Cancer Nursing最新文献

Background: Management of chemotherapy-induced mucosal barrier damage and oral/anal mucositis in leukemia is challenging.

Objective: The aim of this study was to investigate the effect of mucositis care training given to children receiving leukemia treatment and their caregivers on caregiver knowledge and skills, the development of gastrointestinal mucositis in children, the mean oral mucositis area in children, and the mucosal barrier injury laboratory-confirmed bloodstream infection in the clinic.

Methods: A stepped-wedge, quasi-experimental, unpaired control group design was used. The participants in the control group were given routine training, and the intervention group members were given mucositis care training in accordance with the guideline recommendations.

Results: No significant difference was found between groups in developing anal mucositis, but a significant difference in developing oral mucositis was documented, with the mean mucositis area of children being 8.36 ± 3.97 cm 2 in the control group and 4.66 ± 2.90 cm 2 in the intervention group. The mucosal barrier injury laboratory-confirmed bloodstream infection ratio was 4 per 1000 catheter days in the control group and 3 per 1000 catheter days in the intervention group.

Conclusion: Mucositis care training had a significant positive effect on caregivers' knowledge and skills, the development of oral mucositis, and the mean oral mucositis area in children. However, the training had no effect on the development of anal mucositis or the infection rate in the clinic.

Implications for practice: Nurses might increase the knowledge and skill levels of caregivers with training on mucositis care, prevent the development of mucositis, and reduce the mean mucositis area. Training might also contribute to the reduction in the infection rate of the clinic.

Background: Hope has an influential role in oncology patients and is related to perceived social support and spirituality. However, studies on the extent to which the concepts of perceived social support and spiritual care needs affect hope are still limited.

Objective: To examine the effect of perceived social support and spiritual care needs in predicting hope in adult oncology patients.

Methods: Study questionnaires, a demographic form, the Herth Hope Scale, the Multidimensional Perceived Social Support Scale, and the Spiritual Care Needs Scale were administered to participants. Correlation and regression analyses were conducted.

Results: A total of 134 oncology patients completed the study questionnaires. Significant correlations were found between hope and perceived social support and between hope and spiritual care needs ( P < .05). Perceived support explained 11.7% of the variance in hope scores. A 1-unit increase in the support score was associated with a 0.344-unit increase in the hope score. Spiritual care needs did not significantly predict hope.

Conclusion: In line with the results, interventions that promote social support may increase hope in oncology patients.

Implications for practice: Nurses could incorporate interventions into their care to improve social support as one way to enhance hope levels among oncology patients. Further studies are required to understand more about the impact of spiritual care needs on hope.

Background: The low levels of physical activity in childhood cancer survivors have increasingly garnered attention from nursing scholars. Exercise-related worry is a prominent barrier, yet the understanding of such experiences among childhood cancer survivors and their primary caregivers remains scarce.

Objective: The aim of this study was to further understand the factors contributing to exercise-related worry from the perspective of childhood cancer survivors and their primary caregivers.

Methods: In this qualitative study, we conducted face-to-face semistructured interviews with childhood cancer survivors (n = 20) and carers (n = 20) in 2 hospitals in China. The interviews were analyzed according to thematic analysis.

Results: Two main themes and 8 subthemes emerged: (1) internal factors: changes in the perception of physical activity (threat perception from the disease, active avoidance of stressful events, lack of safety due to past experiences), and (2) external factors: weak support system (limited peer support, family strength, feeling abandoned by the tumor team, reintegration into school, external environmental constraints). In summary, exercise-related worry is from internal factors and can be influenced by external factors.

Conclusion: There are various factors contributing to the concerns of exercise in childhood cancer survivors, which may be a key factor for their significantly lower levels of physical activity compared to guideline recommendations.

Implications for practice: The findings of this study call for healthcare professionals to provide additional assistance for childhood cancer survivors with exercise-related worry and establish personalized mechanisms for supporting physical activity in pediatric cancer survivors within the Chinese healthcare system.

Background: With the increasing survival rates of childhood cancer, nurses' familiarity with published evidence has become crucial to care for this population and their families throughout the survival process.

Objective: To systematically identify and conduct a bibliometric analysis of nursing-related evidence concerning extended and long-term survival of childhood survivors.

Methods: A scoping review was conducted using bibliometric analysis with searches performed in the PubMed, CINAHL, SCOPUS, and Web of Science databases. A total of 300 studies on childhood cancer survival within the nursing field were included.

Results: The first study on this topic was published in 1975. American and Chinese researchers lead study publications, primarily publishing in nursing journals such as Cancer Nursing . Quantitative designs were prevalent, and the majority of the studies focused on physical late effects, overall quality of life, and survivor follow-up care.

Conclusions: This study has allowed us to map and synthesize the bibliometric evidence pertaining to the extended and long-term survivorship of childhood cancer survivors in the nursing field. Consequently, it identifies gaps in knowledge, research trends, and areas necessitating further exploration.

Implications for practice: The evidence presented in this review can facilitate academic and clinical discussions, offering a comprehensive synthesis of the published knowledge. More research needs to be developed on the topic, particularly in Central and Latin America, Africa, Southern and Eastern Europe, and in some regions of Asia. Furthermore, the scope of studies should extend beyond late effects and quality of life, encompassing the experience of surviving childhood cancer, including psychosocial and spiritual dimensions.

Background: To advance oncology nursing science and clinical practice, researchers and clinicians must understand the important real-world concerns of nurses who provide direct care to people with cancer or manage processes that support patient care.

Objective: This study developed a comprehensive compendium of real-world concerns among oncology nurses and built consensus regarding their importance.

Methods: Using Delphi survey methodology, this prospective, descriptive study was performed in 3 phases: (1) identification of experts, defined as registered nurses (RNs) employed within a comprehensive cancer center; (2) qualitative content analysis of 353 responses from 267 RNs who responded to the question, "What do you see as nursing research concerns, problems, and/or issues on your unit or in your work environment that needs to be studied?"; and (3) rating the importance of 62 research themes identified from the qualitative content analysis (n = 247 RNs).

Results: The top research priority was patient safety followed by patient education, oncologic emergencies, patient expectations and adherence with care, team communication, patient psychosocial needs, patient-reported outcomes and quality of life, healthcare team burnout, workload, and nurse burnout.

Conclusions: The findings support the nursing discipline's fundamental focus on patient safety, the top-rated nursing research priority, along with other patient-related and work environment issues.

Implications for practice: Oncology nursing is complex and complicated. This study identified and prioritized the real-world concerns, issues, and problems of oncology RNs who provide direct care or manage the processes that support care, supporting the need to focus on patient-related and work environment research.

Background: Cancer is a significant public health concern in the healthcare landscape. Amidst this challenging journey, the levels of hope, spiritual well-being, and resilience in patients with cancer have emerged as pivotal factors influencing the healing process.

Objective: This study aimed to evaluate the relationship between hope and spiritual well-being in cancer patients and the mediating role of resilience in the relationship between hope and spiritual well-being levels.

Methods: This study is a descriptive, cross-sectional, correlational study. The study included 152 cancer patients undergoing treatment. A patient information form, the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-SP-12) Scale, the Dispositional Hope Scale, and the Brief Resilience Scale were used to collect study data.

Results: Positive and meaningful correlations were observed between the Dispositional Hope Scale and FACIT-SP-12, Brief Resilience Scale, and FACIT-SP-12 ( r = 0.390, P < .05; r = 0.246, P < .05). Mediation analysis indicated that Brief Resilience Scale scores partially mediated the relationship between the Dispositional Hope Scale and FACIT-SP-12 Scale scores; the indirect effect of hope on spiritual well-being through resilience was 0.351 ( P < .05).

Conclusion: The study has indicated a direct relationship between hope and spiritual well-being, and resilience partially mediated the relationship between hope and spiritual well-being.

Implications for practice: It is significant to provide psychosocial care to cancer patients to increase their resilience levels and to support their hope and spiritual well-being.

Background: Interventions to foster resilience may promote mental health recovery after exposure to stressors. However, comprehensive systematic syntheses of such evidence in family members of pediatric cancer patients are lacking.

Objective: To systematically review and meta-analyze the evidence for the effects of psychological interventions at fostering resilience in family members of pediatric cancer patients.

Methods: PubMed, Cumulative Index to Nursing and Allied Health Literature, and 9 other databases were searched for articles published until March 2023. Empirical studies on psychological interventions to improve resilience in family members of pediatric cancer patients were included. Full-text and quality appraisals were performed independently by 2 reviewers. Pooled effect sizes were calculated using random-effects meta-analyses.

Results: Seventeen studies were included, of which 10 were included in the meta-analyses. There was a positive effect of interventions on resilience at postintervention time points, but no effects on depressive symptoms, stress, or well-being. The improvement in resilience was sustained in the short term (≤3 months) and medium term (>3 to ≤6 months), with delayed effects on depressive symptoms and stress. In the 6 studies that reported moderate effect sizes, the interventions comprised problem-solving skills, cognitive strategies, promotion of personal strength, and social resources.

Conclusion: The findings indicated that psychological interventions targeting resilience have the potential to positively affect the resilience and mental health outcomes of family members, particularly parents.

Implications for practice: Psychological interventions targeting resilience hold promise in improving the mental health of family members. Future interventions should clearly specify the characteristics of the intervention, such as mode of delivery, format, and duration.

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: Chemotherapy-induced peripheral neuropathy (CIPN)-related pain seriously affects patients' quality of life (QoL). Previous studies have shown that exercise interventions can improve symptoms such as pain in patients with CIPN. However, the optimal exercise intervention remains unknown.

Objective: To explore the comparative effects and ranks of all exercise-based interventions in improving CIPN-related pain, CIPN symptoms, and QoL in cancer patients experiencing CIPN.

Methods: We searched 10 electronic databases to identify randomized controlled trials from their inception up to June 23, 2024. We used Review Manager 5.4.1 and Stata v14.0 for traditional meta-analysis and network meta-analysis (NMA).

Results: This review included 14 randomized controlled trials with a total of 1127 participants. The NMA revealed that: (a) a combination of strengthening, stretching, and balance exercises (standardized mean difference [SMD] = -11.43, 95% confidence interval [CI], -13.60 to -9.26) was the most effective intervention for improving CIPN-related pain; (b) walking exercise (SMD = -2.07, 95% CI, -2.70 to -1.43) yielded better outcomes in alleviating CIPN symptoms; and (c) interventions focused on muscle strengthening and balancing exercises (SMD = 1.03, 95% CI, 0.40 to 1.65) were most effective for improving QoL.

Conclusions: Our NMA indicated that strengthening, stretching, and balance exercises could potentially benefit the improvement of CIPN-related pain. Further evidence is needed.

Implications for practice: This study provides evidence about the effectiveness of exercise interventions for CIPN-related pain. Future research on pain management in subgroups of CIPN patients may benefit from exploring the exercise strategies identified in this study, providing important support to healthcare professionals.

Background: Symptom management guidelines are primarily written for single cancer symptoms despite patients experiencing multiple co-occurring symptoms. Coordinating recommendations across guidelines based on patients' self-report of symptom clusters may facilitate efficient multisymptom self-management.

Objective: The aim of this study was to evaluate the feasibility of a nurse-coordinated approach to multisymptom management among patients receiving chemotherapy.

Intervention/methods: Forty-one adults receiving cancer chemotherapy and experiencing ≥2 symptoms were recruited to this pilot randomized controlled trial. Participants self-reported symptom cluster experiences weekly, over 2 cycles of chemotherapy. All participants received usual care during the first cycle on study, and half were randomized to enhanced care during the second cycle. A nurse interventionist reviewed participants' symptom cluster self-reports to understand symptom relationships and etiology, selected 1 or more guideline-based self-management strategies to treat multiple symptoms, and provided participants with weekly self-management instructions.

Results: Recruitment (85%) and retention (83%) met feasibility criteria. Nurse interventionists successfully coordinated a treatment plan with fewer self-management strategies than symptoms for 84% of participants' symptom cluster reports. Coordination challenges included complex multisymptom etiology, prioritizing among self-management strategies, and symptoms with no guideline-recommended treatments. Most participants (≥72%) reported satisfaction with the intervention and study procedures.

Conclusions: Nurse coordination of management strategies for clustered symptoms is feasible and acceptable, and merits further intervention development.

Implications for practice: Eliciting patients' self-reports of symptom clusters provides important insights to drive management recommendations. Drawing on this knowledge and using evidence-based guidelines, oncology nurses may identify self-management strategies that are effective across multiple co-occurring symptoms to reduce patients' symptom and self-management burden.