Cancer Nursing最新文献

Background: Although the number of studies on the reflection of compassionate care practices in patient experiences has increased in recent years, the issue is still not sufficiently studied and clearly defined, and no study has been conducted with patients living with a cancer diagnosis in Türkiye.

Objective: This study aimed to examine the perspectives of compassionate care and compassionate care experiences of cancer patients in-depth using qualitative methods.

Methods: Between March and August 2024, 22 phenomenological semistructured interviews were conducted with cancer patients. The data were analyzed using Colaizzi's 7-step descriptive analysis approach.

Results: Five themes emerged from the analysis: (1) compassionate care behaviors, (2) noncompassionate care behaviors, (3) the value of compassionate care for the patients, (4) perceptions of compassionate care barriers, and (5) suggestions to improve compassionate care.

Conclusions: Compassionate care from cancer patients' perspectives involves being friendly, respectful, and responsive to needs, whereas noncompassionate care behaviors mainly involve ineffective communication skills. Compassionate care has a positive effect on the outcomes of cancer patients with a long and challenging treatment journey. On the contrary, it may adversely affect communication, leading to an increase in unmet needs and a poor impact on cancer prognosis.

Implications for practice: Cancer nurses should be trained to gain awareness of compassionate care and practices to ensure compassionate care, and training should be repeated regularly. For institution managers, reducing the patient-nurse ratio, monitoring cancer nurses for compassion fatigue, implementing prevention and coping programs, and creating a corporate culture to provide compassionate care are recommended.

Background: The global incidence of breast cancer is increasing, making the care of breast cancer survivors a priority for health services worldwide. Spouses are often the primary caregivers for breast cancer survivors, and understanding their caregiving experiences is essential for developing supportive programs aimed at reducing the burden on these caregivers.

Objective: The aim of this study was to synthesize qualitative research evidence on male spouses' experiences in providing support and care for breast cancer survivors.

Methods: Three databases were comprehensively searched, and the Joanna Briggs Institute qualitative synthesis method was used to evaluate the quality of the studies and synthesize the results.

Results: A total of 14 studies identified 4 themes: male spouses have negative and positive emotional responses to breast cancer; male spouses experience physical, economic, and social consequences associated with breast cancer care; male spouses experience changes in child-rearing and intimate relationships; and male spouses use a range of strategies to cope with caregiving for an ill spouse.

Conclusions: Spouses face numerous physical, psychological, and economic challenges when caring for breast cancer survivors. Therefore, support programs for caregivers should be multifaceted. Healthcare professionals should identify these challenges early and develop personalized intervention strategies to effectively enhance caregiving competence and facilitate adaptation to role transitions.

Implications for practice: Healthcare providers should emphasize positive feedback and a sense of benefit in the process of spousal caregiving, enhance training in professional skills, provide diversified support, and promote positive spousal changes to improve the caregiving experience.

Background: The radical shift introduced by cancer can biographically rupture the life of the family caregiver (FCG). The life shift experienced by cancer FCGs calls for stories and storytelling to create meaning and make sense of how their lives can be reshaped and evolve despite the changes and ambiguity that cancer introduces to the family system.

Objective: This study aimed to explore advanced cancer FCGs' experiences of personal becoming across the multifaceted dimensions of self.

Methods: Grounded in unitary-transformative nursing science theories, we used narrative inquiry alongside photo elicitation to create and analyze 5 cancer caregiver narratives. Thematic narrative analysis was used to identify patterns related to personal becoming within and across the narratives.

Results: The findings of personal becoming include multiple themes of transforming in ways of living and knowing: (1) past caring informs present caring of another and self, (2) meaning of life and purpose of self, (3) relationships with others, (4) relating to the natural world, (5) patterns of spiritual knowing, and (6) patterns of aesthetic knowing.

Conclusions: The findings illustrate that cancer FCGs may incorporate new patterns of knowing, perceiving, and understanding themselves, others, and the natural world. Themes of personal becoming illuminate a greater understanding of the complex experience of caring in family relationships affected by advanced cancer.

Implications for practice: Nurses have a vital role in actively engaging cancer FCGs in deriving meaning from their lived experiences of caring through stories and healing modalities that illuminate and facilitate their transformation of self.

Background: Despite Taiwan's advanced healthcare system, many women delay seeking medical attention for breast abnormalities, leading to worsened health outcomes and increased medical costs.

Objective: To explore the psychological journeys of patients with breast cancer who delayed medical consultation and presented with large tumors.

Methods: A phenomenological qualitative study was conducted using purposive sampling and semistructured interviews with 12 participants. Giorgi's phenomenological method guided the data analysis.

Results: Most participants (75%) were aged 50 or younger and had at least a high school education. Delays in seeking medical care ranged from 3 to 36 months, worsening disease severity, complicating treatment, and causing significant breast disfigurement. Four themes emerged from their journeys: being ignorant, inner turmoil, hesitation to move forward, and breaking through.

Conclusions: Participants delayed care due to insufficient awareness, cognitive biases, emotional struggles, and reliance on self-treatment. Consequently, all participants were diagnosed at stage 3 or higher. Addressing barriers such as low health literacy, cultural stigmas, and limited access to care is essential to encourage early detection and timely medical consultation.

Implications for practice: To prevent delays in seeking care, healthcare systems should enhance education on low awareness, cognitive biases, and self-treatment. Targeted interventions can empower women to recognize early symptoms and seek timely care. Healthcare professionals should be trained to address patients' fears and hesitations with empathetic, culturally sensitive communication. Reducing barriers, such as low health literacy, cultural stigmas, and limited access to care through community outreach and improved screening services, is essential for early detection and better outcomes.

Background: Spiritual care is a crucial component of oncology nursing, addressing patients' holistic needs. However, limited research has explored spiritual well-being, competence, practices, and barriers among oncology nurses, particularly within specific cultural and religious contexts.

Objective: To assess spiritual well-being and its predictors, including perceived competence, practices, and barriers to providing spiritual care among oncology nurses in Oman.

Methods: A descriptive correlational study was conducted with 422 oncology nurses from 3 cancer care centers in Muscat, Oman. Convenience sampling was used, and data were collected through validated instruments, including the Spiritual Well-being Scale, Spiritual Care Competence Scale, Nurse Spiritual Care Therapeutics Scale, and Spiritual Care Practice Questionnaire. SPSS version 27 was used for data analysis, using descriptive statistics, Pearson correlation, independent t tests, analysis of variance, and multiple linear regression.

Results: Nurses exhibited high spiritual well-being (mean, 102.1 [SD, 14.7]) and moderate spiritual care competence (mean, 96.1 [SD, 19.1]), yet spiritual care practices were infrequent (mean, 37.6 [SD, 13.1]). Major barriers included beliefs about the privacy of patients' spirituality (59.5%) and lack of time (54.7%). Higher competence and prior oncology training were significantly associated with greater spiritual well-being.

Conclusions: Although oncology nurses in Oman report high spiritual well-being, barriers such as time constraints and role perceptions hinder spiritual care practices.

Implications for practice: Targeted education and training programs are essential to enhance spiritual care delivery. Addressing systemic challenges, including time management and role clarity, can foster a supportive environment for integrating spiritual care into oncology nursing.

Background: Pain, anxiety, and stress are the most common symptoms experienced by patients receiving chemotherapy after breast surgery. Virtual reality (VR) can be used as a method to manage these symptoms.

Objective: To determine the effect of VR on chemotherapy-associated stress (salivary cortisol value), anxiety, pain, and vital signs of mastectomy patients.

Methods: A total of 62 participants were enrolled in this randomized, 2-group design. Participants in the experimental group watched videos with VR glasses during their chemotherapy treatments. Saliva samples were collected from participants in both the control and experimental groups before and immediately after their chemotherapy treatments. The Personal Information Form, state anxiety component of the State-Trait Anxiety Inventory, visual analog scale, and the patients' vital signs were also collected.

Results: The State-Trait Anxiety Inventory state anxiety component and visual analog scale scores and the stress value mean scores differed significantly between the 2 groups at the second data point. There was also a statistically significant decrease in systolic blood pressure and diastolic blood pressure after chemotherapy in the experimental group.

Conclusion: The use of VR in women receiving chemotherapy significantly reduced their pain, anxiety, stress and blood pressure from before to immediately following the chemotherapy infusion.

Implications for practice: VR can be an appropriate intervention to reduce pain, anxiety, and stress in patients receiving chemotherapy after mastectomy.

Background: Dyspnea is a significant symptom in advanced cancer patients, yet comprehensive evidence on its prevalence and related factors is lacking.

Objective: This review aims to summarize the prevalence of dyspnea among advanced cancer survivors and identify associated factors.

Methods: MEDLINE, EMBASE, Cochrane Library, PsycINFO, CINAHL Plus, and Web of Science were searched from inception to May 2024. Observational studies focusing on advanced cancer patients reporting dyspnea were included. Two reviewers performed data extraction and quality assessment independently using the Newcastle-Ottawa Scale. Prevalence estimates were pooled using a random-effects model. Subgroup analyses and metaregression were performed to explore heterogeneity.

Results: A total of 67 studies involving 78 409 advanced cancer survivors were included, revealing a pooled prevalence of dyspnea of 43% (95% prediction interval, 0.07, 0.84). Significant variations were observed based on cancer types, with lung cancer showing a prevalence of 55%. Factors associated with dyspnea were categorized using the Breathing, Thinking, Functioning clinical model: (1) breathing: physical (eg, fatigue), medical (eg, lung disease), and treatment-related (eg, palliative sedation) factors; (2) thinking: psychological (eg, anxiety) factors; and (3) functioning: performance (eg, Karnofsky Performance Status) and demographic characteristics (eg, age).

Conclusions: The findings highlight a high prevalence of dyspnea among advanced cancer survivors and identify several associated factors, stressing the need for early detection and comprehensive management strategies.

Implications for practice: Health providers can improve the quality of life for patients by effectively managing dyspnea, thereby reducing symptom burden, and alleviating psychological distress, leading to better overall well-being for patients and caregivers.

Background: Children with acute lymphoblastic leukemia experience various adverse symptoms during remission induction. Elucidating the interrelationships among symptoms can facilitate precise and efficacious symptom management.

Objective: This study aimed to elucidate symptom clusters and sentinel symptoms and to examine core and bridge symptoms within the symptom network in children with acute lymphoblastic leukemia during remission induction.

Methods: A cross-sectional survey of 226 children aged 8 to 16 years with a new diagnosis of acute lymphoblastic leukemia during remission induction chemotherapy was conducted using the Chinese version of the Memorial Symptom Assessment Scale 10-18. Symptom clusters and sentinel symptoms were identified using exploratory factor analysis and Apriori algorithm. Core and bridge symptoms were identified using network analysis.

Results: Five symptom clusters and sentinel symptoms were identified: gastrointestinal (constipation as the sentinel symptom), emotional (feeling sad as the sentinel symptom), and somatic (cough as the sentinel symptom); however, the sentinel symptoms of neurological and self-image impairment symptom clusters were not specified. In symptom network, feeling sad and nausea were core symptoms, whereas dizziness and lack of energy were the bridge symptoms.

Conclusions: The somatic symptom cluster should be prioritized for intervention during remission induction. Network analysis and sentinel symptom analysis must be extended to the symptom research in pediatric cancer to provide a scientific basis for symptom management.

Implications for practice: Nurses should aim to identify and intervene with sentinel and networked symptoms to ensure that children are effectively supported during the remission induction, reducing symptom burden and improving quality of life.

Background: Telecommunication (telephone, video) is increasingly being used in healthcare, including in the cancer area. Still, patients' lived experiences of receiving bad news over the telephone of first a suspected and later a confirmed cancer diagnosis remain sparsely researched.

Objective: This study aimed to explore the lived experience of receiving results and plans by telephone in patients during an invasive workup for suspected lung cancer.

Methods: Individual interviews were conducted with 11 patients 2 to 3 months after the final disclosure of cancer. Data were analyzed and interpreted within a phenomenological-hermeneutic framework.

Results: When "being on a journey from anticipation to the fact of the cancer diagnosis," patients appreciated being gently guided via ongoing information by telephone. However, some calls were confusing or inconvenient or did not involve desired relatives. When "transferring toward the next step of treatment and care," patients felt warned and prepared for the planned disclosure of a cancer diagnosis by telephone.

Conclusions: Using telephone communication during the diagnostic workup is well-suited to support patients during the vulnerable time of receiving a cancer diagnosis. To be effective, informing patients by telephone must involve a relational structure of anticipation, including a warning and personalized approach to help them and their relatives gradually realize the bad news.

Implication for practice: This study contributes to the evidence base for breaking bad news via telecommunication. When connecting with patients remotely, an optimal procedure must be arranged so that matters of confidentiality, emotional concerns, and needs for involvement of relatives are explicitly ensured.