Cancer Nursing最新文献

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: Low anterior resection syndrome (LARS) is a result of removing part or most of the rectum as a treatment for rectal cancer that negatively impacts quality of life. There is a lack of standardized nursing symptom-specific self-care recommendations for patients suffering from LARS.

Objective: The aim of this study was to map the existing research regarding nursing guidelines and symptom-specific recommendations for LARS self-care.

Methods: A systematic scoping review using 4 comprehensive databases (ProQuest, EMBASE, PubMed, and Web of Science) was completed using the PRISMA Extension for Scoping Reviews guidelines. Applying specified search terms, relevant articles were extracted using criteria and entered into an Excel database.

Results: Three publications met the study inclusion criteria: 1 randomized controlled pilot study; 1 nonrandomized, retrospective pilot study; and 1 retrospective, comparative, cross-sectional study. No professional nursing guidelines were found, but 3 nurse-led management programs were reviewed. Publications provided self-care nursing recommendations for all LARS symptoms except for repeated painful stools/tenesmus, soiling, or discrimination disorders/flatulence. Combination of nursing self-care recommendations included dietary/lifestyle modifications, fiber supplements/bulking agents, antidiarrheal and laxative over-the-counter medications, and pelvic floor muscle exercises.

Conclusions: When mapping the literature, there appears to be nurse-led management programs and recommendations for self-care for patients with LARS for almost all symptoms. Yet, there are no standardized recommendations.

Implications for practice: Professional nursing practice guidelines for all symptoms are lacking. Nursing recommendations for self-care of LARS exist and need to be expanded and standardized to include all symptoms. Further research regarding comprehensive nursing self-care recommendations and management is warranted.

Background: Despite the growing preference for end-of-life care at home, numerous oncological patients continue to spend their final moments in surgical wards. This incongruity in settings may contribute to "dysthanasia," unnecessarily prolonging futile treatments and resulting in undue suffering. As frontline caregivers, nurses frequently bear the brunt of these challenging situations for patients and their families.

Objective: To investigate the experiences of nurses providing care to terminally ill oncological patients inappropriately admitted to surgical departments.

Methods: We adopted a phenomenological descriptive study. Nurses purposefully selected from 7 distinct surgical units at a University Hospital in Northeast Italy were recruited. Data collection took place through open-ended semistructured interviews. The interview content was analyzed using Colaizzi's framework.

Results: The study with 26 participants revealed emotional challenges, especially for less-experienced nurses. Diverse perspectives among nurses emphasized the need for better palliative care knowledge. Despite the commitment to quality care, collaboration challenges and discordant goals with physicians impacted comprehensive care delivery.

Conclusions: Dysthanasia relates to participants' challenges in caring for oncological patients in inappropriate settings, hindering transparent communication and exacerbating discordance with doctors.

Implications for practice: Communication and collaboration among healthcare professionals, particularly nurses, and surgeons are crucial. Ongoing education in end-of-life care, coupled with advance care planning, empowers patients, aligns treatment choices, and prevents dysthanasia across diverse healthcare settings.

Background: Individuals who undergo chemotherapy for cancer are at elevated risk of developing depressive symptoms, yet substantial interindividual variation exists in trajectories of these symptoms.

Objective: To examine interindividual variations in trajectories of depressive symptoms during 2 cycles of chemotherapy and to evaluate associations between demographic and clinical characteristics, symptom severity scores, psychological adjustment characteristics (eg, stress and coping), and initial levels and trajectories of depressive symptoms.

Methods: Patients (n = 1323) diagnosed with breast, gynecologic, lung, or gastrointestinal cancer completed the Center for Epidemiological Studies-Depression Scale 6 times, over 2 cycles of chemotherapy. At enrollment, patients provided demographic information and completed a broad range of symptom, stress, and coping measures. Hierarchical linear modeling was used to identify characteristics associated with initial levels and trajectories of depressive symptoms.

Results: Interindividual differences in initial levels of depressive symptoms were associated with marital status, functional status, level of comorbidity, chemotherapy toxicity, sleep disturbance, morning fatigue, cognitive function, global and cancer-related stress, and coping characteristics (ie, sense of coherence, venting, behavioral disengagement, and self-blame). Interindividual differences in depression trajectories were associated with education, cancer type, chemotherapy toxicity, sleep disturbance, evening energy, evening fatigue, cognitive function, global and cancer-related stress, and self-blame.

Conclusions: We present new findings concerning the trajectories and predictors of depressive symptoms during chemotherapy.

Implications for practice: Modifiable risk factors (eg, stress and coping) are important targets for intervening to address depressive symptoms in oncology patients.

Background: Numerous physical and psychological symptoms experienced by cancer patients seriously affect their normal lives. Many academics and medical professionals have attempted to use aromatherapy in this situation to help cancer patients manage their physical and emotional problems.

Objective: To systematically investigate the efficacy of aromatherapy on physical and psychological symptoms in cancer patients.

Methods: A systematic review and meta-analysis of randomized controlled trials was performed. Four electronic databases were searched. The review process followed a registered priori review protocol and was reported using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Data extraction and quality assessment were performed in parallel.

Results: Twenty-six studies with 2912 subjects were included. Meta-analysis showed that aromatherapy significantly improved sleep quality, fatigue, anxiety, and depression. We performed a subgroup analysis according to the different plant or animal aromatics contained in the oil, which found that lavender oil significantly reduced preoperative anxiety. In addition, aromatherapy massage was superior to inhaled aromatherapy in reducing anxiety. Moreover, cancer patients who used aromatherapy reduced the frequency of vomiting in 24 hours.

Conclusions: Aromatherapy is a useful treatment for improving sleep quality and reducing symptoms of fatigue, anxiety, and depression in cancer patients, as well as the frequency of vomiting over 24 hours.

Implications for practice: Healthcare providers can use aromatherapy to alleviate psychological and physical symptoms in cancer patients. The use of lavender oil and massage is recommended in clinical settings to improve anxiety symptoms in cancer patients.

Background: Leukemia represents the most prevalent childhood malignancy. Understanding the symptom clusters (SCs) associated with leukemia may help develop an effective care plan for affected children.

Objectives: The aims of this study were to summarize the methods of identifying SCs; ascertain the types, attributes, and changing patterns of SCs during different chemotherapy phases; and provide a point of reference for the subsequent improvement of symptom management in pediatric leukemia.

Methods: The methodological framework employed was the Joanna Briggs Institute Scoping Review Guide. A comprehensive search was conducted across various databases, including PubMed, EMBASE, CINAHL, Web of Science, MEDLINE, Scopus, and China National Knowledge Infrastructure from inception until July 15, 2023.

Results: A total of 14 articles were included in this review, 6 in English and 8 in Chinese. The Memorial Symptom Assessment Scale 10-18 is the most commonly used instrument, whereas factor analysis is the most common statistical method for SC identification. The SCs were classified into 12 categories. The most severe SCs varied across different phases. Specifically, the emotional cluster dominated the prechemotherapy phase, the gastrointestinal cluster surfaced during postinduction therapy, and the consolidation and maintenance therapy phases revealed the self-image disorder cluster.

Conclusion: Various consistent and dynamic SCs manifest among pediatric patients with leukemia undergoing chemotherapy.

Implications for practice: Future research endeavors should formulate clear criteria to determine the stability and consistency of SCs, validate SC composition and characteristics, and devise precise symptom management protocols based on SC characteristics in the distinct chemotherapy phases.

Background: Cancer caregivers experience significant stress due to their multifaceted role. Current support methods are limited by unidimensional assessments.

Objective: The aim of this study was to evaluate a Web-based support system aimed at reducing caregiver stress and anxiety, and improving resilience, vigilance, and quality of life, using both subjective and objective measures.

Methods: A randomized controlled trial with a single-center, 2-arm parallel design and longitudinal assessment was conducted in Taiwan. Caregivers of patients recently diagnosed with cancer were randomly allocated to either a standard care group or an intervention group that received enhanced nurse-led support. Metrics including psychological resilience, caregiver burden, anxiety, quality of life, stress levels, and vigilance were systematically evaluated on a monthly basis over a period of 5 months, starting from the initial baseline measurement.

Results: Following the intervention, participants in the intervention group exhibited statistically significant reductions in caregiver burden and anxiety, alongside a notable improvement in resilience. Objective evaluations revealed a significant reduction in stress levels within this group. However, there were no discernible differences in vigilance and quality of life metrics between the intervention and control groups.

Conclusion: The Web-based program effectively reduced caregiver stress and burden, as indicated by multiple metrics.

Implications for practice: This accessible and efficient Web-based support is beneficial for cancer caregivers facing diverse challenges.

Background: The incidence and mortality rates of gastrointestinal (GI) cancers are high in the United States as well as worldwide. The widespread use of social media provides unique opportunities to facilitate the dissemination of information, especially in the context of health.

Objective: We aim to characterize the public's primary discussions, including perceptions, concerns, and interests toward GI cancers, from prevention, diagnosis, and treatment to survivorship care through the social media platform Twitter, using tweets posted by Twitter users.

Methods: We analyzed 87 860 Twitter posts related to GI cancers. We used machine learning with natural language processing to identify salient topics and themes in the collected tweets.

Results: The most common themes across all GI cancer types included cancer risk prevention and awareness outreach programs, risk factors including lifestyles (primarily diet), and cancer survivorship-related discussions (primarily GI symptoms and quality of life). GI symptom-related tweets were prevalent in patients with colorectal and stomach cancers, whereas themes of newer clinical trials, end-of-life trials, palliative care trials, and disease prognosis were common in tweets related to liver/biliary and pancreatic cancers.

Conclusions: Our research emphasizes the importance of individualized approaches in managing GI cancers, considering lifestyle and diet, the need for comprehensive survivorship care, raising awareness, delivering information, and improving targeted interventions related to GI cancers.

Implications for practice: Our study suggests utilizing Twitter data to better understand the real-world interest and concerns about GI cancers among the public, which can guide future patient-centered research in this field.

Background: The number of allogeneic hematopoietic stem cell transplantation (allo-HSCT) survivors is increasing globally. Although qualitative studies in this population are reported, clear understanding of how allo-HSCT survivors experience survivorship is lacking.

Objective: This study aimed to identify, appraise, and synthesize evidence from qualitative research on survivorship experience among allo-HSCT survivors.

Methods: A qualitative systematic review was conducted. A literature search of 9 databases and OpenGrey, Google Scholar, and Google was performed from inception to February 2023. Two reviewers independently screened and assessed the eligibility of each study. Descriptive information was extracted from the studies by one reviewer and checked by another. Findings were extracted and analyzed using thematic synthesis.

Results: Seventeen articles were included. Four themes and 12 subthemes regarding allo-HSCT survivors' experiences emerged: (1) recovery as being a longer process than they thought (influenced by long-term physical symptoms, disturbed by survivorship uncertainty); (2) experiencing a restricted survivorship life (shrunken social world, forced dietary limitations, centered around hospitals); (3) suffering from stigma and discrimination (perceived as a burden, seen differently by others, difficulties establishing and maintaining romantic relationships and marriage, limited opportunities in work); and (4) realizing something positive obtained during survivorship (enriched survivorship self-management skills, enhanced personal growth, developed positive relationships).

Conclusions: The findings reveal the challenges, needs, and growth that allo-HSCT survivors experienced during survivorship. Some understudied areas were identified, which warrant further exploration.

Implications for practice: Targeted survivor-centered care should be provided to allo-HSCT survivors, and interventions to resolve issues experienced during survivorship should be developed.

Background: Breast cancer is the most common cancer in women, and first-degree relatives (FDRs) of breast cancer patients have a significantly higher risk of developing breast cancer. However, the factors affecting breast cancer screening behavior of FDRs in China remain unclear.

Objective: The aim of this study was to determine the social cognitive theory factors influencing screening behaviors of FDRs.

Methods: A cross-sectional survey was conducted, and 430 FDRs were recruited. Data were collected using demographic information and self-reported questionnaire based on the social cognitive theory. The structural equation modeling method was used to analyze the influence of social cognitive factors on breast cancer screening behavior.

Results: The model showed a good fit (goodness of fit = 0.462). Goal setting and self-regulation (β = 0.631, P < .001) and positive outcome expectation (β = 0.098, P = .042) were positively related to breast cancer screening behavior. Negative outcome expectation was negatively related to breast cancer screening behavior (β = -0.102, P = .024). In addition, positive outcome expectation, negative outcome expectation, and goal setting and self-regulation are mediators of self-efficacy (β = 0.475, P < .001) to breast cancer screening behavior.

Conclusion: Goal setting and self-regulation are important influences on breast cancer screening behavior. The social cognitive theory is both applicable to and effective in explaining and predicting breast cancer screening behavior.

Implications for practice: Health professionals can develop appropriate intervention strategies based on the social cognitive theory among FDRs. It is necessary to focus on the people who influence women, such as spouses, mothers, or daughters.