Oncology nursing forum最新文献

Objectives: To describe longitudinal oral health symptom patterns of patients receiving concurrent chemotherapy and radiation therapy for head and neck cancer (HNC) and examine associations between phenotypic characteristics, including human papillomavirus (HPV) status and oral health symptoms.

Sample & setting: A pilot retrospective longitudinal chart review (N = 270) of patients with HNC at a northeastern U.S. regional cancer institute.

Methods & variables: HPV status and oral health symptoms (pain, mucositis, taste alteration, xerostomia, dysphagia, and candidiasis) were examined during treatment (six weeks) and survivorship (three months). Latent transition analysis was conducted across each time point.

Results: The latent transition analysis revealed classes with moderate to high symptom expression persisted into survivorship. The HPV-negative phenotype had higher symptom expression across treatment and survivorship.

Implications for nursing: Patients with HPV-negative HNC may require early intervention, while considering social determinants of health to attenuate symptom expression and improve outcomes.

Objectives: To explore the incidence of adverse childhood experiences (ACEs) in breast cancer survivors and potential associations with long-term treatment-related sequelae.

Sample & setting: English-speaking breast cancer survivors three or more years from diagnosis with complete treatment response (N = 120) were recruited prior to scheduled survivorship clinic visits.

Methods & variables: Participants in this cross-sectional observational feasibility study rated anxiety, depression, fatigue, sleep disturbance, cognitive issues, resilience, and ACEs (experienced prior to age 18 years). Blood samples were analyzed for inflammatory and epigenetic biomarkers.

Results: ACEs assessment was feasible. Higher ACE scores correlated with greater fatigue, anxiety, and depression, and with lower cognitive function (p < 0.05). Resilience was positively associated with cognitive function and negatively associated with fatigue, anxiety, and depression.

Implications for nursing: There is evidence for the impact of ACEs on long-term treatment-related sequelae in women with breast cancer. Oncology nurses should consider incorporating ACEs assessment into the workflow for women receiving survivorship care.

Problem statement: To define the Oncology Nursing Society Research Agenda for 2024-2027.

Design: An iterative, multiple data sources consolidation through the Research Agenda Project Team.

Data sources: Previous research priorities, literature review, stakeholder survey, and research priorities from other cancer care organizations and funding agencies.

Findings: 10 evergreen statements articulated foundational values for oncology nurse scientists, and 5 topics emerged as research priorities for the upcoming three years: Advance patient-centric, precision symptom science; provide evidence for safe and effective cancer care delivery models and support of the oncology nursing workforce; describe the impact of the environment on cancer care outcomes; integrate patient navigation into cancer care across the trajectory; and advance the use of innovative methodologies in oncology nursing research.

Implications for nursing: The Oncology Nursing Society Research Agenda is an effective resource for directing the organization's research vision. This foundational document directs funding awards and requests, mentorship, and policy initiatives.

Objectives: To identify subgroups of patients with distinct psychological profiles at the beginning of the COVID-19 pandemic and evaluate for differences.

Sample & setting: Online survey of patients with cancer during the COVID-19 pandemic.

Methods & variables: Patients completed measures of demographic and clinical characteristics, as well as cancer- and COVID-19-related stress, global stress, social isolation, loneliness, financial toxicity, and common symptoms. Latent profile analysis was used to identify distinct psychological profiles.

Results: Among 1,145 patients, three subgroups were identified (i.e., no anxiety or depression and normative level of resilience; high depression, high anxiety, and low resilience; and very high depression, very high anxiety, and very low resilience). Patients with the two worst psychological profiles were younger, more likely to be female, more recently diagnosed with cancer, and more likely to have breast cancer.

Implications for nursing: Findings may assist clinicians to identify patients at increased risk for significant psychological morbidity and provide more timely, targeted, and cost-effective interventions.

Problem identification: Previous reviews have reported the efficacy of acupuncture in managing cancer-related symptoms. However, there is a lack of comprehensive reviews examining how patients' expectancy regarding acupuncture influences treatment outcomes in the context of cancer survivorship.

Literature search: 9 databases were searched for articles published through August 2023. The authors included acupuncture studies that reported on patient expectancy for the effectiveness of acupuncture.

Data evaluation: 10 studies were included in this review. Study quality was assessed using the Cochrane risk-of-bias tool and the ROBINS-I (Risk Of Bias In Non-randomised Studies-of Interventions) tool.

Synthesis: 5 studies explored the relationship between expectancy and cancer-related outcomes, and in 3, expectancy was significantly associated with reduced pain, frequency of bowel movements, and severity of insomnia. Male and older patients, nonresponders to acupuncture, and those with lower education levels had lower expectancy regarding acupuncture.

Implications for nursing: Healthcare providers should assess patient expectancy to comprehensively understand its role in improving acupuncture outcomes.

Objectives: To explore burden and its related factors among primary caregivers of patients with cancer.

Sample & setting: This study was conducted in an oncology ward at a medical center in southern Taiwan. A total of 137 dyads of patients with cancer and their primary caregivers were recruited.

Methods & variables: This cross-sectional correlational study used a structured questionnaire to assess the burden of primary caregivers. Data on patients' basic characteristics and disease profiles were extracted from medical records from January to June 2019. Linear regression analysis was used to identify factors associated with the burden of primary caregivers.

Results: The majority of primary caregivers were female (70%) and aged younger than 65 years (85%). Overall, the mean primary caregiver burden score was 38.83 (SD = 12.86), with spiritual burden ranking highest among the four domains assessed. Factors related to overall primary caregiver burden included psychiatric symptoms, daily care hours, patient age, and the lack of rotational support.

Implications for nursing: Hospice and oncology nurses can actively identify psychiatric symptoms in primary caregivers, targeting high-risk groups to provide timely resources or psychiatric referrals, aiming to alleviate future caregiver burden.

Collaboration between DNP-prepared nurse scientists and DNP-prepared nurse clinicians strengthens oncology science and can potentially improve patient-centered outcomes. Many within the nursing community associate the reducti.

Objectives: To identify barriers to surveillance mammography adherence in Korean breast cancer survivors (BCSs), which is crucial for early detection of recurrence and new cancers.

Sample & setting: 195 BCSs were recruited from a breast cancer clinic and its support groups at a South Korean hospital.

Methods & variables: This descriptive study used a cross-sectional design. Participants completed a self-administered multi-instrument survey based on a comprehensive framework for adherence, including individual characteristics, symptoms, quality of life, cognitive appraisal, social support, and healthcare system factors.

Results: Having had a mammogram within the past year was considered adherent (n = 177), and no mammography within the past year was considered nonadherent (n = 18). Logistic regression revealed that longer time since diagnosis (p < 0.001), greater depression (p = 0.024), and higher health services utilization (p < 0.001) were predictors of lower mammography adherence (chi square = 76.618, p < 0.001, R2 = 58%).

Implications for nursing: This is the first study to identify depression as a barrier to surveillance mammography in BCSs, suggesting that depression screening and treatment may be important for increasing adherence.

Objectives: To explore cancer survivors' historical and current use of analgesics for chronic chemotherapy-induced peripheral neuropathy (CIPN).

Sample & setting: 142 post-treatment cancer survivors who received neurotoxic chemotherapy and were experiencing moderate to severe CIPN.

Methods & variables: Participants completed the Treatment-Induced Neuropathy Assessment Scale at baseline and reported all analgesics used to manage CIPN. Frequency of historical or current prescription analgesic use for chronic CIPN was described and stratified by CIPN pain severity.

Results: At baseline, 31% of participants reported historical use of analgesics for CIPN and 46% of participants were currently using analgesics for CIPN. Gabapentin was the most frequently used analgesic, historically (20%) and currently (34%), and duloxetine was used less frequently (6% historical use, 10% current use). Many participants with severe pain (59%) reported using analgesics for CIPN.

Implications for nursing: Duloxetine, the first-line treatment for chronic CIPN pain, was used less frequently than gabapentin, a common prescription analgesic for neuropathic pain. Further research is needed to determine strategies to promote the implementation of evidence-based CIPN treatments in clinical practice.

Problem identification: Chemotherapy-induced peripheral neuropathy (CIPN) can cause treatment delays or discontinuation. Exercise can improve CIPN, but the effects have been inconsistent.

Literature search: 12 databases and 5 websites were searched from database inception to December 22, 2023, for primary studies that were reported in English and examined the effects of exercise on CIPN in cancer survivors.

Data evaluation: 20 studies (N = 1,308 total participants) were identified and reviewed.

Synthesis: Using a random-effects model, exercise slightly improved symptoms of CIPN (Hedges's g = 0.28, Hartung-Knapp adjusted 95% confidence interval [0.12, 0.45], p = 0.002). The 95% prediction interval showed that the true effect size of future studies would likely range from -0.1 to 0.66. Frequency of performing exercise moderated the effect size, further improving symptoms.

Implications for nursing: Nurses can encourage cancer survivors to engage in exercise, such as resistance training, aerobic exercise, balance training, and/or yoga. Nurses can refer cancer survivors to trained exercise specialists or provide information about finding a community exercise program for patients with cancer.