Canadian Oncology Nursing Journal最新文献

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.

Objectif: Le myélome multiple est un cancer hématologique incurable. Pour alléger la souffrance, il est possible d'employer une approche palliative en conjonction avec un traitement curatif, mais cette approche est sous-utilisée chez les patients en hémato-oncologie. L'objectif de la présente étude est d'examiner l'expérience des personnes atteintes d'un myélome multiple qui reçoivent un traitement palliatif dans le cadre de leurs soins, et de comprendre comment ils perçoivent cette approche.

Méthodologie: La présente étude suit le modèle de la théorie ancrée de Strauss. En tout, 10 personnes atteintes de myélome multiple y ont participé entre octobre 2021 et mai 2022.

Résultats: Les chercheuses ont créé un modèle théorique illustrant le processus de l'expérience du myélome multiple. Les données ont permis d'extrapoler 7 catégories, ainsi qu'une catégorie centrale, c'est-à-dire « le fait d'exister dans l'espace liminal entre la vie avec le myélome multiple et la mort à cause de la maladie ». Selon les résultats, le recours à l'approche palliative manquait de constance.

Conclusion: Le modèle conçu à partir des données recueillies auprès des participants rend compte de l'expérience du myélome multiple et de l'utilité de l'approche palliative.

Introduction: In February 2022, we introduced the innovative new role of mental health nurse clinician (MHNC) in pediatric hematology/ oncology in a pediatric hospital in Quebec with the aim of better addressing the needs of young cancer patients and their families. In two previous articles, we explained the method used to develop the role, as well as the strategy employed to implement it.

Objectives: In this article, we seek to evaluate the effectiveness of the implementation strategy by measuring role feasibility. We will also examine role acceptability and appreciation 1 year following implementation.

Methodology: We asked three groups of participants (adolescents, parents and care providers) to complete a research questionnaire based on the Theoretical Framework of Acceptability (TFA), with good inter-rater reliability and discriminant validity. The questionnaire, which was made available online, consisted of statements with Likert-scale responses (from 1 to 5), as well as open questions. We performed a standard descriptive analysis and used the responses to the open questions to support or add nuance to the quantitative results.

Results: In total, 31 healthcare professionals, 10 adolescent cancer patients and 10 parents of adolescent cancer patients filled out the questionnaire. Between February 2022 and February 2023, the MHNC provided a total of 691 interventions to 112 individuals (patients and parents). Follow-up sessions were offered to 61 individuals, and 99.6% of them accepted. We found a very strong correlation (r = 0.96) between the number of hours worked by the MHNC and the number of interventions provided. The vast majority of participants from all three groups agreed that the role is appropriate, appreciated and necessary, and that it brings much-needed clinical expertise in mental health to the department. Care providers, adolescents, and parents indicated that they would request this service again and would recommend it to others, if it were needed. The results, therefore, demonstrate excellent feasibility and high levels of acceptability and appreciation.

Conclusion: Our study shows that the implemented MHNC role helps improve the clinical management of the mental health of adolescents with cancer, as well as their parents. The role brings much-needed expertise in psychiatric nursing care and supports the clinical practice of care providers. Another study will be conducted in the near future to measure the effectiveness of the MHNC's interventions.

Introduction: Holistic healthcare approaches tailored to people's needs can enhance quality of life. However, needs of immigrant women in breast cancer survivorship have received little attention. Language barriers can result in significant challenges to accessing healthcare and difficulty in translating information from healthcare providers into self-management. The purpose of this review was to examine the experiences and meaningfulness of breast cancer survivorship care in improving the quality of life for immigrant breast cancer survivors.

Methods: A qualitative systematic review using a systematic search of peer-reviewed and non-peer-reviewed articles of empirical research was conducted. Articles about immigrant women who were diagnosed, treated, and completed their initial course of breast cancer treatment were included. Exclusion criteria were non-immigrant women, men, younger than 18 years, no breast cancer diagnosis, not currently undergoing active or advanced treatment, and not receiving palliative or end-of-life care. Thematic synthesis and qualitative systematic review included studies of survivorship care targeting breast cancer treatment and post-treatment. Articles were obtained from PubMed/MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, and Google Scholar searches, with findings configured according to the JBI methodology.

Results: Twenty studies, most of moderate-to high-quality were included. The thematic synthesis identified two overall themes regarding breast cancer survivorship care, as well as subthemes for both. The subthemes of the first theme, challenges and experiences accessing and using healthcare services, were inadequate insurance and benefits, less acculturation and decision-making, discrimination and differential treatment, and influencing sociocultural factors. The subthemes of the second theme, facilitators and barriers to accessing and using healthcare services, included ineffective knowledge and communication, lack of continuity and information, cultural and language barriers, limited access to services, and quality of care.

Conclusions: Supporting and engaging immigrant women throughout their breast cancer journey is critical. To do so requires integrating advancements in survivorship care as a systematic approach to lead to a better quality of life and improving patient-reported outcomes.

Background: Young adults (YA) with cancer often have unmet psychosocial needs. The impact of peer support delivered in an online format to fulfil these needs in the populations of YA with cancer has not been thoroughly examined.

Methods: We searched Cochrane Central Register of Controlled Trials, CINAHL, Embase, and Medline databases. We included articles about online peer support interventions for YA cancer survivors between the ages of 18 to 40 years old.

Results: Our literature search yielded n = 2,773 articles and we obtained consensus on 12 articles for inclusion. We qualitatively synthesized these articles using data abstraction based on the Template for Intervention and Replication (TIDierR) checklist. Overall, six studies demonstrated correlation between online peer support and improved wellbeing of participants. Thus, online peer support may be useful for young cancer patients.

Conclusion: This systematic review summarizes the current state of knowledge regarding the availability and evaluation of online YA peer support programs and reveals the need for further research in this field.

Chimeric antigen receptor t-cell (CAR-T) therapy is a newly evolving therapy with well-known acute neurotoxic effects. While the long-term neurotoxic effects of this therapy are under-researched, they exist in subsets of the post-treatment population. Nurses can focus on assessments before and after CAR-T therapy to determine the degree to which these neurotoxic effects progress. These assessments include subjective and objective tools, as well as an understanding of risk factors associated with a higher degree of adverse cognitive events. By utilizing current research, hematological nurses can advocate for this unmet need to be monitored and intervened upon to improve patient outcomes.

Introduction: Pediatric hematological and oncological illnesses present many coping challenges. Mental health issues can arise during and after treatment, in both patients and their families. The current model of care does not always seem to meet the needs identified by some young patients. In Quebec, nurses are allowed to assess and care for patients experiencing physical and mental health difficulties (Ordre des infirmières et infirmiers du Québec, 2016). Therefore, a mental health nurse clinician (MHNC) with experience in pediatric hematology/oncology could provide care that is complementary to that offered by psychologists, social workers, and other psychosocial professionals in the pediatric hematology/oncology unit in order to meet any needs that remain unmet. The MHNC project has three stages: (1) role development, (2) role implementation, and (3) role assessment one year after implementation. In this first article, we explain how the MHNC role was developed.

Methodology: We used the participatory, evidence-based, patient-focused process for advanced practice nursing (APN) role development, implementation, and evaluation (PEPPA Framework; Bryant-Lukosius & Dicenso, 2004) to develop this model. The first five steps in the PEPPA Framework were applied in the creation of the MHNC role to (1) select the target population, (2) identify the stakeholders to be involved, (3) ascertain needs, (4) determine and prioritize problems and set goals, and (5) define a new model of care.

Results: After multiple meetings involving numerous health professionals and managers, the MHNC role was developed with a versatile, transdisciplinary perspective to address better the needs of young cancer patients (especially those in their teens) and their families. The role was developed around four main areas of practice: (1) interventions offered to patient-family, (2) interventions offered to health professionals, (3) psychiatric consultation-liaison, and (4) education and research.

Conclusion: The next steps are to use a strategic plan to implement the role and then to evaluate the impact of the role one year after implementation.