Social determinants of health in post-treatment cancer survivors: Scoping review

PURPOSE

To identify, analyze and describe the available scientific evidence about the influence of social determinants of health on cancer survivors.

METHODS

A scoping review was outlined according to the steps described by the Joanna Brigs Institute Reviewer's Manual: selection of studies, data mapping, and results grouping, synthesis and report, was conducted. PubMed, CINAHL, Scopus and LILACS databases were searched from 2011 to 2023.

RESULTS

Out of a total of 1783 papers initially screened, only 19 studies met the inclusion criteria for the scoping review, focusing on the primary social determinants impacting the health of cancer survivors. These studies were categorized into six main themes: a) employment (challenges in work reintegration and work-place difficulties); b) variations among different ethnic groups; c) disparities based on sex; d) barriers and facilitators in accessing health and social security services; e) the role of support networks and social environments; and f) socioeconomic lever (influence of income and socioeconomic status).

CONCLUSIONS

Understanding the impact of social determinants on the post-treatment quality of life for cancer survivors is crucial. Comprehensive survivorship care should address not just medical needs but also holistic aspects like social support, education, overall well-being, and improvements in physical and social environments. This multifaceted approach ensures the well-rounded support needed for optimal survivorship outcomes.

Use of Online Communities among People with Type 2 Diabetes: A Scoping Review

PURPOSE OF REVIEW

People with diabetes require continuous self-monitoring and face numerous decisions in their day-to-day lives. Therefore, on many occasions, they need more support than that provided by health professionals. In this context, peer support in online diabetes communities could be a useful tool. The purpose of the review is to describe, analyze and synthesize the available evidence on the use and health out-comes of online communities for people with type 2 diabetes mellitus. A scoping review was conducted in accordance with the Joanna Briggs Institute guidelines. Searches were performed PubMed, Web of Science, CINHAL, Scopus and Cochrane databases.

RECENT FINDINGS

From 1821 identified documents, 6 articles were included. These studies explored the characteristics of diabetes online communities and the population features. Besides, the results were classified according to whether they were clinical, psychosocial, or addressed people's experiences with the online community. The analysis underscores their value in facilitating communication, improving diabetes management, and enhancing psychosocial well-being. Future investigations should prioritize longitudinal assessments to elucidate the sustained impact of community engagement and optimize user participation for enhanced patient outcomes. The growing relevance of new technologies has led to a significant number of individuals with chronic illnesses seeking peer support. Online health communities have emerged as virtual spaces where individuals with shared health interests interact and form relationships. Within these digital spaces, individuals can engage in peer interaction, observe behaviors, and mutually benefit, potentially leading to improved attitudes toward the disease.

Healthcare interventions for older people with dementia and family caregivers in Europe: A scoping review

AIM

This study aimed to examine the extent, range and variety of research in Europe describing healthcare interventions for older people with dementia (PwD) and family caregivers.

METHODS

This was a scoping review and followed the PRISMA Scoping Review guideline. MEDLINE, CINAHL and Cochrane library databases were searched for studies published between 2010 and 2020. Studies reporting healthcare interventions in Europe for PwD over 65 years and their family caregivers were included.

RESULTS

Twenty-one studies from six European countries were included. The types of healthcare intervention identified were categorized as follows: (1) family unit intervention (interventions for both PwD and their family caregiver), (2) individual intervention (separate interventions for PwD or family caregivers) and (3) family caregiver only intervention (interventions for family caregivers only but with outcomes for both PwD and family caregivers).

CONCLUSIONS

This review provides insight into healthcare interventions for older PwD and family caregivers in Europe. More studies are needed that focus on the family as a unit of care in dementia.

"Opportunistic Care": A Focus Group Study of Nurses' Perspective on Caring for Long-term Cancer Survivors and Their Families

BACKGROUND

The global population of long-term cancer survivors is increasing, thanks to advances in treatments and care. Healthcare systems are working to address the unique needs of these individuals. However, there remains a knowledge gap concerning nurses' view on cancer survivorship care.

OBJECTIVE

To identify nurses' perspective of care for long-term cancer survivors and their families.

METHODS

This qualitative descriptive study used 5 focus groups comprising 33 nurses from primary healthcare and specialized oncology care. Data analysis was conducted through thematic analysis, and the study received ethical approval.

RESULTS

Long-term cancer survivors and their families often remained unrecognized as a distinct group within the healthcare system. Consequently, nurses provide what can be termed as "opportunistic care" during nurse-survivor encounters, addressing health needs beyond the purpose of the initial healthcare visit. This absence of a systematic or structured approach for this patient group has prompted nurses to seek the establishment of a comprehensive framework through survivorship care plans, thus ensuring a continuum of care for this specific population.

CONCLUSION

The lack of a structured approach to caring for long-term cancer survivors and their families, often invisible as a distinct population group, results in nurses providing care on an opportunistic basis.

IMPLICATIONS FOR PRACTICE

It is crucial to develop and implement survivorship care plans tailored to this population's needs. Simultaneously, it is important to advance research in this area and establish an educational framework for nurses, enabling them to effectively address the care of long-term cancer survivors and their families.

Effectiveness of Digital Health on the Quality of Life of Long-Term Breast Cancer Survivors: A Systematic Review

OBJECTIVES

To identify, critically appraise, and synthesize the available evidence on the effectiveness of digital health interventions to improve the quality of life or any of its four dimensions (physical, psychological, social, and spiritual) in women survivors of breast cancer who are in the extended or permanent survival stage.

DATA SOURCES

Systematic review-Four databases were searched: PubMed, CINAHL, PsycINFO, and Web of Science.

CONCLUSION

The clinical evidence shows a positive relationship or association between eHealth use and improved quality of life in breast cancer survivors at extended or permanent survival stage. However, the findings point to a deficit in the assessment of the social and spiritual domains that play a fundamental role in the quality of life of survivors.

IMPLICATION FOR NURSING PRACTICE

The findings found reflect implications of great value for nursing practice because these professionals are the main users of digital health tools to provide them to patients. Using these digital tools contributes to improving evidence-based practice and providing greater efficiency and effectiveness in the care of long-term cancer survivors.

Educational Intervention for Family Nursing Students in Long-Term Cancer Survivorship: A Randomized Pilot Trial

A randomized pilot study was conducted involving 69 third-year nursing students (ClinicalTrials.gov ID: NCT05270252). Students were randomly assigned to the CG (n = 34) or the intervention group (n = 35), using computer-generated randomization. The CG completed the third-year nursing, and the intervention group received in addition the Learning & Care educational intervention. The aim of this study was to determine the effectiveness, feasibility, and acceptability of the Learning & Care for students to acquire the knowledge, skills, and attitudes necessary to care for survivors and their families. The intervention group significantly improved in knowledge (p = .004; -1.15, 95% confidence interval [CI] [-1.94, -0.37]), skills (p ≤ .0001; -13.51, 95% CI [-15.19, -11.83]), and attitudes (p = .006; -5.61, 95% CI [-8.81, -2.42]). The students' satisfaction was found to be high (93.75%). Offering a family nursing approach improves students' competence to care for long-term cancer survivors and their families.

Assessing the Reliability and Validity of the Spanish Version of the Actual Scope of Nursing Practice Scale

Nursing workforce shortage is one of the main challenges for healthcare organizations and it is important to determine if nurses are fulfilling their full scope of practice. There is a questionnaire that measures the activities carried out by nurses, but there is no version available for the Spanish context. The purpose of this study was to develop a cross-cultural adaptation of the "Actual Scope of Nursing Practice" questionnaire by D'Amour et al., and to assess the psychometric characteristics of the Spanish version. An exploratory sequential research design was used. The cross-cultural adaptation was performed using translation, back-translation, review, and pre-testing. Psychometric properties were assessed to determine its construct validity and internal consistency. Among the 501 eligible nurses from the three main hospitals in the region, the first 310 nurses to respond to an online questionnaire were included in our study. The response rate was 61.9%. They were invited via email and completed the survey using the SurveyMonkey platform. The Spanish version of the questionnaire was obtained. A final scale with twenty items and two factors was confirmed with an adequate fit, with the item scores demonstrating that all items were optimally related to their respective latent construct. The alpha coefficients for the Spanish ASCOP scale were robust and revealed good internal consistency. This study showed that the Spanish version of the scale, "Scope of Nursing Practice", has a good degree of validity and reliability. This questionnaire can support nurse managers in realising nursing activities within their organisations and in promoting desirable work outcomes among nurses.

Differences in Quality of Life and Emotional Well-being in Breast, Colon, and Lung Cancer Patients During Outpatient Adjuvant Chemotherapy: A Longitudinal Study

BACKGROUND

Adjuvant chemotherapy used at each cancer site may affect quality of life (QoL) and emotional well-being (affect) of cancer patients differently; however, these differences between groups have not been studied.

OBJECTIVES

The aim of this study was to assess differences in QoL and affect by cancer site at the start of outpatient adjuvant chemotherapy, whether QoL and affect change during this treatment, and whether adverse effects influence these variables.

METHODS

A multicenter longitudinal descriptive study was conducted with 247 participants with breast, colon, or lung cancer at the beginning (T1) and end of treatment (T2). We used the SF-12 Health Survey, Positive and Negative Affect Scale, and an "ad hoc" adverse effects questionnaire.

RESULTS

At the start of chemotherapy, the lung group had poorer Physical Component Summary and poorer positive and negative affect ( P < .05) scores. In the end-of-treatment comparisons, breast and colon cancer patients' status had worsened, whereas lung cancer patients had tended to stabilize, although they remained the most vulnerable. Adverse effect severity was significant for Physical Component Summary ( r = -0.13, P = .035), with decreases in positive affect ( r = -0.17, β = -.16) and increases in negative affect ( r = 0.15, β = .14).

CONCLUSIONS

Changes in QoL and emotional state differ between groups, implying a need for varying levels of follow-up and emotional support. Patients with lung cancer seem particularly vulnerable.

IMPLICATIONS FOR PRACTICE

Cancer nurses could strengthen the assessment of patients undergoing chemotherapy using more sensitive instruments such as the Positive and Negative Affect Scale and considering differences by cancer site, to provide care tailored to individual patient needs and preferences.

Development of a European Centre of Excellence (Coe) for Research in Continuing Professional Development (UPGRADE)

The European Centre of Excellence (CoE) for Research in Continuing Professional Development (UPGRADE) is a pan-European network of researchers, clinicians, regulators, educators, and professional bodies, established in 2020 through a consensus group of experts, who defined its mission, vision, values, aims and objectives. The Centre's aim is to advance the science of Continuing Professional Development (CPD) for healthcare professionals through research and dissemination of best practices for CPD. Debate among UPGRADE partners and interchange of research data will yield best practices across countries to optimise quality CPD programmes. Collaboration, information exchange and communication among CPD experts will be facilitated through UPGRADE via an online Community of Inquiry (CoI). UPGRADE aims to evolve as a driving force network of academics and health professional leaders in research, education, professional regulation, and clinical practice whose collaborative work ensures quality and safe person-centred care. UPGRADE members are from 22 European countries, represented by strategic leaders in diverse sectors of health, policy, academia, and professional organisations. Three research-working groups constitute the pillars of UPGRADE, which addresses gaps in research, collect and create critical databases, and solidify the effectiveness of CPD.

Density of nurses and midwives in sub-Saharan Africa: Trends analysis over the period 2004-2016

AIM

To analyse the trends of density rates of nurses and midwives per population in sub-Saharan Africa over the period from 2004 to 2016.

BACKGROUND

Nursing, the largest health care workforce, is actively contributing to the achievement of the Sustainable Development Goals. The African continent is one of the most affected areas by the differences in the density of nurses and midwives indicator.

METHODS

Joinpoint regression analysis was applied to identify significant changes in trends of the density of nurses and midwives from the 50 countries of sub-Saharan Africa.

RESULTS

From 2004 to 2013, the density of nurses and midwives in sub-Saharan Africa increased significantly from 5.6 to 12.44 per 10,000 population, although it exhibited a increasing trend of a magnitude of 8.3% until 2013 that does not continue from that year.

CONCLUSIONS

Only seven countries show an increasing trend, although in the case of the rest, they do not present any trend that suggests a change in this indicator in the short term.

IMPLICATIONS FOR NURSING MANAGEMENT

From a macrolevel nursing management point of view, our study shows the importance of implementing actions that contribute to the increase of the nursing workforce in Africa, essential to achieve the Sustainable Development Goals.

Analysis of mental health effects among nurses working during the COVID-19 pandemic: A systematic review

WHAT IS KNOWN ON THE SUBJECT?: Working on the frontline during the pandemic has had a negative impact on the mental health of health professionals. A significant proportion experienced anxiety, insomnia, posttraumatic stress or depression. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Analysis and synthesis of the evidence of the impact of the COVID-19 pandemic on the mental health of nurses based on their work context. There exists a gap in the literature as no studies were found that analysed the effects on nurses' mental health according to the level of care they worked in (hospital-primary care-nursing home). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is an urgent need to assess and respond to the impact of COVID-19 on the physical and mental well-being of nurses, and to monitor international policies for the improvement of nurses' working conditions. ABSTRACT: Introduction Health professionals have suffered negative consequences during the COVID-19 pandemic. No review has specifically addressed the impact of the pandemic on the mental health of nurses exclusively according to the work context. Aim To analyse the impact of the COVID-19 pandemic on the mental health of nurses who have worked in hospitals, primary care centres and social health centres. Method PubMed, CINAHL, PsychINFO and Cochrane databases were searched (Prospero number: CRD42021249513). Out of 706 papers, 31 studies (2020-2021) were included in the systematic review. A qualitative synthesis method was used to analyse the data. Results Most studies were conducted in hospitals or frontline settings. The prevalence of moderate-to-severe symptoms was for anxiety 29.55%, depression 38.79%, posttraumatic stress disorder 29.8%, and insomnia 40.66%. Discussion This review highlights the mental health effects among nurses working in acute hospital settings. It also evidences a data gap on mental health effects among nurses working in primary health care and in nursing homes. Implications for practice In the post phase of the pandemic, there is an urgent need to assess and respond to the impact on the mental well-being of nurses, and to monitor international policies for the improvement of nurses' working conditions.

Web-Based Personalized Intervention to Improve Quality of Life and Self-Efficacy of Long-Term Breast Cancer Survivors: Study Protocol for a Randomized Controlled Trial

Long-term breast cancer survivors (>5 years free of disease) may suffer late sequelae of cancer that impact on their quality of life. The use of telehealth for cancer care is recommended but little is known about the effectiveness of digital interventions for long-term cancer survivors. This study aims to evaluate the effectiveness of a web-based personalized intervention based on artificial intelligence instead of usual primary health care to improve the quality of life of long-term survivors of breast cancer and self-efficacy for the management of late sequelae. A randomized controlled trial will be conducted. The sample will consist of long-term breast cancer survivors recruited from primary health centers. Women will be randomly assigned to the intervention group to receive a web-based personalized intervention or to the control group to receive standard primary health care by nurses. Data on quality of life of cancer survivors and self-efficacy for the management of late sequelae of cancer will be collected and assessed at preintervention, and at 3, 6, and 9 months. It is expected that, at the end of the programme, the experimental group will have improved quality of life and improved self-efficacy for the management of late sequelae of cancer.

The experience of coronaphobia among health professionals and their family members during COVID-19 pandemic: A qualitative study

Background

Coronaphobia is an excessive fear of becoming infected by the COVID-19 virus. Situations of coronaphobia against health professionals have been identified. Therefore, there is a need to develop studies to understand family impact and experience of COVID-19 pandemic and coronaphobia.

Aim

To describe the coronaphobia experience of health professionals and of one of their family members during the first wave of the COVID-19 pandemic.

Methods

Exploratory qualitative study using narrative inquiry was used. This study was guided by the concept of coronaphobia and Family Systems Nursing as conceptual frameworks. Face-to-face and telephone interviews were conducted from September to November 2020 with 14 health professionals, including nurses and physicians and one of their family members (n = 14).

Findings

Three descriptive themes were identified which highlight professional-family dyads’ experience of coronaphobia as a reciprocal and relational process. Coronaphobia was demonstrated by unknown or close people, in a disguised or explicit way, and generated suffering in the dyads and in the family unit. Consequently, individual and/or family strategies were developed to allow for the protection of the family system and the maintenance of its functioning.

Discussion

This study describes how the dyads of health professionals and their family members identify the experiences of coronaphobia. In addition, it was possible to analyze the repercussions of coronaphobia on the dyad and the strategies they used to deal with it.

Conclusions

This study extends understanding about the relationships between the experience of coronaphobia among health professionals and one of their family members and the experience of physical, cognitive and emotional suffering during the COVID-19 pandemic.

Continuity of Care Challenges for Professional Nursing Practice

The transformation of health systems to meet the needs of chronic and multi-pathological patients has turned continuity of care into one of the mainstays of care programs and the design of new resources to care for these patients and their families. In this context, nurses’ professional practice poses challenges for the three dimensions of continuity of care: relational, informational, and managerial. Faced with these challenges, nursing research is essential for the profession and necessary to promote innovative quality care.

The Spanish Version of the Child Medical Fear Questionnaire: Cross-Cultural Adaptation and Validation

Having valid and reliable tools that help health professionals to assess fear in children undergoing medical procedures is essential to offer humanised and quality of care in the paediatric population. The aim of this study was to develop the cross-cultural adaptation and the evaluation of the psychometric properties of the Spanish version of the "Child Medical Fear Scale" in its shortened version (CMFS-R). The design consisted of two phases: first, of cross-cultural adaptation and second, of the psychometric validation of the CMFS-R with a sample of 262 children from Spain, applying a cross-sectional design. Confirmatory factor analysis was conducted to assess construct validity and the Cronbach's alpha and the adjusted item-total score correlation coefficients were performed to study reliability. The results confirmed internal consistency and construct validity of the Spanish version of the CMFS-R, indicating that the scale has an acceptable level of validity and reliability. Therefore, this study brings a new version of the scale to assess fear related to medical procedures for use in the Spanish paediatric population.

Waves of family hope: narratives of families in the context of pediatric chronic illness

OBJECTIVE

to analyze narratives about the experience of hope of families in the context of pediatric chronic illness.

METHOD

a narrative research using Family Systems Nursing as a conceptual framework. Three families of children and adolescents diagnosed with complex chronic illness participated in this study, totaling 10 participants. Data collection was developed using family photo-elicitation interviews. Family narratives were constructed and analyzed according to inductive thematic analysis with theoretical data triangulation.

RESULTS

the analytical theme - Waves of Family Hope in the Context of Pediatric Chronic Illness - is composed of four different types of hope: uncertain hope, caring hope, latent hope, and expectant hope. Movement through these hopes generates a driving energy and depends on a number of factors: support, information, searching for normality, and thoughts and comparisons.

CONCLUSION

the results highlight the interaction and reciprocities of the members of the family unit, and the dynamics of hope, and illustrate the different types of hope and the factors that influence them. This study highlights the experience of hope as a family resource rather than just an individual resource, and supports health professionals in the planning of family care considering hope as an essential and dynamic family resource.

Healthcare practices and interventions in Europe towards families of older patients with cardiovascular disease: A scoping review

BACKGROUND

In Europe, cardiovascular disease is one of the predominant causes of mortality and morbidity among older people over 65 years. The occurrence of cardiovascular disease can have a negative impact on the quality of life of older patients and their families and family health overall. Assuming that illness is a family affair shaped by culture and health care systems, we explored European health care practices and interventions toward families of older patients with cardiovascular disease and heart failure.

AIMS

This paper aimed to determine the extent, range, and variety of practices and interventions in Europe directed to families of older patients and to identify knowledge gaps.

MATERIALS & METHODS

A scoping review was conducted including studies published in Medline, CINHAL, or Cochrane library between 2009 and mid-2020.

RESULTS

A total of 22 articles from 17 studies were included, showing diverse practices and interventions. The interventions targeted the family as a unit (six studies), dyads (five studies), patients alone, but assessed family members' reactions (five studies) or the family member primarily, but assessed the reaction of the patient (one study). Target outcomes were family caregiver burden; health-related QoL; and perceived control in patients; and family functioning and changes in health behavior or knowledge in both, family members and patients. Most studies did not include an integral view of the family as the unit of care but rather had a disease-centered approach.

DISCUSSION

This scoping review provides insight into a variety of healthcare practices towards families of older patients with cardiovascular disease in Europe. Clarifying underlying assumptions to involve families is needed. More studies with family-focused approaches as integral models could lead to practices that improve families' well-being. Exploring integral models for their acceptance in health care and family systems appears pertinent to develop European policy to support and add to family health.

Validación de una versión reducida del Cuestionario Estilos de Respuesta Parental (CERP-R) frente a la enfermedad de un hijo

Tener un hijo con una enfermedad grave puede ser muy estresante para los padres. Con el objetivo de ofrecer a los profesionales de la salud un sistema preciso y de fácil aplicación para detectar diferentes respuestas parentales frente a la enfermedad del hijo se creó una versión breve del Cuestionario de Estilos de Respuesta Parental (CERP). Objetivo: Analizar la fiabilidad y la validez de una versión reducida del CERP en una muestra de padres de niños y adolescentes con enfermedad crónica. Metodología: Se analizaron las características psicométricas (validez, fiabilidad y análisis factorial) de una versión reducida a 16 ítems de la versión original del CERP, que mide principalmente cuatro formas de respuesta parental negativa frente a la enfermedad del hijo: desgana/disforia, irritabilidad/rechazo, sobreprotección y percepción de desajuste. La muestra estuvo compuesta por 28 padres y madres de un hijo enfermo. Resultados: El análisis de fiabilidad de la versión reducida (CERP-R) mostró un índice de consistencia interna alto. En los datos globales del cuestionario no hay diferencias estadísticamente significativas entre padres y madres de las mismas parejas en cuanto a su puntuación global. En el análisis por factores, las respuestas de disforia/desgana son significativamente más altas en madres, mientras que la sobreprotección es significativamente superior entre padres. Conclusión: El CERP-R  analiza las diferencias en las respuestas afectivas de los padres y madres frente a la enfermedad del hijo. Es un instrumento fiable y válido, que permite medir los diferentes estilos de respuesta parental, de cara a planificar intervenciones familiares.

Validación de una versión reducida del Cuestionario Estilos de Respuesta Parental (CERP-R) frente a la enfermedad de un hijo

Tener un hijo con una enfermedad grave puede ser muy estresante para los padres. Con el objetivo de ofrecer a los profesionales de la salud un sistema preciso y de fácil aplicación para detectar diferentes respuestas parentales frente a la enfermedad del hijo se creó una versión breve del Cuestionario de Estilos de Respuesta Parental (CERP). Objetivo: Analizar la fiabilidad y la validez de una versión reducida del CERP en una muestra de padres de niños y adolescentes con enfermedad crónica. Metodología: Se analizaron las características psicométricas (validez, fiabilidad y análisis factorial) de una versión reducida a 16 ítems de la versión original del CERP, que mide principalmente cuatro formas de respuesta parental negativa frente a la enfermedad del hijo: desgana/disforia, irritabilidad/rechazo, sobreprotección y percepción de desajuste. La muestra estuvo compuesta por 28 padres y madres de un hijo enfermo. Resultados: El análisis de fiabilidad de la versión reducida (CERP-R) mostró un índice de consistencia interna alto. En los datos globales del cuestionario no hay diferencias estadísticamente significativas entre padres y madres de las mismas parejas en cuanto a su puntuación global. En el análisis por factores, las respuestas de disforia/desgana son significativamente más altas en madres, mientras que la sobreprotección es significativamente superior entre padres. Conclusión: El CERP-R  analiza las diferencias en las respuestas afectivas de los padres y madres frente a la enfermedad del hijo. Es un instrumento fiable y válido, que permite medir los diferentes estilos de respuesta parental, de cara a planificar intervenciones familiares.

Health practices in Europe towards families of older patients with cancer: a scoping review

INTRODUCTION

In Europe, cancer is one of the predominant causes of mortality and morbidity among older people aged over 65. A diagnosis of cancer can imply a negative impact on the quality of life of the older patients and their families. Despite research examining the impact of cancer on the family, it is unclear what kind of information is available about the types of clinical practice towards older patients with cancer and their families. The aim is to determine the extent, range and variety of research in Europe describing health practices towards families of older patients with cancer and to identify any existing gaps in knowledge.

METHODS

Scoping review.

RESULTS

A total of 12 articles were included, showing that family interventions are generally based on end-of-life care. Most studies used a qualitative approach and involved different types of family member as participants. Most studies were conducted in the UK.

CONCLUSIONS

Review findings revealed limited knowledge about health practices in Europe towards families with an older patient with cancer. This review indicates a need to increase family-focused research that examines health practices that meet the needs of families of older patients with cancer. Seeing cancer as a chronic disease, there is an urgent need for the implementation of family-focused interventions.

Relationship Between Level of Care Dependency and Quality of Life of Family Caregivers of Care-Dependent Patients

A cross-sectional study was conducted with 139 family caregivers in two community health center areas in the city of Belo Horizonte, located in the southeastern state of Minas Gerais, Brazil. The purpose of the study was to analyze the relationship between level of care dependency and quality of life (QOL) of family caregivers. A socio-demographic questionnaire, the Barthel Index for assessing patients' care dependency level, and the World Health Organization's Quality of Life-BREF (WHOQOL-BREF) for evaluating family caregivers' QOL were used. Patients' care dependency level was not significantly associated with family caregivers' QOL. However, the QOL decreased when family caregivers had chronic disease and were dependent on public health care services, and increased when they received caregiver education and practiced a leisure activity. These factors are modifiable or controllable; therefore, family health nurses have an important role in formulating strategies to support family caregivers, especially those related to health education aimed at health care, health promotion, control, and prevention of diseases.

Necesidades de los familiares en la etapa de larga supervivencia de cáncer

Introducción: El cáncer es una experiencia familiar en la que los supervivientes y sus familiares vivencian cambios a corto y largo plazo, especialmente en la esfera emocional. La preocupación por la recidiva o la incertidumbre del futuro generan niveles de estrés significativo en la familia. A pesar de ello, existe escasa investigación sobre las necesidades de los familiares en la supervivencia de cáncer. Objetivos: Identificary describir las necesidades de los familiares de pacientes supervivientes de cáncer en la etapa de larga supervivencia. Métodos: Revisión narrativa con metodología sistemática de selección de artículos en cuatro bases de datos publicados entrediciembre de 2015 y marzo de 2018, y revisión manual de las 10 revistas internacionales más relevantes del ámbito de la oncología. Los 14 artículos identificados fueron analizados y la calidad de estos fue también evaluada. Resultados:Los familiares, denominados como “supervivientes secundarios”, tienen necesidades específicas que precisan ser abordadas por los profesionales. Estas necesidades fueron clasificadas en las siguientes categorías: apoyo emocional y espiritual, información, manejo de cuidados al superviviente y atención al propio familiar. Conclusiones: Esta revisión recopila información que demuestra que la familia debe considerarse como unidad de cuidado en la larga supervivencia de cáncer. Además, proporciona un punto de partida para el desarrollo de nuevas guías de práctica clínica que promuevan la evaluación e intervención familiar, no solo en las fases iniciales del diagnóstico y tratamiento del cáncer, sino también en la larga supervivencia de cáncer.

"What I was and what I am": A qualitative study of survivors' experience of urological cancer

PURPOSE

Most qualitative studies do not explore experience throughout the urologic cancer survival trajectory. Moreover, the evidence of the experience of cancer survivors that focuses on the contextual aspects of culture is scarce in oncology literature. This study aimed to analyze the survival experience of urological cancer from the perspective of men.

METHOD

This was a narrative research based on the concepts of culture derived from the interpretative medical anthropologic approach. Semi-structured interviews were conducted with 10 male survivors of urological cancer at different survival seasons. Seven participants agreed to a second interview, which resulted in 17 interviews. The data were analyzed using a five-phase thematic analysis approach. The findings are presented as narrative syntheses. The standards for reporting qualitative research (SPQR) was used in this study.

RESULTS

Two narrative syntheses were constructed: "The journey of urological cancer: discovering oneself as a survivor" and "What I was and what I am today": the disruption on the body and life. The narrative synthesis shows that survivors undergo transitions of identity from being healthy men to wrecked men. The survivors tried to present themselves as normal men to keep their masculinity intact. However, the experience of survival constituted a process of liminality and biographical disruption.

CONCLUSION

The experience of surviving urological cancer has highlighted the physical, emotional, and social challenges experienced by these male survivors. It is recommended to oncology nurses that nursing care should be planned along survival seasons considering the survivors' individual and subjective experiences.

Are Nursing Students Trained to Meet the Needs of Cancer Survivors and Their Families? New Challenges, New Opportunities

Abstract:Current cancer treatments, along with more effective prevention measures, are producing increased cancer survival globally;(1) becoming – in many cases – a chronic disease.(2) Care of patients and families, living with a chronic disease, like cancer, constitutes one of the principal challenges for most health systems because they represent a heavy burden in terms of morbidity and mortality and carry a high percentage of the public expenditure in health.(3) Above all, the impact of cancer entails suffering and represents an important limitation in the quality of life, productivity, and functional state of the sick individuals and those living with them, that is, their family. More so, with evidence of the progressive increase of the number of older people with cancer, who are more prone to having comorbidities and other problems associated with their age, like dementia, depression, cerebrovascular accident, and diabetes.(4)

The transition of palliative care from the hospital to the home: a narrative review of experiences of patients and family caretakers

OBJECTIVE

This work sought to identify, analyze, and synthesize the qualitative studies published on the experiences of patients and family caretakers during the transition of palliative care from the hospital to the home.

METHODOLOGY

A narrative review was conducted on the PubMed, Cochrane Central, ScienceDirect, Ovid Nursing, CINALH, Scielo, and Bireme databases, from 2000 to 2014.

RESULTS

After the analysis and comparison of the data, the results were grouped into six themes: (1) the dyad and its knowledge regarding the diagnosis and prognosis; (2) emotions experienced by the family caretaker and the patient during discharge; (3) effective communication among those involved with the care; (4) education for the care of the person at home; (5) continuous support to the dyad at home, and (6) care overload: social support for the family caretaker.

CONCLUSION

Patients and relatives in palliative care experience a broad range of needs during the transition process from the hospital to the home, which are often not covered by healthcare professionals. This review evidences the need to research further on the experiences of these families, especially during the stage prior to the transfer to the domicile.

Intervention study for smoking cessation in Spanish college students: pragmatic randomized controlled trial

AIM

To evaluate the effectiveness of a nurse intervention aimed at helping college student smokers quit smoking.

DESIGN

Single-blind, pragmatic randomized controlled trial which compares a multi-component intervention, tailored specifically to college students, with a brief advice session with a 6-month follow-up.

SETTINGS

This study was conducted at the University of Navarra, Spain.

PARTICIPANTS

A total of 255 college student smokers (age range = 18-24 years) were randomized to an intervention group (n = 133) or to a control group (n = 122).

INTERVENTION

A multi-component intervention based on the Theory of Triadic Influence of Flay was developed. The intervention consisted of a 50-minute motivational interview conducted by a nurse and online self-help material. The follow-up included a reinforcing e-mail and group therapy.

MEASUREMENTS

The primary outcome was self-reported abstinence, with biochemical verification at 6 months. The secondary outcomes consisted of the mean number of cigarettes smoked per day, self-reported attempts to quit smoking and stage of change at 6 months.

FINDINGS

At the 6-month follow-up, the smoking cessation incidence was 21.1% in the intervention group compared with 6.6% in the control group (difference = 14.5 confidence interval = 6.1-22.8; relative risk = 3.41, 95% confidence interval = 1.62-7.20). The difference in the mean number of cigarettes at 6 months was significantly different (difference = -2.2, confidence interval = -3.6 to -0.9).

CONCLUSIONS

A multi-component intervention tailored to college students and managed by a nurse is effective in increasing smoking cessation among college students.

[Effectiveness of family interventions in nursing homes. A systematic review]

The process of nursing home placement can be a stressful event for both the dependent elderly person and the family. During admission, especially the first few months, the family may suffer feelings of loss, sadness, failure and guilt. In this context, support and guidance from health professionals are essential to address the needs of residents and families through effective interventions. The aim of this systematic review is to identify the most effective interventions to help families during the process of institutionalization of a relative in a nursing home. Two types of family interventions were identified: those that focused on family-staff relationship and those that focused on family support groups, the latter being the most effective. On the other hand, most interventions have an individualistic approach, focusing on the primary caregiver. Finally, there is a shortage of quality studies that present the results of family interventions in the geriatric field and also a lack of such studies in the Spanish context.