Oncology nursing forum最新文献

Objectives: To examine associations between a history of adverse childhood experiences (ACEs) and receiving preventive cervical cancer screening and to investigate whether number and type of ACE exposures were predictive of cervical cancer screening uptake.

Sample & setting: Data were from 11,042 adults who completed the 2020 Texas Behavioral Risk Factor Surveillance System survey. The U.S. Preventive Services Task Force guidelines were used to indicate whether individuals had received cervical cancer screening at recommended intervals.

Methods & variables: Multiple logistic regression analysis was used to predict the likelihood of not having received the recommended preventive cancer screening by number and type of ACE exposures. Chi-square analysis was used to determine associations among demographic characteristics, cancer screening uptake, and ACE number and type.

Results: Individuals with one to three ACEs and those with six or more ACEs were statistically more likely not to have received the recommended cervical cancer screenings compared to those with zero ACEs. A history of physical ACEs was associated with 3.88 times the likelihood of not having received the recommended cervical cancer screening.

Implications for nursing: To promote timely cervical cancer screening and prevent retraumatization of patients with a history of ACEs, providers should implement trauma-informed care principles in their healthcare settings.

Problem identification: To provide an overview of telenursing interventions, primary outcomes, and tools used in patients with cancer receiving chemotherapy, a scoping review was conducted.

Literature search: PubMed®, Embase®, and CINAHL® databases were searched using the following keywords: telenursing, adverse event, and drug therapy.

Data evaluation: From the screening process, 11 studies were identified.

Synthesis: In patients with cancer receiving chemotherapy, telenursing interventions were mainly used to monitor symptoms, particularly fatigue, anxiety, and depression. The interventions used included outcome-specific, nonspecific, and validated tools, or tools developed from reporting systems for adverse events.

Implications for research: Large-scale, well-conducted randomized controlled trials, systematic reviews, and meta-analyses are needed to test the results of this scoping review.

Purpose: To understand the sources of social support and perceptions of cancer and the caregiving role for Korean American patients with cancer and their family caregivers.

Participants & setting: Using convenience sampling, Korean American patients with cancer and their family caregivers were recruited from Korean American churches and community health agencies.

Methodologic approach: Semistructured interviews guided by the sociocultural stress and coping model were conducted with 12 dyads (N = 24) of Korean American patients with cancer and their family caregivers. Data were analyzed using thematic analysis.

Findings: Patients' social support sources included Korean cancer support programs, family or friends, and religion. Family caregivers' sources of social support were limited to religion and friends.

Implications for nursing: Nurses can encourage patients with cancer in racial and ethnic minority groups to attend cancer support programs offered in their primary language to enhance their quality of life during cancer survivorship. Culturally tailored interventions are needed to support the patients' family caregivers.

Problem identification: This scoping review aimed to explore symptom clusters (SCs) in patients with lung cancer and how included symptoms and symptom dimensions are measured.

Literature search: PubMed®, CINAHL®, Scopus®, and Cochrane Library were searched for studies published until December 31, 2021. Fifty-three articles were included.

Data evaluation: Data extracted included descriptive items and SC constellations. Patient-reported outcome instruments and measured symptom dimensions were described according to the middle-range theory of unpleasant symptoms.

Synthesis: 13 articles investigated SCs a priori and 40 de novo. Thirty-six instruments were used, mostly measuring intensity alone or in combination with timing. Qualitative articles (n = 6) provided rich descriptions within the distress, timing, and quality dimensions.

Implications for research: Fatigue was the symptom found to most frequently co-occur with other symptoms in SCs. Fatigue, psychological symptoms, and nutritional aspects are emphasized as important areas for oncology nursing practice and further research to improve SC management for patients with lung cancer.

Objectives: To determine whether there are differences in the health-related quality of life (HRQOL) of older adult survivors of breast cancer (BC) diagnosed in different time periods and to gain insight into whether advances in BC treatment have improved HRQOL.

Sample & setting: Three cohorts of older adult survivors of BC diagnosed before 1995, from 1996 to 2005, and from 2006 to 2015 were examined using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey linked databases.

Methods & variables: HRQOL was measured using the Veterans RAND 12-Item Health Survey. Mean cohort HRQOL scores were compared using analysis of variance, then multivariate regression models were used to examine the effects of cohort membership and covariates on mental and physical HRQOL.

Results: Adjusted mean HRQOL scores trended significantly lower with each successive cohort. Higher comorbidity count and increased functional limitations were negatively associated with HRQOL, and income, education level, and better general health perceptions were positively associated with HRQOL.

Implications for nursing: Regardless of time since diagnosis, older survivors of BC are at risk for poor HRQOL and should be regularly assessed. Maximizing HRQOL requires consideration of the survivor's resources, comorbidities, and functional limitations when planning care.

Purpose: To gain insight into how survivors of breast cancer (SBCs) with cancer-related fatigue (CRF) self-monitor and manage exercise dose in the context of daily life, and how they identify an optimal exercise dose.

Participants & setting: 11 SBCs with CRF who reported weekly exercise were recruited from a breast cancer center at a large urban hospital in the northeastern region of the United States.

Methodologic approach: One-on-one semistructured interviews were conducted using a descriptive phenomenologic method. Inductive data analysis was performed within and across cases.

Findings: The following themes emerged: examining the impact of exercise, finding an optimal dose, and remaining flexible to sustain exercise. Participants used trial and error to explore exercise dose, examining the effects of varying doses on daily life. These effects had behavioral implications and resulted in a nonlinear process and the perception that an optimal exercise dose is dynamic within the context of daily life.

Implications for nursing: Strategies to support SBCs with CRF to efficiently achieve optimal exercise doses with fewer setbacks may improve individuals' ability to self-manage and mitigate CRF. This study's findings provide practical approaches for nurses to encourage the initiation and adoption of exercise behaviors after treatment for breast cancer.

Purpose: To explore whether patients with multiple myeloma changed their construct of health-related quality of life during treatment.

Participants & setting: 14 participants were selected from 10 hematology-oncology departments in Denmark.

Methodologic approach: This interview study used a prospective, longitudinal, exploratory design. Semistructured interviews were conducted while participants were undergoing active treatment for multiple myeloma and six months after the baseline interview. Interviews were analyzed using systematic text condensation.

Findings: The overall theme at baseline was insecurity, and the overall theme at six months was coping. The following subthemes were also identified based on participants' description of their health-related quality of life: concerns about having a meaningful life, dealing with everyday limitations, and maintaining social networks; adjusting expectations to abilities; expanding social networks; and exploring a meaningful life.

Implications for nursing: Patients' ability to use coping strategies should be considered when screening for rehabilitation needs. During systematic in-depth symptom screening, unmet rehabilitation needs (e.g., physical functioning, fatigue, pain) may become apparent.

Objectives: To investigate the associations between women's health beliefs and their intention to use chemoprevention.

Sample & setting: Participants were postmenopausal women (N = 400) aged 50-64 years who were recruited for a study on mammographic breast density.

Methods & variables: Participants completed a screening mammogram and breast cancer health belief questionnaires. The authors regressed intention to use chemoprevention onto health belief scores (breast cancer fatalism, fear, perceived threat, perceived benefits, barriers, and self-efficacy).

Results: Nearly half of the participants indicated that they would be interested in using chemoprevention if they were found to be at high risk for developing breast cancer. Women who reported higher perceived benefits of chemoprevention, higher perceptions of their ability to use chemoprevention (self-efficacy), and fewer logistic barriers to seeking health care had significantly higher intention to use chemoprevention.

Implications for nursing: Interventions aimed at reducing logistic barriers to health care may increase the uptake of chemoprevention among at-risk women. In addition, women at the time of mammography and women with higher levels of education may be motivated to consider using chemoprevention.

Purpose: To explore the experiences of lung cancer survivors (LCSs) and their informal and professional caregivers with post-treatment care and to empower them to implement action-based study findings.

Participants & setting: Participants were recruited using purposeful and snowball sampling from patients at a National Cancer Institute-designated cancer center in the northeastern United States.

Methodologic approach: This study used a participatory action research (PAR) four-phase design. Phase 1 was a focused ethnography; phase 2 consisted of a core group of participants deciding on an action, which was implemented in phase 3; and phase 4 consisted of an evaluation of the action.

Findings: The study found 28 categories, eight patterns, and three themes. The themes were the need for resources and education, involvement in mentoring and advocacy, and the value of living versus surviving. The action was creating two flyers focused on resources and advocacy for post-treatment support for LCSs. All participants agreed with the themes and action. Tobacco management and smoking-related stigma for LCSs were the only topics of dissent.

Implications for nursing: Oncology nurses can use PAR to empower survivors in their post-treatment care. Future PAR cycles should focus on creating support groups and alleviating stigma for LCSs and their caregivers.

Objectives: To evaluate for subgroups of patients with distinct symptom profiles and differences in demographic and clinical characteristics and stress and resilience among these subgroups.

Sample & setting: 1,145 patients with cancer aged 18 years or older completed a survey online. Data were collected between May 2020 and February 2021.

Methods & variables: Patients completed measures for depression, state anxiety, cognitive function, morning fatigue, evening fatigue, morning energy, evening energy, sleep disturbance, pain, stress, and resilience. Latent class profile analysis was used to identify subgroups of patients with distinct symptom profiles. Differences among the subgroups on study measures were evaluated using parametric and nonparametric tests.

Results: Four distinct profiles were identified (none, low, high, and very high). Patients in the high and very high classes reported clinically meaningful levels of all nine symptoms. Differences among the four profiles for stress and resilience exhibited a dose-response effect.

Implications for nursing: Findings can serve as benchmark data of the symptom burden of patients with cancer following the COVID-19 pandemic.