Cancer Nursing最新文献

Background: Interactive features of computerized cognitive training (CCT) may enhance adherence to training, providing a relatively low-cost intervention. A robust systematic review on the effectiveness of CCT for improving working memory (WM) among pediatric survivors with cancer is lacking.

Objective: To summarize the available evidence and determine the effectiveness of CCT for WM among pediatric survivors with cancer.

Interventions/methods: Five databases were searched. The Effective Public Health Practice Project was used to assess the study quality. ReviewerManager was used. The primary outcome was WM performance. Secondary outcomes included processing speed, attention, intervention adherence, and number of adverse events.

Results: Six studies were included. Regarding overall quality, 1 study was weak, and 5 studies were moderate. Five studies reported a significant improvement of WM postintervention (P < .05). The meta-analysis of Cogmed interventions on symbolic WM revealed a significant difference between groups (vs placebo), with an overall pooled effect size of 0.71 (95% confidence interval, 0.02-1.41; P = .04). Two and 4 studies investigated the effects of CCT on processing speed and attention, respectively, with conflicting results. Four studies reported adherence of 80% or greater. Two studies reported no adverse events.

Conclusions: Computerized cognitive training using Cogmed has a significant positive effect on WM. The effects of CCT on processing speed and attention remain inconclusive.

Implications for practice: More rigorous trials should be conducted to elucidate the cognitive effects of CCT, particularly processing speed and attention, in the pediatric population with cancer. Further studies should consider combining CCT with other existing interventions to strengthen their effectiveness.

Background: Benefit finding is gaining attention as a strong predictor of quality of life, but few studies have addressed the mechanisms of its development.

Objective: The purpose of this study was to determine the relationship between illness perception and benefit finding in female thyroid cancer survivors and to further elucidate the mechanisms by which illness perception contributes to benefit finding through sense of coherence and self-disclosure.

Methods: A total of 280 female thyroid cancer survivors completed the questionnaire between January and August 2023. The study investigated participants' baseline information, illness perception, sense of coherence, self-disclosure, and benefit finding. The bootstrap method was used to test the chain mediation effect.

Results: The findings showed that in the chain-mediated model, illness perception negatively predicted sense of coherence (β = -.475, P < .001) and self-disclosure (β = -.335, P < .001). Sense of coherence positively predicted self-disclosure (β = .272, P < .001) and benefit finding (β = .251, P < .001). Self-disclosure positively predicted benefit finding (β = .213, P < .001). The separate mediating roles of sense of coherence and self-disclosure between illness perception and benefit finding were both significant, as were the chained mediating roles of sense of coherence, and self-disclosure.

Conclusion: This study provides a theoretical basis for elucidating the mechanisms of benefit finding and provides precise targets for clinical intervention.

Implications for practice: Healthcare professionals can improve mental health outcomes by improving cancer survivors' disease awareness, fostering their sense of coherence, and encouraging moderate self-disclosure to achieve benefit finding.

Background: Having a cancer diagnosis during early adulthood can be a significant challenge for an individual. Nurses' supportive communication plays a vital role during the diagnosis and treatment period to lessen psychological distress and promote coping.

Objective: This exploratory study aimed to examine (1) the experiences of emerging adults with cancer (EAs) aged between 18 and 25 years in communicating with nurses during diagnosis and treatment and (2) nurses' experiences of providing supportive communication with this patient group.

Methods: Semistructured interviews were conducted with EAs and nurses with experience caring for this patient group. Thematic analysis was conducted, guided by interpretive hermeneutic perspectives.

Results: Eight EA participants and 7 nurse participants participated in interviews. Five themes emerged: (1) having casual conversations with nurses helped EAs cope during cancer treatment and (2) helped EAs fulfill the need for social connectedness, (3) nurses as a different form of peer-like support, (4) nurses used themselves as a therapeutic tool to foster trust and emotional safety of EAs, and (5) nurses needed to maintain professional boundaries while being compassionate.

Conclusions: This study highlighted a rather underdocumented aspect of supportive communication: meeting psychosocial needs through casual, day-to-day conversations.

Implications for practice: Having casual conversations with nurses appeared to help EAs' psychological coping during cancer treatment. These casual conversations, which on the surface seemed clinically insignificant, fulfilled their psychosocial needs. Considering the valuable interpersonal engagement that led to emotional benefits for EAs, communication training for cancer nurses needs to build their capacity to maintain both relational and emotional boundaries.

Background: Recipients of allogeneic hematopoietic stem cell transplant (HSCT) may encounter difficulties in adhering to their post-transplant medication as prescribed to avoid complications. Despite the relevance of patients' perspectives to inform the clinical practice, to date, no summary regarding their lived experience of oral medication adherence (MA) has been produced.

Objective: To summarize the lived experience of MA by recipients of allogeneic HSCT as documented in qualitative studies.

Methods: A systematic review and meta-synthesis of qualitative research was performed. Six databases were searched up to June 27, 2023. Four qualitative studies met eligibility and were included: those designed and conducted with scientifically sound methodologies and those regarding adult patients who had undergone allogeneic HSCT and required an oral medication regimen in the post-transplant phase. Data were extracted and synthesized using thematic analysis.

Results: Four analytical themes were identified: "The initiation is a challenge," "Time as a new issue," "Internal and external obstacles threaten medication adherence," and "Different strategies are the answer to medication non-adherence."

Conclusions: Medication adherence in patients after HSCT is a complex phenomenon wherein different factors play a role. When designing targeted interventions to improve MA, it is imperative to start with patients' experiences and perspectives.

Implications for practice: Patients developed different strategies to deal with obstacles to MA that may inform daily practice. Before discharge, healthcare professionals should emphasize to both patients and carers the importance of MA.

Background: Cancer, regardless of type, presents a formidable life challenge affecting patients' psychological well-being. Many perceive cancer diagnosis and treatment as traumatic.

Objectives: This study aimed to estimate posttraumatic stress disorder (PTSD) prevalence in Omani adult cancer patients, identify predictors, and probe its correlation with social support.

Methods: This cross-sectional study enrolled 343 adult cancer patients undergoing treatment from 3 hospitals in the Middle East country of Oman. Posttraumatic stress disorder was assessed via the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and perceived social support was measured using the Multidimensional Scale of Perceived Social Support.

Results: The prevalence of PTSD among Omani adult cancer patients was 27.4%. Enhanced social support correlated with lower PTSD risk (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93-0.97; P < .001). Predictors included shorter time since diagnosis (OR, 0.98; 95% CI, 0.97-0.99; P = .017), no psychiatric referral (OR, 0.46; 95% CI, 0.23-0.96; P = .04), and insufficient social support (OR, 0.96; 95% CI, 0.94-0.98; P < .001).

Conclusions: Social support significantly mitigates PTSD risk. Routine assessment and psychiatric referrals, especially for recent diagnoses, can enhance patients' lives. Reevaluating the PTSD diagnostic cutoff score (33) merits consideration for improved clinical use.

Implications for practice: Early PTSD assessment, particularly for low-social support new-diagnosed patients, is crucial for timely intervention. Psychiatric referrals can guide specialized treatments. Stressing social support's role can guide healthcare providers, including oncology nurses, in supporting patients effectively.

Background: Promoting lung cancer screening (LCS) is complex. Previous studies have overlooked that LCS behaviors are stage based and thus did not identify the characteristics of LCS interventions at different screening stages.

Objective: The aims of this study were to explore the characteristics and efficacy of interventions in promoting LCS decision making and behaviors and to evaluate these interventions.

Methods: We conducted a study search from the inception of each bibliographic database to April 8, 2023. The precaution adoption process model was used to synthesize and classify the evidence. The RE-AIM framework was used to evaluate the effectiveness of LCS programs. Heterogeneity tests and meta-analysis were performed using RevMan 5.4 software.

Results: We included 31 studies that covered 4 LCS topics: knowledge of lung cancer, knowledge of LCS, value clarification exercises, and LCS supportive resources. Patient decision aids outperformed educational materials in improving knowledge and decision outcomes with a significant reduction in decision conflict (standardized mean difference, 0.81; 95% confidence interval, -1.15 to -0.47; P < .001). Completion rates of LCS ranged from 3.6% to 98.8%. Interventions that included screening resources outperformed interventions that used patient decision aids alone in improving LCS completion. The proportions of reported RE-AIM indicators were highest for reach (69.59%), followed by adoption (43.87%), effectiveness (36.13%), implementation (33.33%), and maintenance (9.68%).

Conclusion: Evidence from 31 studies identified intervention characteristics and effectiveness of LCS interventions based on different stages of decision making.

Implications for practice: It is crucial to develop targeted and systematic interventions based on the characteristics of each stage of LCS to maximize intervention effectiveness and reduce the burden of lung cancer.

Background: The global population of long-term cancer survivors is increasing, thanks to advances in treatments and care. Healthcare systems are working to address the unique needs of these individuals. However, there remains a knowledge gap concerning nurses' view on cancer survivorship care.

Objective: To identify nurses' perspective of care for long-term cancer survivors and their families.

Methods: This qualitative descriptive study used 5 focus groups comprising 33 nurses from primary healthcare and specialized oncology care. Data analysis was conducted through thematic analysis, and the study received ethical approval.

Results: Long-term cancer survivors and their families often remained unrecognized as a distinct group within the healthcare system. Consequently, nurses provide what can be termed as "opportunistic care" during nurse-survivor encounters, addressing health needs beyond the purpose of the initial healthcare visit. This absence of a systematic or structured approach for this patient group has prompted nurses to seek the establishment of a comprehensive framework through survivorship care plans, thus ensuring a continuum of care for this specific population.

Conclusion: The lack of a structured approach to caring for long-term cancer survivors and their families, often invisible as a distinct population group, results in nurses providing care on an opportunistic basis.

Implications for practice: It is crucial to develop and implement survivorship care plans tailored to this population's needs. Simultaneously, it is important to advance research in this area and establish an educational framework for nurses, enabling them to effectively address the care of long-term cancer survivors and their families.

Background: Postoperative experiences after breast cancer surgery, such as lymphedema, phantom breast sensations, persistent chronic pain, and changes in body image and sexuality, can negatively impact women's quality of life.

Objective: To investigate women's experiences of sequelae at 3, 6, and 12 months after mastectomy.

Methods: A survey including women ≥18 years, cognitively intact, and Danish speaking was conducted from May 2021 to October 2021. The researchers contacted the participants by telephone using 4 validated questionnaires investigating phantom sensation, body image, quality of life, and sexuality.

Results: Forty-four women were eligible for participation, and 23 (14 women aged ≤65 years and 9 women aged >66 years) were included in the analysis. The results showed an overall decrease in the severity of physical sequelae and an improvement in body image and sexual function. However, the women reported concerns about the future and decreased sexual enjoyment. Nearly half of the women received information about sexuality from healthcare professionals.

Conclusion: The study demonstrated decreased sequelae during the follow-up period. Still, there seem to be unanswered questions concerning the quality of life and the content of information regarding sexuality. The findings require attention and further research to benefit the individual woman and her partner in accommodating the consequences after mastectomy.

Implications for practice: Persistent pain and concerns for the future are present for half of the women after 1 year. Information about possible changes in sexuality is not standard. A nurse-patient dialogue that discusses hospitalization and sexuality on an individual level can be a way to address concerns and challenges.

Background: Children with cancer and other serious illnesses experience symptom burden during hematopoietic stem cell transplantation and chimeric antigen receptor T-cell therapy, yet limited research has characterized how these symptoms interact with overall quality of life over time.

Objective: The aim of this study was to examine the longitudinal relationship between symptoms and quality of life in children receiving hematopoietic stem cell transplantation or chimeric antigen receptor T-cell therapy.

Methods: A multisite study design was used to collect symptom and quality of life information at pre-cell infusion and days +30, +60, and +90 from children (N = 140) receiving hematopoietic stem cell transplantation and chimeric antigen receptor T-cell therapy. A longitudinal parallel process model was used to characterize the relationship between symptoms and quality of life.

Results: Children (mean age, 8.4 years) received allogeneic transplant (57.9%), autologous transplant (25.7%), or chimeric antigen receptor T-cell therapy (16.4%). Symptom prevalence was highest at baseline (>50%) for pain, fatigue, nausea, vomiting, and low appetite. Quality of life scores were worse at baseline (mean [SD], 69.5 [15.8]) and improved by 10 points by day +90. The longitudinal model indicated high symptom prevalence at baseline predicted worse quality of life at both baseline and day +90.

Conclusions: Children felt worse early in the treatment trajectory and improved by day +90. The level of symptom burden predicted the overall quality of life at all time points.

Implications for practice: Children experiencing high symptom burden should receive frequent assessment and enhanced symptom management throughout the treatment trajectory to mitigate negative impacts on quality of life.