Canadian Oncology Nursing Journal最新文献

Purpose: Gynecological cancer (GC) survivors desire holistic, person-centred, supportive care interventions to address their unmet needs after treatment. The development of such interventions requires an understanding of both the expectations and needs of GC survivors. The purpose of this study was to understand GC survivors' expectations and needs for post treatment, and to consider how their expectations and needs converge and diverge to inform care.

Methods: A convergent mixed-methods design (QUAL+quant) was used. Qualitative data were collected via 1:1 telephone interviews. Quantitative data were collected using the Cancer Survivors' Unmet Needs measure.

Results: Twenty-four individuals participated. Survivors' expectations for interventions after treatment included the implementation and outcomes of interventions and were grouped into two themes: Wrestling the unknown and Trusted information strengthens capacity. The most common unmet needs were related to existential survivorship. However, mixed-methods analysis revealed participants primarily expected to have their informational needs met in post-treatment interventions.

Conclusions: Study findings illuminate GC survivors' expectations and needs after treatment, and the importance of analyzing both when planning and providing care. Clinicians may use these findings to develop and refine interventions to address unmet needs of GC survivors.

Purpose: The purpose of this qualitative study is to demonstrate the use of patient-reported outcome measure-based journey maps in facilitating clinicians' ability to communicate with patients about their well-being at each phase of their cancer journey.

Methods: Individual semi-structured online and phone interviews were conducted with older adults in British Columbia, Canada. Participants (n = 6) were asked to describe their cancer experiences associated with their well-being score using the Edmonton Symptom Assessment System revised questionnaire throughout their cancer journey (i.e., pre-diagnosis, diagnosis, treatment, to post-treatment).

Results: Six older adults who received cancer treatment were interviewed. Six journey maps were developed with evidence of fluctuation in participants' level of well-being through their cancer journeys.

Conclusion: Journey maps can facilitate patient-clinician communication for tailoring interventions and draw clinicians' attention to additional prompts to better understand patients' well-being throughout the cancer journey.

Supportive care services can reduce distress and improve quality of life for cancer survivors and their caregivers. However, people often struggle to access these services. With this issue in mind, the current study aimed to explore the experiences of cancer survivors and their caregivers in accessing supportive care services in New Brunswick, Canada, as well as their prospective interest in a provincial supportive care centre. Forty-four individuals participated in an online or mail survey designed to identify experiences accessing supportive care services and supportive care needs. Results indicated the supportive care services that are most important to participants (e.g., mental and emotional support). Many participants noted that they were unaware of the availability of follow-up services and methods of access. Participants had a variety of unmet care requirements including lack of informational support and care coordination. All participants reported that they would like to have a supportive care centre in New Brunswick. These findings offer important recommendations for improving the coordination and delivery of supportive cancer care for this population.

The Northwest Territories (NWT) is one of the three territories in Canada and is located above or north of the 60th parallel. The Northwest Territories Health and Social Services Authority (NTHSSA) is the largest health authority in the territory and was created in 2016 as a consolidation of pre-existing regional health authorities. I have been an oncology nurse in the NWT for the past 11 years, spanning my entire nursing career. During that time, the NTHSSA's Cancer Care team has expanded and worked hard to increase access to consistent, coordinated, and high-quality oncology care and supports, vastly improving NWT residents' cancer care experience and outcomes. This article describes the evolution of cancer care and patient navigation in the NWT.

Background: The current advances in radiotherapy (RT) have improved the outcome of breast cancer (BC) patients. Despite its therapeutic benefits, the iatrogenic toxicities of RT and its impact on BC survivors are still debated, and further evaluations should be considered. This study aims to assess the rate of subclinical hypothyroidism and hypoparathyroidism among BC patients who were exposed to therapeutic radiation.

Methods: Seventy females undergoing RT for BC were enrolled in this cross-sectional study. Laboratory assessment of thyroid stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels was obtained to evaluate thyroid function. The parathyroid function was evaluated by measuring serum levels of Calcium (Ca), Phosphorus (P), and parathyroid hormone (PTH) at baseline, six and 12 months after RT.

Results: The mean age of patients was 54.3±6.4 years. We found no cases of hypothyroidism before radiotherapy. However, nine patients developed hypothyroidism in the six months after radiotherapy (one clinical and eight subclinical, 13% in total), and six patients were identified with hypothyroidism in the 12 months after radiotherapy (one clinical and five subclinical, 8.7% in total). Significant relationships were observed in the hypothyroidism rate at both six months (p = 0.003) and 12 months (p = 0.028) after RT compared with the baseline. There was no case of hypoparathyroidism before and after RT.

Conclusion: In summary, we found that thyroid and parathyroid dysfunction after RT are relatively common findings among women with BC. It is a treatable source of morbidity in patients undergoing RT. Therefore, routine thyroid function monitoring should be recommended to improve the quality of life in BC survivors.

Sleep disruptions are commonly reported during and after cancer. In addition to its immediate relevance for patients' immunity and response to treatment, poor sleep can also affect their psychological health and, ultimately, quality of life. Sleep disturbances can also affect caregivers who are supporting cancer patients, adding to their burden. Therefore, it is important for both patients and their families to receive personalized advice and assistance to improve sleep quality. Research has demonstrated that providing intervention for sleep difficulties early in the care trajectory of cancer patients can enhance satisfaction with care and reduce depression. In this article, we will outline basic practical tips that oncology nurses can offer to patients experiencing sleep difficulties, ranging from basic sleep hygiene practices to rearranging their bedroom environment for better rest.

Purpose: Multiple myeloma is an incurable hematologic cancer. A palliative approach to care can be used in conjunction with curative therapy to alleviate suffering, but is underutilized in the hemato- oncology population. The purpose of this study was to explore living with multiple myeloma and individuals' experiences with, and perceptions of a palliative approach in their care.

Methods: Straussian grounded theory was employed. Ten individuals with multiple myeloma participated between October 2021 and May 2022.

Results: A theoretical model depicting the process of living with multiple myeloma was developed. Seven categories emerged from the data, as well as a core category: 'existing in the liminal space between living with and dying from multiple myeloma'. Results demonstrate that a palliative approach to care was inconsistently utilized.

Conclusions: The model designed from the participant data offers an explanation of the process of living with multiple myeloma and how a palliative approach to care can be utilized to help these individuals.

With increasing numbers of individuals presenting with advanced cancer, strong recommendations for the integration of palliative care in oncology, and the availability and acceptance of medical assistance in dying, oncology nurses must be informed and prepared to provide patient-centred care in advanced cancer. This is part one of a two-part case report presenting an exploration of early palliative care and medical assistance in dying in the setting of advanced cancer. It focuses on the patient and family experience throughout the illness trajectory, from diagnosis to death, and incorporates some of the common challenges seen in supporting someone with advanced cancer. While highlighting the perspective of the patient and family, it demonstrates how palliative care and medical assistance in dying can work together to achieve a patient's goals. The paper provides valuable insight for oncology nurses to consider in their practice.