IDEC program between 2015 and 2018, where 28 private nurses provided a 24/7 hotline. The objective was to qualitatively assess the coordination of this system. The nature and number of calls, patient satisfaction and medico-economic parameters were assessed. RESULTS More than a hundred patients (n=114) were included in this device (mean age: 72 ± 12 years). The most frequent reasons for calls concerned the patient's general condition (35 %) and home treatment follow-ups (13 %) but also referrals to the primary doctor (4 %), which helped avoiding hospitalizations. The patients were satisfied with the experiment (overall score of 8.4/10). DISCUSSION Thanks to the ONC'IDEC program, patients were able to benefit from more appropriate care through a privileged interlocutor by making their care pathway more fluid and avoiding hospitalizations. It would be interesting to confirm these results by means of a study with a higher level of evidence, by comparing this protocol to conventional hospital coordination.
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Affiliation(s)
- Maxence Bargoin
- Service de thérapie cellulaire et d'hématologie clinique Adulte, CHU ESTAING, 1, place Lucie-Aubrac, 63100 Clermont-Ferrand, France.
| | - Philippe Rey
- Union régional des professionnels de santé infirmiers libéraux d'Auvergne Rhône-Alpes, 21, quai Antoine-Riboud, 69002 Lyon, France
| | - Nadia Maffre
- Infirmiers libéraux coordinateurs ONC'IDEC, 15, rue Pré-La-Reine, 63000 Clermont-Ferrand, France
| | - Thierry Hudde
- Infirmiers libéraux coordinateurs ONC'IDEC, 15, rue Pré-La-Reine, 63000 Clermont-Ferrand, France
| | - Eric Sérange
- Infirmiers libéraux coordinateurs ONC'IDEC, 15, rue Pré-La-Reine, 63000 Clermont-Ferrand, France
| | - Nathalie Chalard
- Union régional des professionnels de santé infirmiers libéraux d'Auvergne Rhône-Alpes, 21, quai Antoine-Riboud, 69002 Lyon, France
| | - Bénédicte Guérin
- Réseau régional en cancérologie ONCAUVERGNE, 58, rue Montalembert, 63011 Clermont-Ferrand, France
| | - Cécile Moluçon Chabrot
- Service de thérapie cellulaire et d'hématologie clinique Adulte, CHU ESTAING, 1, place Lucie-Aubrac, 63100 Clermont-Ferrand, France
| | - Frédérique Collombet-Migeon
- DGOS : direction générale de l'offre de soins, sous-direction régulation de l'offre de soins, bureau plateaux techniques et prise en charge hospitalière aigüe - R3, 14, avenue Duquesne, 75350 Paris, France
| | - Jacques-Olivier Bay
- Service de thérapie cellulaire et d'hématologie clinique Adulte, CHU ESTAING, 1, place Lucie-Aubrac, 63100 Clermont-Ferrand, France
| | - Mohun R K Bahadoor
- Réseau régional en cancérologie ONCAUVERGNE, 58, rue Montalembert, 63011 Clermont-Ferrand, France
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Wimberly CE, Towry L, Caudill C, Johnston EE, Walsh KM. Impacts of COVID-19 on caregivers of childhood cancer survivors. Pediatr Blood Cancer 2021; 68:e28943. [PMID: 33565259 PMCID: PMC7995053 DOI: 10.1002/pbc.28943] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE We sought to assess the impact of disruptions due to coronavirus disease 2019 (COVID-19) on caregivers of childhood cancer survivors. METHODS A 13-question survey containing multiple-choice, Likert-type, and free-text questions on experiences, behaviors, and attitudes during the COVID-19 outbreak was sent to childhood cancer caregivers and completed between April 13 and May 17, 2020. Ordered logistic regression was used to investigate relationships between demographics, COVID-related experiences, and caregiver well-being. RESULTS Caregivers from 321 unique families completed the survey, including 175 with children under active surveillance/follow-up care and 146 with children no longer receiving oncology care. Overall, caregivers expressed exceptional resiliency, highlighting commonalities between caring for a child with cancer and adopting COVID-19 prophylactic measures. However, respondents reported delayed/canceled appointments (50%) and delayed/canceled imaging (19%). Eleven percent of caregivers reported struggling to pay for basic needs, which was associated with greater disruption to daily life, greater feelings of anxiety, poorer sleep, and less access to social support (p < .05). Caregivers who were self-isolating reported greater feelings of anxiety and poorer sleep (p < .05). Respondents who expressed confidence in the government response to COVID-19 reported less disruption to their daily life, decreased feelings of depression and anxiety, better sleep, and greater hopefulness (p < .001) CONCLUSIONS: Caregivers are experiencing changes to medical care, financial disruptions, and emotional distress due to COVID-19. To better serve caregivers and medically at-risk children, clinicians must evaluate financial toxicity and feelings of isolation in families affected by childhood cancer, and work to provide reliable information on how COVID-19 may differentially impact their children.
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Affiliation(s)
- Courtney E. Wimberly
- Division of Neuro‐Epidemiology, Department of NeurosurgeryDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Lisa Towry
- Alex's Lemonade Stand FoundationBala CynwydPennsylvaniaUSA
| | - Caroline Caudill
- Institute for Cancer Survivorship and OutcomesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Emily E. Johnston
- Division of Pediatric Hematology/Oncology, Department of PediatricsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Kyle M. Walsh
- Division of Neuro‐Epidemiology, Department of NeurosurgeryDuke University School of MedicineDurhamNorth CarolinaUSA
- Duke Cancer InstituteDuke University School of MedicineDurhamNorth CarolinaUSA
- Children's Health and Discovery Institute, Department of PediatricsDuke University School of MedicineDurhamNorth CarolinaUSA
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Rosa WE, Dahlin C, Battista V, Finlayson CS, Wisniewski RE, Greer K, Ferrell BR. Primary Palliative Care Clinical Implications: Oncology Nursing During the COVID-19 Pandemic. Clin J Oncol Nurs 2021; 25:119-125. [PMID: 33739351 PMCID: PMC8219217 DOI: 10.1188/21.cjon.119-125] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic continues to affect the health and well-being of individuals and communities worldwide. Patients with cancer are particularly vulnerable to experiencing serious health-related suffering from COVID-19. This requires oncology nurses in inpatient and clinic settings to ensure the delivery of primary palliative care while considering the far-reaching implications of this public health crisis. With palliative care skills fully integrated into oncology nursing practice, health organizations and cancer centers will be better equipped to meet the holistic needs of patients with cancer and their families receiving care for serious illness, including improved attention to physical, psychosocial, cultural, spiritual, and ethical considerations.
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12
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Strategies to promote coping and resilience in oncology and palliative care nurses caring for adult patients with malignancy. Nurs Health Sci 2021; 23:768-72. [PMID: 33787011 DOI: 10.1111/nhs.12801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Su Z, McDonnell D, Liang B, Kue J, Li X, Šegalo S, Advani S, Flores BE, Wang J. Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: a systematic review protocol. Syst Rev 2021; 10:43. [PMID: 33526095 PMCID: PMC7849615 DOI: 10.1186/s13643-021-01592-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/15/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. METHODS A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. CONCLUSIONS COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020196301.
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Affiliation(s)
- Zhaohui Su
- School of Nursing, Center on Smart and Connected Health Technologies, Mays Cancer Center, UT Health San Antonio, San Antonio, TX 78229 USA
| | - Dean McDonnell
- Department of Humanities, Institute of Technology Carlow, Carlow, R93 V960, Ireland
| | - Bin Liang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10010 China
| | - Jennifer Kue
- School of Nursing, Ohio State University, Columbus, USA
| | - Xiaoshan Li
- Program of Public Relations and Advertising, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - Sabina Šegalo
- Department of Microbiology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Shailesh Advani
- Terasaki Institute of Biomedical Innovation, Los Angeles, CA 21100 USA
| | - Bertha E. Flores
- School of Nursing, UT Health San Antonio, San Antonio, TX 78229 USA
| | - Jing Wang
- School of Nursing, Center on Smart and Connected Health Technologies, Mays Cancer Center, UT Health San Antonio, San Antonio, TX 78229 USA
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Maskor NA, Muhamad M, Krauss SE, Nik Mahmood NH. Relationship between Personal Values, Work Experience and Nursing Competencies among Cancer Care Nurses in Malaysia. Asian Pac J Cancer Prev 2021; 22:287-294. [PMID: 33507710 PMCID: PMC8184200 DOI: 10.31557/apjcp.2021.22.1.287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 01/21/2021] [Indexed: 12/03/2022] Open
Abstract
Oncology nurses are an essential component of cancer care teams. Nurses play a vital role in ensuring that cancer patients comply with their cancer treatment. In the cancer care nursing context, competency is not merely being skilled, but also implies the characteristic of being able to perform effectively. In addition to the need for competence, nursing is a discipline rich in values including human dignity, caring, humanity, and respect for personal privacy. Research from a variety of disciplines indicates that values often influence human behaviour in professional and work settings. It is often believed, therefore, that nurse' values and work experience influence and contribute to their work performance. Few studies have attempted to examine these relationships, particularly in the context of cancer care nursing. The purpose of this study was to determine the relationship between personal values, work experience and competency among cancer care nurses in Malaysia. Quantitative surveys were used to collect the data. A total of 845 cancer care nurses from 38 public hospitals in Peninsular Malaysia participated in the study. Descriptive statistics and Pearson Product-Moment Correlations were used to analyse the data. The findings revealed positive and significant relationships between personal values and competency (r = 0.59, p < 0.01) and work experience and competency (r = 0.11, p < 0.047). The findings support the assertion that Malaysian nurses' values and work experience are related to performance-related competency. .
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Affiliation(s)
- Nor Aida Maskor
- Professional Development and Continuing Education, Faculty of Educational Studies, Universiti Putra Malaysia, Malaysia.
| | - Mazanah Muhamad
- Professional Development and Continuing Education, Faculty of Educational Studies, Universiti Putra Malaysia, Malaysia.
| | - Steven Eric Krauss
- Professional Development and Continuing Education, Faculty of Educational Studies, Universiti Putra Malaysia, Malaysia.
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15
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Miao B, Sun Y, Gong L, Liu W. Modular transitional nursing intervention improves pain-related self-management for cancer patients: Study protocol for a randomized controlled trial. Medicine (Baltimore) 2020; 99:e23867. [PMID: 33371172 PMCID: PMC7748349 DOI: 10.1097/md.0000000000023867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To explore the effect of modular transitional nursing intervention on the improvement of self-management of the patients with cancer pain. METHOD This study will be conducted from March 2021 to May 2022 at Affiliated Hospital of Beihua University. The experiment was granted through the Research Ethics Committee of Affiliated Hospital of Beihua University (4348-019). Eighty patients are analyzed in our study. The patients will be included if they are between 18 and 70 years old and are diagnosed with cancer, the pain intensity score on moderate level, the pain lasts for more than 3 days, and the patients who have signed the written informed consent. While the patients will be excluded if they have a documented history of drug or alcohol abuse, and patients with limited performance, and patients have a surgery in the past 3 days. The primary result mainly expresses as intergroup differences in self-management disorders (Barriers Questionnaire-II) associated with the cancer pain. And the secondary results include the quality of life (QOL) and pain intensity. All the analyses are implemented with SPSS for Windows Version 20.0. RESULTS Table 1 will show the clinical outcomes between the 2 groups. CONCLUSION A modular transitional nursing intervention appears to reduce pain in cancer patients. TRIAL REGISTRATION NUMBER researchregistry6262.
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Bravery B, Loughnan S, Murphy M. Depression treatment research in people with cancer does not reflect cancer prevalence: findings from a systematic review. Evid Based Ment Health 2020; 23:155-160. [PMID: 32788165 PMCID: PMC10231615 DOI: 10.1136/ebmental-2020-300145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND One in six people with cancer will develop depression at some point in their care. Untreated depression affects quality of life, cancer care satisfaction and healthcare expenditure. Treatments for this vulnerable heterogenous population should be evidence based and specific. A common sentiment is that psychiatric research does not reflect the prevalence of patients with cancer and comorbid depression and is biased towards certain cancers, but this has not been empirically shown. STUDY SELECTION AND ANALYSIS A systematic review of studies on psychological and pharmacological treatments for depression in people with cancer was conducted. Of 4621 papers identified from a search of PubMed and PsycINFO up to 27 June 2020, 84 met inclusion criteria (eg, adults with cancer; depression diagnosis; treatment study) and comprised 6048 participants with depression with cancer. FINDINGS Cancer types are not proportionally represented in depression research in accordance with their incidence. Breast cancer is over-represented (relative frequency in research 49.3%, but 11.7% of global cancer). Cancers of the head and neck and bone and soft tissue were close to parity. All other cancers are under-represented. Representativeness varied 40-fold across different cancers. CONCLUSIONS The evidence base for depression treatments is dominated by a single cancer. Given heterogeneity in cancer populations (eg, stage of illness; psychological impact; cancer treatments), it is possible that depression treatments may not have the same benefits and harms across all cancers, impeding the ability to offer people with different cancers the best depression treatment. While the dominant opinion within this research field is that a cancer bias exists, this is the first study to demonstrate as such.
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Affiliation(s)
- Benjamin Bravery
- School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
| | - Siobhan Loughnan
- Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent's Hospital, UNSW, Darlinghurst, New South Wales, Australia
| | - Michael Murphy
- Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent's Hospital, UNSW, Darlinghurst, New South Wales, Australia
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17
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Saouma Nehmé M, Desbiens JF, Gagnon J. [Nursing practice in palliative care with terminally ill cancer patients in an interdisciplinary team: A case study in Lebanon]. Rech Soins Infirm 2020; 141:60-69. [PMID: 32988191 DOI: 10.3917/rsi.141.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Nurses in Lebanon are poorly prepared to provide palliative care (PC), and practice in this area is poorly documented. This qualitative descriptive study aimed to understand the reality of nursing practice in PC, with terminally ill cancer patients, within an interdisciplinary team. A simple case study was conducted with eleven nurses, three families, an interdisciplinary team, and national experts in PC. Data analysis, carried out with triangulation of both methods and sources, highlighted a humanist relationship characterized by caring, transcending the five central emerging themes : the perception of PC as a means of offering a better quality of life, comprehensive patient care, interdisciplinarity, spirituality, and family support during PC. The results could provide empirical foundations to guide the development of PC nursing practice in the country.
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18
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Yang WFZ, Liu J, Chan YH, Griva K, Kuparasundram S, Mahendran R. Validation of the Needs Assessment of Family Caregivers-Cancer scale in an Asian population. BMC Psychol 2020; 8:84. [PMID: 32787927 PMCID: PMC7424999 DOI: 10.1186/s40359-020-00445-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/20/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The Needs Assessment of Family Caregivers- Cancer (NAFC-C) scale is shown to have adequate psychometric properties in assessing family caregiver needs during the cancer journey and its psychometric properties have been studied only in Western populations. This study sought to validate the NAFC-C in an Asian population for wider applicability. METHODS Participants (n = 363) completed questions on sociodemographics, the Depression Anxiety Stress Scale, the Zarit Burden Interview, the Caregiver Quality of Life Index-Cancer scale, and the NAFC-C. RESULTS Results revealed good internal consistency, test-retest reliability, and concurrent validity of the NAFC-C. Confirmatory factor analysis did not demonstrate a good fit of the NAFC-C in our sample. Exploratory factor analysis revealed a similar factor structure in this study's population. Further reliability and validity analyses with the EFA factor structure demonstrated similar reliability and validity assessments. CONCLUSIONS The NAFC-C is shown to be applicable in an Asian population. It would be a useful instrument for determining family caregivers' needs and to inform future interventions to address those needs and improve or maintain quality of life in both patients and their caregivers.
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Affiliation(s)
- Winson Fu Zun Yang
- National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074 Singapore
- Department of Psychological Science, Texas Tech University, Box 42051, Lubbock, TX 79409-2051 USA
| | - Jianlin Liu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, Faculty of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, Singapore, 539747 Singapore
| | - Yiong Huak Chan
- Dean’s Office, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore, 119228 Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Imperial College & Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921 Singapore
| | - Sangita Kuparasundram
- SingHealth Residency, Ministry of Health Holdings, 1 Maritime Square, Singapore, 009253 Singapore
| | - Rathi Mahendran
- National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074 Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, Faculty of Medicine, National University of Singapore, Singapore, Singapore
- Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
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19
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Nishikido N, Yoshikawa E, Sasaki M, Sudo J, Mochizuki M, Ito M, Watai I. Support for balancing cancer treatment and work by occupational health nurses: support structures and implementation status. Ind Health 2020; 58:354-365. [PMID: 32062626 PMCID: PMC7417504 DOI: 10.2486/indhealth.2019-0150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
This study aimed to quantitatively grasp the structure of support for balancing cancer treatment and work among occupational health nurses (OHNs) with the current implementation status. The anonymous questionnaire was designed based on the findings of our previous qualitative study and distributed to OHNs. The degrees of support implementation for workers with cancer, superiors and colleagues, and human resource managers were assessed for each item. Factor analysis of support items was conducted, and Wilcoxon signed-rank test was carried out to compare the support scores between the factors. Support for workers with cancer comprised six factors in which the factor, concerning the provision of information regarding resources inside and outside the company, showed the lowest score. Support for superiors and colleagues was divided into three factors, and that for human resource managers comprised two factors. By Mann-Whitney's U-test, it was found that OHNs, who worked without full-time occupational health physicians for smaller companies, showed significantly higher implementation for several support factors, such as support to human resource managers. This study revealed the structure as well as implementation status of OHNs' support for balancing cancer treatment and work, which will provide suggestions for developing training programs for OHNs to promote these activities.
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20
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Affiliation(s)
- Ophira Ginsburg
- Section for Global Health, Department of Population Health, NYU Grossman School of Medicine and Perlmutter Cancer Center, NYU Langone Health, New York, NY 10016, USA.
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Sun WN, Hsu HT, Ko NY, Huang YT. Decision-Making Processes in Surrogates of Cancer Patients in a Taiwan Intensive Care Unit. Int J Environ Res Public Health 2020; 17:ijerph17124443. [PMID: 32575778 PMCID: PMC7345805 DOI: 10.3390/ijerph17124443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 11/16/2022]
Abstract
Background: Few studies in Asian countries have explored the emotional entanglements and conflicts that surrogates often experience during the medical decision-making process. This study was to explore decision-making processes in surrogates of cancer patients in a Taiwan intensive care unit (ICU). This qualitative study surveyed a purposive sample of surrogates (n = 8; average age, 48 years) of cancer patients in the ICU of a medical center in Taiwan. A phenomenological methodology was used, and a purposive sample of surrogates of cancer patients were recruited and interviewed during the first three days of the ICU stay. Results: Based on the interview results, four themes were generalized through text progression: (1) Use love to resist: internal angst. This theme was related to the reflexive self -blame, the feelings of inner conflict, and the reluctance to make healthcare decisions, which surrogates experienced when they perceived suffering by the patient. (2) Allow an angel to spread love among us: memories and emotional entanglements. Memories of the patient caused the surrogate to experience emotional entanglements ranging from happiness to sadness and from cheerfulness to anger. (3) Dilemmas of love: anxiety about ICU visitor restrictions. The confined space and restricted visiting hours of the ICU limited the ability of surrogates to provide emotional support and to share their emotions with the patient. (4) Suffocating love: entanglement in decision-making. Emotional entanglements among family members with different opinions on medical care and their struggles to influence decision-making often prevented surrogates from thinking logically. Conclusions: Expression of emotions by ICU surrogates is often restrained and implicit, particularly in Asian populations. These results can help health professionals understand the psychological shock and inner conflict experienced by surrogates and provide a useful reference for improving their communications with surrogates.
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Affiliation(s)
- Wan-Na Sun
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (W.-N.S.); (N.-Y.K.)
| | - Hsin-Tien Hsu
- School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101 (ext. 2630)
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (W.-N.S.); (N.-Y.K.)
| | - Yu-Tung Huang
- Center for Big Data Analytic and Statistics, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan;
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22
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Jabłoński MJ, García-Torres F, Zielińska P, Bułat A, Brandys P. Emotional Burden and Perceived Social Support in Male Partners of Women with Cancer. Int J Environ Res Public Health 2020; 17:ijerph17124188. [PMID: 32545445 PMCID: PMC7344620 DOI: 10.3390/ijerph17124188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/31/2020] [Accepted: 06/08/2020] [Indexed: 12/31/2022]
Abstract
Background: The aim of this study was to describe the correlations between the psychosocial burden on male caregivers and their perception of social support, as well as distress, anxiety, and depression among their partners in the first six months after a cancer diagnosis. Methods: A cross-sectional, longitudinal and observational study was conducted on a group of 61 couples, with the use of Zarit Burden Interview (ZBI), Caregiver Burden Scale (CBS), Berlín Social Support Scales (BSSS), Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT). Statistical analysis was performed using Statistica v.13. Results: A strong positive correlation between the ZBI and CBS, as well as between support-seeking and the emotional involvement of male partners, was documented. The negative correlation between the lack of instrumental support and a much greater burden on caregivers, in emotional, social, and family life was documented. The level of distress, anxiety, and depression, as well as family problems reported by female patients, were positively correlated with the male caregiver′s burden. A demographic analysis showed significant relationships between the number of offspring and the negative health indicators of patients and their partners. Implications: The obtained results encourage deeper reflection on the need to improve the availability of instrumental support for male caregivers and support for families with an oncological ill parent in caring for minor children, and to maintain the social activity of the caregiver.
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Affiliation(s)
- Marcin J. Jabłoński
- Institute of Psychology, Faculty of Philosophy, Jesuit University Ignatianum in Krakow, 31-501 Kraków, Poland;
| | - Francisco García-Torres
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain
- IMIBIC Health Research Institute, Reina Sofía University Hospital of Cordoba, 14004 Cordoba, Spain
- Correspondence: ; Tel.: +34-957-218-847; +34-646-545-104
| | - Paulina Zielińska
- The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology (MCMCC) branch in Krakow, 31-115 Kraków, Poland; (P.Z.); (A.B.); (P.B.)
| | - Alicja Bułat
- The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology (MCMCC) branch in Krakow, 31-115 Kraków, Poland; (P.Z.); (A.B.); (P.B.)
| | - Piotr Brandys
- The Maria Skłodowska Curie Memorial Cancer Centre and Institute of Oncology (MCMCC) branch in Krakow, 31-115 Kraków, Poland; (P.Z.); (A.B.); (P.B.)
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Lacroix C, Georges G, Thézenas S, Flori N, Francioni L, Janiszewski C, Courraud J, Lecornu H, de Forges H, Senesse P. [The role of the specialist nurse in parenteral nutrition : An observational study of complications with home parenteral nutrition in adult cancer patients]. Rech Soins Infirm 2020; 140:107-116. [PMID: 32524798 DOI: 10.3917/rsi.140.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background : In France, home parenteral nutrition (HPN) is managed by two parallel healthcare systems : in approved specialist centers (HPN > 12 weeks), and outside of these approved specialist centers (HPN<12 weeks).
Objective : To prospectively evaluate infectious and vascular complications in adult cancer patients undergoing HPN administered via a central venous line, outside of approved specialist HPN centers.
Methods : Our observational prospective study included adult patients with cancer, hospitalized for 48 hours or more, and under HPN. They had a WHO performance status of ≤ 2 and had had a nutritional consultation before discharge.
Results : 25 patients were included in the study, with a median age of 63 years [19–74]. Weight loss of ≥ 5% was reported in 79% of patients. The Ingesta score was < 7 in 96% of cases. 87% of patients presented chill or body temperature variation episodes, with a median of 2 episodes [1–6] per patient. The median delay between end of hospitalization and the first chill episode was 11 days [1–85]. A vascular complication (obstruction without thrombosis) was reported in one patient.
Discussion : This high number of infectious episodes requires improvement of patient care when it comes to strictly adhering to the recommendations. Getting the approved specialist HPN centers to work together and share care protocols could be the first important step.
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Winterling J, Lampic C, Wettergren L. Fex-Talk: a Short Educational Intervention Intended to Enhance Nurses' Readiness to Discuss Fertility and Sexuality with Cancer Patients. J Cancer Educ 2020; 35:538-544. [PMID: 30825079 PMCID: PMC7245594 DOI: 10.1007/s13187-019-01493-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexual and reproductive health is known to generally be insufficiently addressed by health care personnel working in cancer care. We hence developed a short educational intervention, Fex-Talk, to overcome the barriers to communicate about sexuality and fertility. The present study sought to evaluate the Fex-Talk intervention, which aims to enhance nurses' readiness to discuss fertility and sexuality issues with cancer patients. The educational intervention involves a single session with an optional follow-up session, and it includes different components in accordance with Kolb's experiential learning cycle. The evaluation was based on participants' oral and written feedback regarding the content and organization of the intervention, as well as on teachers' field notes from five educational events involving nurses who work with cancer patients (n = 140). The data were analyzed using a thematic approach. Four themes were identified, namely increased awareness, need for knowledge, challenging discomfort, and dealing with external obstacles. The intervention increased participants' awareness of patients' need to discuss sexuality and fertility and of their own need for additional knowledge. The role-play exercise was said to challenge personal discomfort, although the participants still felt it helped to boost their courage to, in the future, engage in such conversations. Several external obstacles to initiate a conversation about sexuality or fertility were identified, and possible strategies for overcoming them were discussed. In conclusion, the Fex-Talk intervention was experienced positively by the participating nurses. The results indicate that the intervention increased nurses' understanding of patients' needs related to sex and fertility and overcome barriers to initiate discussions about sex and fertility with patients.
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Affiliation(s)
- Jeanette Winterling
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23 300, SE-141 83, Huddinge, Sweden.
- Patient Area of Hematology, Karolinska University Hospital, Stockholm, Sweden.
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lena Wettergren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Abstract
There is a critical need for quality oncology education in Canadian baccalaureate nursing programs considering the vast amount of cancer diagnoses and deaths in the Canadian population, as well as the likelihood that all nurses will care for oncology patients in various settings. The incidence and mortality of cancer within the Canadian population impact the need to incorporate an all-inclusive view of cancer care into baccalaureate nursing curriculums and develop nurse leaders in oncology at this level. Currently, Canadian nursing programs are generalist programs and provide little oncology content especially in the clinical setting. It is essential that baccalaureate nursing programs examine strategies to incorporate a comprehensive view of cancer care into programs to ensure that baccalaureate nursing students meet the entry to practice competencies to care for patients across the cancer care trajectory.
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Affiliation(s)
- Cindy Davidson
- Vancouver Island University, 900 Fifth St, Nanaimo, BC, V9R 5S5, Canada.
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Skeens MA, Cullen P, Stanek J, Hockenberry M. Perspectives of Childhood Cancer Symptom-Related Distress: Results of the State of the Science Survey. J Pediatr Oncol Nurs 2020; 36:287-293. [PMID: 31307322 PMCID: PMC7197224 DOI: 10.1177/1043454219858608] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Management of symptom-related distress is an important area of pediatric oncology nursing. Participants who attended the Children's Oncology Group (COG) State of the Science Symposium on symptom distress completed an anonymous survey. The purpose was to explore participant perceptions of symptom distress experienced by children receiving cancer treatment on clinical trials, determine how symptom distress is currently assessed at COG institutions, and to identify what interventions are used to reduce symptom distress for these children. Among the 90 symposium attendees, 72% completed the survey, the majority (92%) of whom were nurses. The five most distressing symptoms in children with cancer enrolled on clinical trials identified by survey respondents were nausea/vomiting, fatigue, pain, anxiety, and sleep disturbances. Results from our survey also suggest that symptom distress may differ by disease type. For example, symptoms associated with leukemia/lymphoma included steroid side effects, procedural pain, and neuropathy. The majority of respondents (90%) also reported that symptoms go unrecognized by health care providers. The most commonly described unrecognized symptoms were behavioral (i.e., sadness, anxiety, fear, depression, and emotional needs; 45%) and fatigue (19%). Key focus areas reported by respondents included informal and inconsistent symptom assessment, the need for uniform measurement tools, and improved documentation of symptom-related distress. Management of symptom-related distress is an important aspect of pediatric oncology nursing. Further exploration of symptom distress experienced by children with specific types of cancers, and the development of standardized symptom assessment processes, will provide a foundation for developing future interventions aimed at alleviating symptom-related distress.
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Affiliation(s)
| | | | - Joe Stanek
- 1 Nationwide Children's Hospital, Columbus, OH, USA
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Ketcher D, Ellington L, Baucom BRW, Clayton MF, Reblin M. "In Eight Minutes We Talked More About Our Goals, Relationship, Than We Have in Years": A Pilot of Patient-Caregiver Discussions in a Neuro-Oncology Clinic. J Fam Nurs 2020; 26:126-137. [PMID: 32475300 PMCID: PMC9119347 DOI: 10.1177/1074840720913963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Primary brain cancer is a diagnosis that can have drastic health impacts on patient and caregiver alike. In high-stress situations, dyadic coping can improve psychosocial and health outcomes and communication about personal life goals maybe one way to facilitate this coping. In this study, we describe the feasibility and accessibility of a one-time, self-directed goal discussion pilot intervention for neuro-oncology patients and their primary caregivers. Ten dyads were taken to a private room to complete a pre-discussion questionnaire, a worksheet to elicit personal goals, complete an 8-min discussion of goals, a post-discussion questionnaire, and provided open-ended feedback about the process. Post-discussion, dyads reported that the intervention was not stressful. In open-ended feedback, dyads overwhelmingly reported that the intervention was a positive experience, providing a safe, calm environment to have difficult conversations. This intervention provides a positive framework for improving communication and discussion of goals between patient-caregiver dyads.
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Abstract
Oncology nurses are at increased risk for compassion fatigue compared with those in other specialties. This article describes a quality improvement project to create self-compassion tool kits by incorporating the input and opinions of the frontline staff.
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Affiliation(s)
- Victoria L Reiser
- In Pittsburgh, Pa., Victoria L. Reiser is a senior professional staff nurse II at the University of Pittsburgh Medical Center, Shadyside, and a DNP student at the University of Pittsburgh; and Judith F. Zedreck Gonzalez is a professor and coordinator of the health systems executive leadership program at the University of Pittsburgh
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Segerlantz M, Axmon A, Ahlström G. End-of-life care among older cancer patients with intellectual disability in comparison with the general population: a national register study. J Intellect Disabil Res 2020; 64:317-330. [PMID: 32067284 DOI: 10.1111/jir.12721] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/13/2019] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Increasing life expectancy for people with an intellectual disability (ID) is resulting in more persons with cancer and a greater need for end-of-life (EoL) care. There is a need for knowledge of health care utilisation over the last year of life to plan for resources that support a high quality of care for cancer patients with ID. Therefore, the aims of the study were to compare (1) health care utilisation during the last year of life among cancer patients with ID and cancer patients without ID and (2) the place of death in these two groups. METHODS The populations were defined using national data from the period 2002-2015, one with ID (n = 15 319) and one matched 5:1 from the general population (n = 72 511). Cancer was identified in the Cause of Death Register, resulting in two study cohorts with 775 cancer patients with ID (ID cohort) and 2968 cancer patients from the general population (gPop cohort). RESULTS Cancer patients with ID were less likely than those without ID to have at least one visit in specialist inpatient (relative risk 0.90, 95% confidence interval 0.87-0.93) and outpatient (0.88, 0.85-0.91) health care, during their last year of life. Those with ID were more likely to have no or fewer return visits than the patients in the gPop cohort (5 vs. 11, P < 0.001), also when stratifying on sex and median age at death. Most cancer patients with ID died in group homes or in their own homes and fewer in hospital (31%) as compared with cancer patients in the gPop cohort (55%, 0.57, 0.51-0.64). CONCLUSIONS Older cancer patients with ID were less likely to be assessed or treated by a specialist. This may suggest that people with ID have unaddressed or untreated distressing symptoms, which strongly contributes to a decreased quality of EoL care and a poor quality of life. There is a need to acquire further knowledge of the EoL care and to focus on adapting and evaluating quality indicators for older cancer patients with ID.
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Affiliation(s)
- M Segerlantz
- Department of Clinical Sciences Lund, Oncology and Pathology, Institute for Palliative Care, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Palliative Care and Advanced Home Health Care, Primary Health Care Skåne, Region Skåne, Lund, Sweden
| | - A Axmon
- EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - G Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Pergert P, Sullivan CE, Adde M, Afungchwi GM, Downing J, Hollis R, Ilbawi A, Morrissey L, Punjwani R, Challinor J. An ethical imperative: Safety and specialization as nursing priorities of WHO Global Initiative for Childhood Cancer. Pediatr Blood Cancer 2020; 67:e28143. [PMID: 31886610 DOI: 10.1002/pbc.28143] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 12/05/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Pernilla Pergert
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Melissa Adde
- International Network for Cancer Treatment and Research (INCTR), Brussels, Belgium
| | | | - Julia Downing
- International Children's Palliative Care Network, Durban, South Africa
- Makerere University, Kampala, Uganda
| | - Rachel Hollis
- The Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | | | | | - Julia Challinor
- University of California San Francisco, San Francisco, California, USA
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Moosavi S, Borhani F, Akbari ME, Sanee N, Rohani C. Recommendations for spiritual care in cancer patients: a clinical practice guideline for oncology nurses in Iran. Support Care Cancer 2020; 28:5381-5395. [PMID: 32144583 DOI: 10.1007/s00520-020-05390-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND In spite of the necessity of implementing spiritual care practices for cancer patients, there is no clear process in this regard in palliative care programs of the health system of countries. The present study was designed with the aim of developing a clinical practice guideline of spiritual care in cancer patients for oncology nurses in the current context. METHODS This is a multi-method study which was conducted in five stages within the framework of the National Institute for Health and Care Excellence (NICE) guideline. A research committee consisting of four focal and 16 secondary members was formed. The stages included determining the scope of the study, developing guideline (a qualitative study and a systematic review, triangulation of the data, and producing a preliminary draft), consultation stage (validation of the guideline in three rounds of the Delphi study), as well as revision and publication stages. RESULTS The clinical guideline of spiritual care with 84 evidence-based recommendations was developed in three main areas, including the human resources, care settings, and the process of spiritual care. CONCLUSIONS We are hoping by applying this clinical guideline in oncology settings to move towards an integrated spiritual care plan for cancer patients in the context of our health system. Healthcare organizations should support to form spiritual care teams under supervision of the oncology nurses with qualified healthcare providers and a trained clergy. Through holistic care, they can constantly examine the spiritual needs of cancer patients alongside their other needs by focusing on the phases of the nursing process.
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Affiliation(s)
- Soolmaz Moosavi
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Borhani
- Medical-Surgical Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nadia Sanee
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Community Health Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr Avenue and Hashemi Rafsanjani (Neiaiesh) Highway, Opposite to Rajaee Heart Hospital, Tehran, 1996835119, Iran.
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Campbell S. Living with and beyond cancer: an evolving landscape. Br J Nurs 2020; 29:S3. [PMID: 32053447 DOI: 10.12968/bjon.2020.29.3.s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Sandra Campbell
- Macmillan Nurse Consultant, Cancer and Palliative Care, NHS Forth Valley, UKONS Board Member and Chair, UKONS Living With and Beyond Cancer Members Interest Group
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Hassankhani H, Rahmani A, Taleghani F, Sanaat Z, Dehghannezhad J. Palliative Care Models for Cancer Patients: Learning for Planning in Nursing (Review). J Cancer Educ 2020; 35:3-13. [PMID: 31020622 DOI: 10.1007/s13187-019-01532-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cancer is the second cause of mortality in the world. Increased incidence of cancer and its growing trend have drawn attention to care for these patients. Palliative care is a solution for improving the quality of cancer care. However, only 14% of cancer patients in the world are receiving palliative care and most nurses lack the adequate knowledge and education to implement different palliative care models for cancer patients. This review of the literature intended to identify the palliative care models used by nurses for cancer patients as well as the similarities and differences between these models. Databases such as PubMed, ProQuest, google scholar, and CINAHL were searched, and experimental studies that presented palliative care models for cancer patients that nurses were involved were selected. From a total of articles selected by searching the databases, 16 experimental articles were selected. These articles presented 12 palliative care models that involved nurses and participants were cancer patients. The palliative care models presented in the experimental articles were based on hospice, hospital, home care, ambulatory, community, pediatric, spirituality, early, family, telehealth, dignity, and integrated. It was found out that several palliative care nursing models for cancer patients can be employed by nurses as they are the key agents in the provision of palliative care. The collaborative nature of the models, their positive consequences for patients being common components of models, and the implementation of the models considering the disease trajectory were among their distinctions.
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Affiliation(s)
- Hadi Hassankhani
- Medical-surgical Department, Nursing & Midwifery Faculty, Center of Qualitative Studies, School of Nursing and Midwifery, Tabriz University of Medical Sciences, South Shariati Street, Tabriz, East Azerbaijan Province, Iran
| | - Azad Rahmani
- Medical-surgical Department, Nursing & Midwifery Faculty, Medical Education Research Center, Tabriz University of Medical Sciences, South Shariati Street, Tabriz, East Azerbaijan Province, Iran
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Hezarjereeb Avenue, Isfahan, Iran
| | - Zohreh Sanaat
- Department of Hematology and Oncology, Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Dehghannezhad
- Medical-surgical Department, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, South Shariati Street, Tabriz, East Azerbaijan Province, Iran.
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Tsai WI, Wen FH, Kuo SC, Prigerson HG, Chou WC, Shen WC, Tang ST. Symptoms of prolonged grief and major depressive disorders: Distinctiveness and temporal relationship in the first 2 years of bereavement for family caregivers of terminally ill cancer patients. Psychooncology 2020; 29:751-758. [PMID: 31957171 DOI: 10.1002/pon.5333] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/11/2019] [Accepted: 01/13/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Prolonged grief disorder (PGD) and major depressive disorder (MDD) are common syndromes shaping bereaved caregivers' quality of life (QOL). However, distinctiveness of these syndromes warrants confirmation, and the temporal relationship of PGD and MDD symptoms has not been established. To fill these knowledge gaps, we conducted this longitudinal study. METHODS PGD symptoms, depressive symptoms, and psychological QOL were measured over 398 caregivers' first 2 years of bereavement using the Prolonged Grief-13 (PG-13) scale, Center for Epidemiologic Studies-Depression (CES-D) scale, and Short Form-36 Health Survey mental health summary, respectively. To clarify the distinctiveness of PGD and MDD symptoms, we examined their associations with psychological QOL by incremental validity testing. Distinctiveness and temporal relationship of PGD and MDD symptoms were also examined using longitudinal, lower-level mediation analysis with a lagged approach. RESULTS After the variance in psychological QOL was explained by CES-D scores (pseudo-R2 = 44.19%, P < .001), PG-13 scores significantly, incrementally increased the explained variance in psychological QOL (pseudo-R2 = 0.21%, P < .001), confirming the distinctiveness of PGD and MDD symptoms. CES-D scores mediated 40.7% of the time vs PG-13 score relationship, whereas PG-13 scores mediated 78.2% of the time vs CES-D score relationship with a better model fit, indicating that PG-13 scores assessed earlier mediated caregivers' current depressive status rather than vice versa. CONCLUSIONS PGD and MDD are distinct constructs, and PGD precedes onset of MDD. Clinicians should distinguish between these two disorders and address bereaved caregivers' PGD to reduce PGD-associated distress and morbidity and to prevent MDD onset, thereby improving their QOL.
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Affiliation(s)
- Wei-I Tsai
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Meiho University of Medical Technology, Pingtung, Taiwan
| | - Fur-Hsing Wen
- Department of International Business, Soochow University, Taipei, Taiwan
| | - Su-Ching Kuo
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Holly G Prigerson
- Sociology in Medicine, Weill Cornell Medical College, New York City, New York
| | - Wen-Chi Chou
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Chi Shen
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Siew Tzuh Tang
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- School of Nursing, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan
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35
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Compaci G. [Nursing expertise and assistance for patients in ambulatory care in haemato-oncology]. Rev Infirm 2019; 68:27-28. [PMID: 31757325 DOI: 10.1016/j.revinf.2019.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
An innovative programme to assist outpatients aims to improve the support provided to patients being treated for cancer in the context of their community-hospital care pathway. Evaluated in haematology with patients receiving treatment for lymphoma, leukaemia, including allografts, the programme highlights new nursing roles at the heart of patient follow-up care. The safety and fluidity of the patient pathway is improved and the medical time optimised.
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Affiliation(s)
- Gisèle Compaci
- Institut universitaire du cancer de Toulouse-Oncopole, centre hospitalier universitaire de Toulouse, 1 avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
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Chou PL, Fu JY, Cheng CH, Chu Y, Wu CF, Ko PJ, Liu YH, Wu CY. Current port maintenance strategies are insufficient: View based on actual presentations of implanted ports. Medicine (Baltimore) 2019; 98:e17757. [PMID: 31689833 PMCID: PMC6946320 DOI: 10.1097/md.0000000000017757] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/26/2019] [Accepted: 10/02/2019] [Indexed: 12/28/2022] Open
Abstract
Nursing staff play a crucial role in maintaining a functional port. Nursing guidelines recommend standard maintenance with 10 ml irrigation without consideration for variations among patients and individual nursing staff. The aim of this study is to identify the efficacy of the current maintenance strategy and analyze the correlation between complications and actual port presentations, based on disassembled intravenous ports after removal from patients. We attempt to organize the information and propose a definite maintenance strategy.After treatment completion, or due to complications, 434 implanted intravenous ports were removed from patients. All ports were deconstructed to observe their actual presentations and were then analyzed in conjunction with medical records. The correlation between complications and actual presentations was analyzed.From March 2012 to December 2017, 434 implanted intravenous ports were removed from oncology patients after completion of treatment or catheter related complications. From the view of maintenance related presentations, injection chamber blood clot was highly correlated with chemotherapy completion (P < .001) and malfunction (P = .005), while tip blood clot (P = .043) was related with chemotherapy completion and catheter fibrin (P = .015) was related to malfunction. From the view of structure related presentations, broken catheter integrity was correlated to chemotherapy completion (P = .007), fracture (P < .001), and malfunction (P = .008). Compression groove was related to chemotherapy completion (P = .03) and broken catheter at protruding stud was related to fracture (P = .04), while diaphragm rupture was correlated to chemotherapy completion (P = .048) and malfunction. (P < .001).Current port maintenance is insufficient for ideal port maintenance, whereby maintenance-related presentations, including tip clot, catheter fibrin, and injection chamber blood clot were identified. We propose a recommended maintenance strategy based on our findings. Structure-related presentations, including broken catheter integrity, broken catheter at protruding stud and diaphragm rupture were seen in patients with longer implantation period. Removal of the implanted port may be considered after 5 years if no disease relapse is noted.
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Affiliation(s)
- Pin-Li Chou
- Chang Gung University, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jui-Ying Fu
- Chang Gung University, Taiwan
- Division of Chest, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chia-Hui Cheng
- Laboratory of Cardiovascular Physiology, Department of Medical Research and Development, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yen Chu
- Chang Gung University, Taiwan
- Laboratory of Cardiovascular Physiology, Department of Medical Research and Development, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-Feng Wu
- Chang Gung University, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Po-Jen Ko
- Chang Gung University, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yun-Hen Liu
- Chang Gung University, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-Yang Wu
- Chang Gung University, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
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Cheron M, Jezequel T, Boscaro M, Consani D. [Support care in paediatric oncology]. Rev Infirm 2019; 68:29-30. [PMID: 31757326 DOI: 10.1016/j.revinf.2019.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
From the diagnosis of leukaemia and throughout the complex care pathway in paediatric oncology, nurses support the child and the parents, notably as part of the cross-disciplinary support care provided. They play a pivotal role within the multidisciplinary team and favour a personalised treatment helping the child-parent dyad cope better with the disease.
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Affiliation(s)
- Maëva Cheron
- Service oncologie pédiatrique, PHU 5 femme, enfant, adolescent, 5(e) étage, centre hospitalier universitaire de Nantes, hôpital enfant-adolescent, quai Moncousu, 44093 Nantes cedex 1, France
| | - Thomas Jezequel
- Service oncologie pédiatrique, PHU 5 femme, enfant, adolescent, 5(e) étage, centre hospitalier universitaire de Nantes, hôpital enfant-adolescent, quai Moncousu, 44093 Nantes cedex 1, France
| | - Maria Boscaro
- Service oncologie pédiatrique, PHU 5 femme, enfant, adolescent, 5(e) étage, centre hospitalier universitaire de Nantes, hôpital enfant-adolescent, quai Moncousu, 44093 Nantes cedex 1, France.
| | - Delphine Consani
- Service oncologie pédiatrique, PHU 5 femme, enfant, adolescent, 5(e) étage, centre hospitalier universitaire de Nantes, hôpital enfant-adolescent, quai Moncousu, 44093 Nantes cedex 1, France
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Leung DYP, Choy YP, Ling WM, Yim E, So WKW, Chan CWH, Mak YW. Validation of the Hong Kong Chinese version of the Support Person's Unmet Needs Survey-Short Form. Int J Environ Res Public Health 2019; 16:E4103. [PMID: 31653067 PMCID: PMC6862032 DOI: 10.3390/ijerph16214103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/15/2019] [Accepted: 10/22/2019] [Indexed: 11/16/2022]
Abstract
This study describes the psychometric properties of a Hong Kong Chinese version of the short form of the Support Person's Unmet Needs Survey (SPUNS-SF) for caregivers of patients with cancer. A convenience sample of 280 patient-caregiver dyads was recruited between April and June 2018. A subsample of 70 caregivers completed the survey again, two weeks later. A confirmatory factor analysis (CFA) examined the instrument's factorial structure, ordinal alpha coefficients evaluated the internal consistency, and intra-class correlation coefficients (ICCs) assessed the test-retest reliability. Convergence validity was evaluated by the correlations with sleep disturbance and caregiver burden in caregivers. The Hong Kong Chinese version of the SPUNS-SF (SPUNS-SFHKC) had a high completion rate of 96.8% (271/280) among caregivers. The original five-factor model provided an acceptable fit with the data in the CFA. The ordinal alpha coefficients were 0.866-0.945, and the two-week test-retest reliabilities were 0.524-0.678. The correlations of the five domains of the SPUNS-SFHKC with caregiver burden were 0.257-0.446, and for sleep disturbance were 0.075-0.464. The SPUNS-SFHKC has a suitable factor structure and psychometric properties for use in assessing unmet supportive needs among Chinese caregivers of patients with cancer. The applicability of the instrument for long-term use still needs to be studied.
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Affiliation(s)
- Doris Y P Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Yin-Ping Choy
- Department of Oncology, Princess Margaret Hospital, Hong Kong, China.
| | - Wai-Man Ling
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
| | - Elaine Yim
- Department of Oncology, Princess Margaret Hospital, Hong Kong, China.
| | - Winnie K W So
- Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Carmen W H Chan
- Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Yim-Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
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Monton O, Lambert S, Belzile E, Mohr-Elzeki D. An evaluation of the suitability, readability, quality, and usefulness of online resources for family caregivers of patients with cancer. Patient Educ Couns 2019; 102:1892-1897. [PMID: 31151780 DOI: 10.1016/j.pec.2019.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 03/20/2019] [Accepted: 05/08/2019] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Evaluate the suitability, readability, quality, and usefulness of publicly available online resources for cancer caregivers. METHODS Resources identified through a Google search and environmental scan were evaluated using the Suitability Assessment of Materials (SAM), an online readability text analysis tool, the DISCERN (quality), and caregivers' unmet needs checklist (usefulness). Descriptive analyses and cluster analysis to identify the group of resources with the highest SAM and DISCERN scores were performed. RESULTS 55 resources were evaluated. The suitability of 48/55 (87%) resources were categorized as adequate (SAM scores 40-69), with no resources ranking in the superior category (SAM scores > 70%). The readability of 51/55 (93%) resources exceeded 9th grade reading level. The mean quality score as a percentage was 49% (SD 11.5). On average resources addressed 9.9/33 unmet needs (SD = 5.8). A high-quality cluster was identified and included 15 (27%) websites. CONCLUSION Online resources for cancer caregivers are not optimal in terms of their suitability, readability, quality, and usefulness. The highest ranked resources include, Cancer Council Australia's booklet, Caring for Someone with Cancer, and the American Cancer Society's webpages, Caregivers and Families. PRACTICE IMPLICATIONS Study findings will allow healthcare professionals to better address cancer caregivers' needs by recommending the most optimal resources.
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Affiliation(s)
- Olivia Monton
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Sylvie Lambert
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada; McGill University, Ingram School of Nursing, 680 Sherbrooke West, Montreal, QC, H3A 2M7.
| | - Eric Belzile
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, QC, H3T 1M5, Canada
| | - Dahlal Mohr-Elzeki
- McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada
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Bouya S, Balouchi A, Maleknejad A, Koochakzai M, AlKhasawneh E, Abdollahimohammad A. Cancer Pain Management Among Oncology Nurses: Knowledge, Attitude, Related Factors, and Clinical Recommendations: a Systematic Review. J Cancer Educ 2019; 34:839-846. [PMID: 30315497 DOI: 10.1007/s13187-018-1433-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The current study evaluated the oncology nurse's knowledge, attitude, related factors of cancer-related pain management (CPM), and clinical recommendations for improving knowledge and attitude. In this systematic review, international databases (PubMed, EMBASE, Web of science (WOS), Science Direct, and Scopus) were searched for relevant studies published in English language from March 30, 2000 to March 30, 2018. The quality of the studies was evaluated using the Hoy instrument. Out of 888 initial studies, 12 studies performed on 3574 participants were included in the final stage of the review. Based on the results, most studies indicated that nurses had a poor (n = 4) or moderate (n = 4) knowledge of CPM. The lowest and the highest knowledge levels were 28.5% and 75%, respectively. According to most studies, nurses had a fair (average) (n = 4) or negative (n = 3) attitude toward CPM. The important factors related to the nurses' knowledge of CPM included previous pain-related education programs (n = 7) and having work experience with cancer patients (n = 4). The most important barrier was the deficit in staff's knowledge of pain (n = 2). The important clinical recommendations for improving nurses' levels of knowledge included the implementation of educational programs (n = 9), training programs (n = 3) on CPM and including CPM topics in nursing curricula (n = 5). This systematic review showed that most nurses had poor knowledge of CPM and a fair attitude toward CPM, indicating the importance of considering the barriers to knowledge, strengthening the positive relevant factors, and using clinical recommendations based on clinical guidelines such as including CPM topics in nursing curricula and implementing educational programs on CPM to improve the knowledge, attitude, and skills of oncology nurses. The results of the present study could be used by policymakers to provide care for cancer patients and manage their pain.
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Affiliation(s)
- Salehoddin Bouya
- Internal Medicine and Nephrology, Clinical Immunology Research Center, Ali-Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Abbas Balouchi
- Student Research Committee, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran
- Zabol University of Medical Sciences, Zabol, Iran
| | - Abdulbaset Maleknejad
- Clinical Immunology Research Center, Ali-Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Maryam Koochakzai
- Department of Midwifery, Zabol University of Medical Science, Zabol, Iran
| | - Esra AlKhasawneh
- Department of Maternal & Child Health Nursing, College of Nursing, Sultan Qaboos University, Muscat, Oman
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Roberts AL, Potts HWW, Stevens C, Lally P, Smith L, Fisher A. Cancer specialist nurses' perspectives of physical activity promotion and the potential role of physical activity apps in cancer care. J Cancer Surviv 2019; 13:815-828. [PMID: 31475306 PMCID: PMC6828618 DOI: 10.1007/s11764-019-00801-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/17/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to understand breast, prostate and colorectal cancer clinical nurse specialists' (CNSs) perspectives on physical activity (PA) promotion and the role of smartphone apps to support PA promotion in cancer care. METHODS CNSs working in breast, prostate or colorectal cancer were recruited via advertisements distributed by professional organizations. In-depth semi-structured telephone interviews were conducted and analysed using thematic analysis. RESULTS Nineteen CNSs participated. The analysis resulted in 4 themes regarding CNSs' perspectives of PA promotion within cancer care: (i) policy changes in survivorship care have influenced CNSs' promotion of PA; (ii) CNSs recognize their role in supporting PA but sit within a wider system necessary for effective PA promotion; (iii) CNSs use several techniques to promote PA within their consultations; (iv) remaining challenges in PA promotion. The analysis resulted in 3 themes regarding CNSs' perspectives on the use of apps to promote PA within cancer care: (i) the influence of apps on access to PA support; (ii) the role of apps in self-directed PA; (iii) implementing apps in cancer care. CONCLUSIONS The results of this study provide valuable insight into the CNS role and provide a number of important considerations for the development and implementation of PA interventions within cancer care, with a specific focus on smartphone-based interventions. IMPLICATIONS FOR CANCER SURVIVORS CNSs play an important role in PA promotion in cancer care and this research can inform the development of PA interventions delivered via smartphone app for people affected by cancer.
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Affiliation(s)
- Anna L Roberts
- Department of Behavioural Science & Health, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Claire Stevens
- Department of Behavioural Science & Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Phillippa Lally
- Department of Behavioural Science & Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, UK
| | - Abigail Fisher
- Department of Behavioural Science & Health, University College London, Gower Street, London, WC1E 6BT, UK
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Wang WY, Chu CM, Wu YS, Sung CS, Ho ST, Pan HH, Wang KY. Evaluation of the pain intensity differences among hospitalized cancer patients based on a nursing information system. PLoS One 2019; 14:e0222516. [PMID: 31553746 PMCID: PMC6760775 DOI: 10.1371/journal.pone.0222516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/30/2019] [Indexed: 11/19/2022] Open
Abstract
Evaluating the absolute difference in pain intensity and the percentage difference in pain intensity could facilitate an understanding of pain reduction among cancer patients during repeated hospitalizations. Examinations of the absolute differences in pain intensity and the percentage differences in pain intensity according to the worst pain intensity and last evaluated pain intensity before discharge are lacking. The aim of this study was to evaluate the absolute and percentage difference in pain intensities among cancer patients with moderate or severe pain from their 1st to 18th hospitalizations from 2011–2013. A population-based retrospective cohort study was conducted. Pain intensity was assessed using scales and was recorded in a nursing information system. The absolute and percentage difference in pain intensities were examined via the one-sample Kolmogorov-Smirnov test, and group differences in moderate or severe pain were evaluated with the Mann-Whitney U test. For moderate pain patients, the mean absolute difference in pain intensity was 1.52, and the percentage difference in pain intensity was 29.0%; both these values were significant. More significant changes in the absolute and percentage difference in pain intensities were associated with severe pain patients. Both the average absolute difference in pain intensity (3.09) and the percentage difference in pain intensity (38.5%) in patients with severe pain were significantly higher than the average absolute difference in pain intensity (1.52) and the percentage difference in pain intensity (29.0%) in patients with moderate pain. Cancer patients with moderate and severe pain experienced pain reductions of approximately 30% and 40%, respectively. Early pain management intervention in patients with severe pain is necessary to achieve an obvious analgesic effect, and the formula of the percentage difference in pain intensity should be incorporated into the nursing information system to alert clinicians for early detection of the effectiveness of cancer pain management.
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Affiliation(s)
- Wei-Yun Wang
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Ming Chu
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Syuan Wu
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Sung Sung
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shung-Tai Ho
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsueh-Hsing Pan
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Kwua-Yun Wang
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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Akyar I, Dionne-Odom JN, Ozcan M, Bakitas MA. Needs Assessment for Turkish Family Caregivers of Older Persons with Cancer: First-Phase Results of Adapting an Early Palliative Care Model. J Palliat Med 2019; 22:1065-1074. [PMID: 30969144 PMCID: PMC7364320 DOI: 10.1089/jpm.2018.0643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2019] [Indexed: 12/25/2022] Open
Abstract
Background: Although palliative care is expanding globally for patients with serious illness, Turkey has not had widespread integration of early concurrent oncology palliative care. Hence, adapting and testing models of concurrent oncology palliative care for Turkish patients is imperative. Furthermore, it is critical that these care models also address the needs of family caregivers. Objective: To assess needs and elicit suggestions that would inform the adaptation of the ENABLE (Educate, Nurture, Advise, Before Life Ends) evidence-based early palliative care model for Turkish family caregivers of older persons with cancer. Methods: Formative evaluation study. Semi-structured interviews were conducted with 25 primary family caregivers of older individuals with cancer. Thematic analyses yielded themes in four domains: meaning of caregiving, effect of caregiving, education and consulting needs, and preferences about the delivery of the ENABLE model of palliative care support. Results: Caregivers described the impact of the cancer on their daily lives and responsibilities in the areas of physical, psychological, work, social, and family life. Caregivers emphasized their needs for information about symptoms, physical care, cancer pathology, and prognosis. Regarding the ENABLE model of early concurrent palliative care, participants wanted encounters to be in-person with educational material support that was simple and focused on disease information (prognosis, medication, handling emergency situations), psychological support, caring, nutrition, and acquiring community services. Conclusion: Themes from this study will be used to modify the ENABLE intervention protocol for future pilot and efficacy testing in Turkish caregivers.
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Affiliation(s)
- Imatullah Akyar
- Faculty of Nursing, Hacettepe University, Ankara, Turkey
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - J. Nicholas Dionne-Odom
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, UAB Center for Palliative and Supportive Care, Birmingham, Alabama
| | - Munevver Ozcan
- Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Marie A. Bakitas
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, UAB Center for Palliative and Supportive Care, Birmingham, Alabama
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Abstract
The purpose of this study was to survey knowledge on, and attitudes to, pain and pain management among a cohort of Norwegian Nurses in cancer care, and to explore whether there is any association between various demographic variables and knowledge level. This is a web-based survey and nurses were recruited from the Forum for Cancer Nursing. Nurses completed the questionnaire "Nurses' Knowledge and Attitudes Survey Regarding Pain (NKAS)". Univariate and multivariate linear regression analysis were used to evaluate the association between knowledge and attitudes and demographic variables. Nurses from all over Norway answered. The majority were women and most had education above bachelor level. Mean NKAS total score was 31 points (75%). Significant associations were found between NKAS total score and pain management course (p = 0.01) and workplace (p = 0.04). Nurses in cancer care in Norway have relatively good pain knowledge. The potential for improvement is the greatest with regard to pharmacology and nurses' attitudes to how patients express pain. Our findings suggest that an extensive pain management course with patient histories may result in more theoretical knowledge being applied to the patients. In a time with large migration among nurses, our findings indicate that pain management courses should be aware of cultural differences in the educational training.
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Affiliation(s)
- Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs Plass, NO-0130, Oslo, Norway.
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs Plass, NO-0130, Oslo, Norway
| | - Ulla Nyblin
- Department of Surgery, Vestre Viken Hospital Trust, PO 800, NO-3004, Drammen, Norway
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Bana M, Ribi K, Kropf-Staub S, Zürcher-Florin S, Näf E, Manser T, Bütikofer L, Rintelen F, Peters S, Eicher M. Implementation of the Symptom Navi © Programme for cancer patients in the Swiss outpatient setting: a study protocol for a cluster randomised pilot study (Symptom Navi© Pilot Study). BMJ Open 2019; 9:e027942. [PMID: 31289075 PMCID: PMC6615799 DOI: 10.1136/bmjopen-2018-027942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Self-management interventions show promising results on symptom outcomes and self-management behaviours. The Symptom Navi© Programme (SN©P) is a nurse-led intervention supporting patients' symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi© Flyers (SN©Flyers)), semistructured consultations and a training manual for nurses. METHODS AND ANALYSIS This pilot study will evaluate the implementation of the SN©P based on the Reach Effectiveness-Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the intervention clusters will provide at least two semistructured consultations with the involvement of SN©Flyers. Outcomes include patients' accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses' fidelity of providing the intervention as intended, and patients' safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be analysed by thematic analysis. ETHICS AND DISSEMINATION The Symptom Navi© Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017-00020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences. TRIAL REGISTRATION NUMBER NCT03649984; Pre-results.
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Grants
- Swiss Cancer League, Bern, Switzerland
- Lindenhofgruppe, Bern, Switzerland
- CHUV, Departement of Oncology, Lausanne, Switzerland
- Heds-FR, School of Health Sciences, Fribourg, Switzerland
- Dr. Hans Altschüler Stiftung, St. Gallen, Switzerland
- Institute of Higher Education and Research in Health Care, Faculty of Biology and Medicine, University of Lausanne, Switzerland
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Affiliation(s)
- Marika Bana
- HedS-FR School of Health Sciences, University of Applied Science and Arts Western Switzerland, Fribourg, Switzerland
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
| | - Karin Ribi
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
- Quality ofLife Office, International Breast Cancer Study Group, Bern, Switzerland
| | | | | | - Ernst Näf
- Department of Practice Development in Nursing, Solothurner Spitaler AG, Solothurn, Switzerland
| | - Tanja Manser
- FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | | | | | | | - Manuela Eicher
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
- Departement of Oncology, CHUV, Lausanne, Switzerland
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Coombs LA, Max W, Kolevska T, Tonner C, Stephens C. Nurse Practitioners and Physician Assistants: An Underestimated Workforce for Older Adults with Cancer. J Am Geriatr Soc 2019; 67:1489-1494. [PMID: 31059140 PMCID: PMC6612567 DOI: 10.1111/jgs.15931] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To describe the composition of the US provider workforce for adults with cancer older than 65 years and to determine whether there were differences in patients who received care from different providers (eg, nurse practitioners [NPs], physician assistants [PAs], and specialty physicians). DESIGN Observational, cross-sectional study. SETTING Adults within the 2013 Surveillance, Epidemiology, and End Results cancer registries linked to the Medicare claims database. PARTICIPANTS Medicare beneficiaries who received ambulatory care for any solid or hematologic malignancies. MEASUREMENTS International Classification of Diseases, Ninth Revision (ICD-9), diagnosis codes were used to identify Medicare patient claims for malignancies in older adults. Providers for those ambulatory claims were identified using taxonomy codes associated with their National Provider Identifier number. RESULTS A total of 2.5 million malignancy claims were identified for 201, 237 patients, with 15, 227 providers linked to claims. NPs comprised the largest group (31.5%; n = 4,806), followed by hematology/oncology physicians (27.7%; n = 4,222), PAs (24.7%; n = 3767), medical oncologists (10.9%; n = 661), gynecological oncologists (2.6%; n = 403), and hematologists (2.4%; n = 368). Rural cancer patients were more likely to receive care from NPs (odds ratio [OR] = 1.84; 95% confidence interval [CI] = 1.65-2.05) or PAs (OR = 1.57; 95% CI = 1.40-1.77) than from physicians. Patients in the South were more likely to receive care from NPs (OR = 1.36; 95% CI = 1.24-1.49). CONCLUSIONS A large proportion of older adults with cancer receive care from NPs and PAs, particularly those who reside in rural settings and in the southern United States. Workforce strategies need to integrate these provider groups to effectively respond to the rising need for cancer care within the older adult population.
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Affiliation(s)
| | - Wendy Max
- University of California San Francisco, San Francisco, CA
| | - Tatjana Kolevska
- University of California San Francisco, San Francisco, CA
- Kaiser Permanente Northern California, Vallejo, CA
| | - Chris Tonner
- University of California San Francisco, San Francisco, CA
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Abstract
OBJECTIVE The societal value of unpaid caregiving is estimated to exceed $470 billion annually. In spite of the high value care they provide, caregivers experience significant financial burden. This paper examines the sources and impact of financial burden on cancer caregivers. DATA SOURCES Survey of the published peer-reviewed literature complemented by Web-based sources. CONCLUSION Caregivers for cancer patients may experience financial burden disproportionately relative to other caregivers because of the intensity of care they provide and the cost and complexity of cancer treatment. Financial burden stems from employment loss and cost of care and can continue long after the death of the patient. Few federal policy protections are available for caregivers. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses can play an important role in recognizing the needs of caregivers and act as navigators to connect caregivers to available resources.
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Affiliation(s)
- Cathy J Bradley
- University of Colorado Cancer Center, and Colorado School of Public Health, Aurora, CO.
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Treanor CJ, Santin O, Prue G, Coleman H, Cardwell CR, O'Halloran P, Donnelly M. Psychosocial interventions for informal caregivers of people living with cancer. Cochrane Database Syst Rev 2019; 6:CD009912. [PMID: 31204791 PMCID: PMC6573123 DOI: 10.1002/14651858.cd009912.pub2] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Increasingly, cancer is recognised as a chronic condition with a growing population of informal caregivers providing care for cancer patients. Informal caregiving can negatively affect the health and well-being of caregivers. We need a synthesised account of best evidence to aid decision-making about effective ways to support caregivers for individuals 'living with cancer'. OBJECTIVES To assess the effectiveness of psychosocial interventions designed to improve the quality of life (QoL), physical health and well-being of informal caregivers of people living with cancer compared with usual care. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, ProQuest, Open SIGLE, Web of Science from inception up to January 2018, trial registries and citation lists of included studies. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials comparing psychosocial interventions delivered to adult informal caregivers of adults affected by cancer on a group or individual basis with usual care. Psychosocial interventions included non-pharmacological interventions that involved an interpersonal relationship between caregivers and healthcare professionals. We included interventions delivered also to caregiver-patient dyads. Interventions delivered to caregivers of individuals receiving palliative or inpatient care were excluded. Our primary outcome was caregiver QoL. Secondary outcomes included patient QoL, caregiver and patient depression, anxiety, psychological distress, physical health status and intervention satisfaction and adverse effects. DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened studies for eligibility, extracted data and conducted 'Risk of bias' assessments. We synthesised findings using meta-analysis, where possible, and reported remaining results in a narrative synthesis. MAIN RESULTS Nineteen trials (n = 3, 725) were included in the review. All trials were reported in English and were undertaken in high-income countries. Trials targeted caregivers of patients affected by a number of cancers spanning newly diagnosed patients, patients awaiting treatment, patients who were being treated currently and individuals post-treatment. Most trials delivered interventions to caregiver-patient dyads (predominantly spousal dyads) and there was variation in intervention delivery to groups or individual participants. There was much heterogeneity across interventions though the majority were defined as psycho-educational. All trials were rated as being at 'high risk of bias'.Compared to usual care, psychosocial interventions may improve slightly caregiver QoL immediately post intervention (standardised mean difference (SMD) 0.29, 95% confidence interval (CI) 0.04 to 0.53; studies = 2, 265 participants) and may have little to no effect on caregiver QoL at 12 months (SMD 0.14, 95% CI - 0.11 to 0.40; studies = 2, 239 participants) post-intervention (both low-quality evidence).Psychosocial interventions probably have little to no effect on caregiver depression immediately to one-month post-intervention (SMD 0.01, 95% CI -0.14 to 0.15; studies = 9, 702 participants) (moderate-quality evidence). Psychosocial interventions may have little to no effect on caregiver anxiety immediately post-intervention (SMD -0.12, 95 % CI -0.33 to 0.10; studies = 5, 329 participants), depression three-to-six months (SMD 0.03, 95% CI -0.33 to 0.38; studies = 5. 379 participants) post-intervention and patient QoL six to 12 months (SMD -0.05, 95% CI -0.37 to 0.26; studies = 3, 294 participants) post-intervention (all low-quality evidence). There was uncertainty whether psychosocial interventions improve patient QoL immediately (SMD -0.03, 95 %CI -0.50 to 0.44; studies = 2, 292 participants) or caregiver anxiety three-to-six months (SMD-0.25, 95% CI -0.64 to 0.13; studies = 4, 272 participants) post-intervention (both very low-quality evidence). Two studies which could not be pooled in a meta-analysis for caregiver physical health status found little to no effect immediately post-intervention and a small intervention effect 12 months post-intervention. Caregiver or patient satisfaction or cost-effectiveness of interventions were not assessed in any studies. Interventions demonstrated good feasibility and acceptability.Psychosocial interventions probably have little to no effect on patient physical health status immediately post-intervention (SMD 0.17, 95 % CI -0.07 to 0.41; studies = 4, 461 participants) and patient depression three to six months post-intervention (SMD-0.11, 95% CI -0.33 to 0.12; studies = 6, 534 participants) (both moderate-quality evidence).Psychosocial interventions may have little to no effect on caregiver psychological distress immediately to one-month (SMD -0.08, 95% CI -0.42 to 0.26; studies = 3, 134 participants), and seven to 12 months (SMD 0.08, 95% CI -0.42 to 0.58; studies = 2, 62 participants) post-intervention; patient depression immediately (SMD -0.12, 95% CI -0.31 to 0.07; studies = 9, 852 participants); anxiety immediately (SMD -0.13, 95% CI -0.41 to 0.15;studies = 4, 422 participants), and three to six months (SMD -0.22, 95% CI -0.45 to 0.02; studies = 4, 370 participants); psychological distress immediately (SMD -0.02, 95% CI -0.47 to 0.44; studies = 2, 74 participants) and seven to 12 months (SMD -0.27, 95% CI -0.78 to 0.24; studies = 2, 61 participants); and physical health status six to 12 months (SMD 0.06, 95% CI -0.18 to 0.30; studies = 2, 275 participants) post-intervention (all low-quality evidence).Three trials reported adverse effects associated with the interventions, compared with usual care, including higher distress, sexual function-related distress and lower relationship satisfaction levels for caregivers, higher distress levels for patients, and that some content was perceived as insensitive to some participants.Trials not able to be pooled in a meta-analysis did not tend to report effect size and it was difficult to discern intervention effectiveness. Variable intervention effects were reported for patient and caregiver outcomes. AUTHORS' CONCLUSIONS Heterogeneity across studies makes it difficult to draw firm conclusions regarding the effectiveness of psychosocial interventions for this population. There is an immediate need for rigorous trials with process evaluations and clearer, detailed intervention descriptions. Cost-effectiveness studies should be conducted alongside future trials.
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Affiliation(s)
- Charlene J Treanor
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences Block B, Royal Victoria Hospital SiteGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Olinda Santin
- Queen's University BelfastSchool of Nursing and Midwifery97 Lisburn RoadBelfastUKBT9 7BL
| | - Gillian Prue
- Queen's University BelfastSchool of Nursing and Midwifery97 Lisburn RoadBelfastUKBT9 7BL
| | - Helen Coleman
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences Block B, Royal Victoria Hospital SiteGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Chris R Cardwell
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences Block B, Royal Victoria Hospital SiteGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Peter O'Halloran
- Queen's University BelfastSchool of Nursing and Midwifery97 Lisburn RoadBelfastUKBT9 7BL
| | - Michael Donnelly
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences Block B, Royal Victoria Hospital SiteGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
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Abstract
BACKGROUND Strong family bonds are part of the Indonesian culture. Family members of patients with cancer are intensively involved in caring, also in hospitals. This is considered "normal": a societal and religious obligation. The values underpinning this might influence families' perception of it. AIM To explore and model experiences of family caregivers of patients with cancer in Indonesia in performing caregiving tasks. DESIGN A grounded theory approach was applied. The constant comparative method was used for data analysis and a paradigm scheme was employed for developing a theoretical model. SETTING/PARTICIPANTS The study was conducted in three hospitals in Indonesia. The participants were family caregivers of patients with cancer. RESULTS A total of 24 family caregivers participated. "Belief in caregiving" appeared to be the core phenomenon. This reflects the caregivers' conviction that providing care is an important value, which becomes the will power and source of their strength. It is a combination of spiritual and religious, value and motivation to care, and is influenced by contextual factors. It influences actions: coping mechanisms, sharing tasks, and making sacrifices. Social support influences the process of the core phenomenon and the actions of the caregivers. Both positive and negative experiences were identified. CONCLUSION We developed a model of family caregivers' experiences from a country where caregiving is deeply rooted in religion and culture. The model might also be useful in other cultural contexts. Our model shows that the spiritual domain, not only for the patient but also for the family caregivers, should be structurally addressed by professional caregivers.
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Affiliation(s)
- Martina Sinta Kristanti
- Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
- School of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Christantie Effendy
- School of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Adi Utarini
- Department of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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Lavender V. Systemic anti-cancer therapy: standardising education. Br J Nurs 2019; 28:S3. [PMID: 31116587 DOI: 10.12968/bjon.2019.28.10.s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Verna Lavender
- Head of Guy's Cancer Academy, Guy's and St Thomas' NHS Foundation Trust, London, and President Elect, UKONS
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