Cancer Nursing最新文献

Background: Patients with head and neck cancer (HNC) experience a multitude of symptoms because of the tumor and its treatment.

Objective: To identify the symptom patterns present in cancer treatment and survivorship periods for patients with HNC using latent class analysis.

Methods: A retrospective longitudinal chart review was conducted to examine symptoms reported by patients who received concurrent chemoradiation for HNC in a regional Northeastern United States cancer institute. Latent class analysis was performed to identify the latent classes present across multiple timepoints during treatment and survivorship for the most commonly reported symptoms.

Results: In 275 patients with HNC, the latent transition analysis revealed 3 latent classes for both treatment and survivorship periods: (1) mild, (2) moderate, and (3) severe symptoms. Patients were more likely to report a greater number of symptoms in a more severe latent class. During treatment, moderate and severe classes had representation of all most common symptoms: pain, mucositis, taste alterations, xerostomia, dysphagia, and fatigue. Different symptom patterns emerged for survivorship, with prominence of taste alterations and xerostomia across all classes, and all symptoms present in the severe class. The probability of symptom expression varied more in the survivorship period compared with the treatment period.

Conclusions: Patients reported numerous symptoms during active treatment persisting into survivorship. Patients tended to transition to more severe symptomatology as treatment progressed and to more moderate symptomatology as survivorship evolved.

Implications for practice: Examining the trend of persistent moderate symptomatology into survivorship is useful to optimize symptom management.

Background: A growing body of literature has shown a higher risk of suicide in cancer patients compared with the general population. Early detection of factors related to suicide resilience in cancer patients could prevent loss of life.

Objective: The study aimed to investigate the serial-multiple mediation of self-care self-efficacy and meaning in life in the relationship between social support and suicide resilience among Chinese cancer patients.

Methods: A cross-sectional investigation of 287 cancer patients using a battery of self-reported questionnaires was performed. For preliminary analyses, descriptive, univariate, and Pearson correlation analyses were performed. Mediation analyses were tested using a serial-multiple mediation model (PROCESS model 6).

Results: Mediation analysis indicated the indirect effects of social support on suicide resilience mediated solely by either self-care self-efficacy (point estimate = 0.20; 95% confidence interval [CI], 0.12-0.30), or by meaning in life (point estimate = 0.06; 95% CI, 0.01-0.12), or by the multiple mediation of self-care self-efficacy to meaning in life (point estimate = 0.03; 95% CI, 0.01-0.06).

Conclusions: The findings demonstrated the crucial direct or indirect effects of social support, self-care self-efficacy, and meaning in life on facilitating cancer patients' suicide resilience.

Implications for practice: Oncology nurses, as 24-hour care providers for cancer patients, may interact with and be important sources for the psychosocial care of cancer patients at risk of suicide. Prevention and intervention efforts must be directed at assisting cancer patients, improving self-care self-efficacy, and finding meaning in life after a cancer diagnosis.

Background: Chemotherapy-induced alopecia could cause significant psychological changes, affecting patients' quality of life and their capacity to cope with the disease.

Objectives: The aims of this study was to analyze the effectiveness of scalp cooling (SC) to prevent chemotherapy-induced alopecia in patients with breast cancer and to compare the use of automated versus nonautomated therapy delivery devices.

Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE (through PubMed), Scopus, Web of Science, and ClinicalTrials.gov from their inception to October 2022. A meta-analysis was performed to assess the effects of SC to prevent chemotherapy-induced alopecia in patients with breast cancer using fixed-effects models to calculate the pooled relative risk (RR) and corresponding 95% confidence interval (CI).

Results: The 8 included studies showed a 43% reduction in the risk of chemotherapy-induced alopecia (RR, 0.57; 95% CI, 0.50-0.64) after the use of SC. Moreover, the use of automated SC devices showed a 47% reduction (RR, 0.53; 95% CI, 0.45-0.60) in the risk of chemotherapy-induced alopecia versus a 43% reduction in the risk of chemotherapy-induced alopecia for nonautomated SC devices (RR, 0.57; 95% CI, 0.44-0.70).

Conclusion: Our results showed that SC significantly reduced the risk of chemotherapy-induced alopecia.

Implications for practice: Local cold application is a nonpharmacologic therapy that may provide a useful intervention to reduce hair loss and contribute to the psychological well-being of women. Scalp cooling contributes directly to reducing concern about altered body image and to reducing anxiety related to self-concept.

Background: Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression.

Objective: The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of depression in cancer survivors.

Methods: Participants were 294 adult cancer survivors from the US National Health and Nutrition Examination Survey (NHANES 2007-2018). Allostatic load was measured using 14 indicators representing cardiometabolic risk, glucose metabolism, cardiopulmonary functioning, parasympathetic functioning, and inflammation. Depressive symptoms were measured with the Patient Health Questionnaire-9. The relationship between AL and depressive symptoms was investigated using multiple regression adjusted for diverse sociodemographic and diagnosis variables.

Results: Higher AL was associated with higher depressive symptom scores. The higher risk of depression was concentrated among those survivors in the highest AL quartile, with 21% (95% confidence interval, 11%-32%) of survivors presenting a high risk of depression compared with 8% to 11% of survivors in the lower quartiles. In exploratory analyses, the relationship between AL and depressive symptoms was only significant among survivors with a lower income. In contrast, in survivors in the highest income group, depressive symptoms were lower and unrelated to AL.

Conclusion: High AL is associated with more depressive symptoms among cancer survivors.

Implications for practice: Nurses have an important role in identifying psychological distress in cancer patients and survivors. Further research is needed to investigate the usefulness of AL as a marker in the context of cancer follow-up care and screening for psychological distress.

Background: Bibliometric analysis is an effective method for evaluating the publication characteristics and development of a journal. To our knowledge, this study is the first such analysis of the publications in Cancer Nursing .

Objective: This study aimed to analyze the publication characteristics and evolution of Cancer Nursing over a period of 36 years since its inception.

Methods: Bibliometric analysis was carried out on 3095 publications. Data were collected from the Web of Science Core Collection database on September 15, 2023. Data analysis was conducted with Web of Science Core Collection, VOSviewer, and Bibliometrix package in R software.

Results: The results showed a steady increase in the citation and publication structure of Cancer Nursing . "Quality of life" was at the center of the studies, and "quality of life," "women," and "breast cancer" were identified as trend topics. The United States was both at the center of the cooperation network and was the country that contributed the most publications to the journal.

Conclusion: Cancer Nursing has had an increasing contribution to and impact on cancer nursing in terms of the quality and citations of published articles. It was noted that the journal's network of collaboration has expanded globally and that its thematic diversity is high. Although quality of life, women, and breast cancer have been reported extensively, more studies addressing the concepts of "children," "support," and "needs" are needed in the journal.

Implications for practice: This study not only enriches global readers in the field of cancer nursing but may also be beneficial in providing input to guide future research.

Background: Dysphagia is a leading cause of aspiration pneumonia and negatively affects tolerance of chemoradiotherapy in patients with esophageal cancer.

Objective: This study aimed to assess a protocol for preventing the occurrence of aspiration pneumonia for adult patients with esophageal cancer experiencing swallowing dysfunction.

Methods: This study tested a dysphagia intervention that included high-risk patients confirmed by the Eating Assessment Tool questionnaire and Water Swallowing Test. A protocol guide (Interventions for Esophageal Dysphagia [IED]) to prevent aspiration pneumonia during chemoradiotherapy was also implemented. Thirty participants were randomly assigned to an intervention or control group. The study period was 50 days; participants were visited every 7 days for a total of 7 times. Instruments for data collection included The Eating Assessment Tool, Water Swallowing Test, and personal information. The IED was administered only to the experimental group. All data were managed using IBM SPSS statistics version 21.0.

Results: The IED significantly reduced the occurrence of aspiration pneumonia ( P = .012), delayed the onset of aspiration pneumonia ( P = .005), and extended the survival time ( P = .007) in the experimental group.

Conclusion: For patients with esophageal cancer undergoing chemoradiotherapy, this protocol improved swallowing dysfunction and reduced aspiration pneumonia.

Implication for practice: The IED protocol should be included in continuous educational training for clinical nurses to help them become familiar with these interventions and to provide these strategies to patients.

Background: The literature is inconsistent on the prevalence and risk factors of urinary retention in patients with cervical cancer.

Objective: The aim of this study was to review the literature on the prevalence of urinary retention in patients with cervical cancer and consolidate the risk factors.

Methods: For this meta-analysis, eligible articles published in English or Chinese by December 10, 2021, were systematically searched for and retrieved from PubMed, Cochrane Library, Ovid-Embase Medline, Web of Science, PsycINFO, CINAHL, and Scopus. Prevalence, odds ratios (ORs), and 95% confidence intervals (CIs) were used for meta-analysis.

Results: Twenty-five studies were included in the analysis. The pooled overall prevalence was 0.26 (95% CI, 0.21-0.30, I2 = 95.0%). The identified risk factors were age (OR, 1.13; 95% CI, 1.08-1.19), urinary tract infection (UTI) (OR, 3.33; 95% CI, 1.48-7.49), surgical extent (OR, 2.95; 95% CI, 1.27-6.85), and catheter indwelling time (OR, 3.44; 95% CI, 2.43-3.87).

Conclusions: The prevalence of urinary retention in patients with cervical cancer is 0.26. Older age, UTI, longer catheter indwelling time, and a larger surgical extent may increase the risk of urinary retention. Clinicians should identify patients at risk and adopt interventions such as individualized catheter care.

Implications for practice: Nursing staff should assess the risk of urinary retention in a patient with cervical cancer according to her age, presence of UTI, surgical extent, and catheterization time. A carefully chosen surgical procedure and interventions such as individualized education, timely catheter removal, treatment of UTI, and rehabilitation should be offered.

Background: Oncology nurses have frequent contact with oncology patients during their cancer journey. This long-term, recurrent contact can impact the health and well-being of the nurse through the development of compassion fatigue (CF).

Objectives: To identify what contributes to CF and what individual, interpersonal, and organizational factors mitigate CF among oncology nurses caring for adult patients.

Methods: A scoping review framework by Arksey and O'Malley guided this review. Electronic databases were searched for relevant studies. A blinded screening process was undertaken by the authors using the following inclusion criteria: English language published from January 2011 to December 2021, primary research peer-reviewed studies, and focusing on CF within oncology nurses caring for adult patients in any practice setting.

Results: Nineteen studies (21 articles) were identified. The review found nurses' personal beliefs around nursing care being provided, and personality traits of psychological inflexibility, neuroticism, passive coping, and avoidance contributed to CF. Workplace conflict and lack of a healthy work-life balance also contributed to CF. However, nurses' personal resilience, ability to positively reflect upon their work, a supportive team environment, and continuing education were found to mitigate CF.

Conclusions: Levels of CF vary among oncology nurses caring for adult patients. Oncology nurses may benefit from personal and organizational resources aimed at improving oncology nurses' professional quality of life while decreasing CF.

Implications for practice: Consideration and future research of effective interventions are needed to sustain a future health workforce and mitigate CF among oncology nurses.

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 cm2 in the control group and 4.66 ± 2.90 cm2 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: Breast cancer recurrence is a traumatic event for patients, and its treatment depends on the patient's ability to accept the circumstances.

Objective: The aim of this study was to explore how patients experience breast cancer recurrence and go through a process of negotiating acceptance.

Methods: This study explored the experiences of 16 patients with breast cancer recurrence regarding the acceptance of recurrence in a hospital in Tehran, Iran. Purposive sampling with maximum diversity was used. Data were collected through semistructured telephone interviews from November 2020 to November 2021 and analyzed using the qualitative content analysis.

Results: Four themes emerged that described the process of accepting cancer recurrence: (1) response to recurrence (emotional reactions and loss of trust); (2) psychological preparedness (confirmation of medical diagnosis and acceptance of fate); (3) mobilizing supports (using spiritual capacities, utilizing supportive resources, and seeking relationships to promote knowledge); and (4) return to the path of treatment (rebuilding trust and continuation of treatment).

Conclusions: The acceptance of breast cancer recurrence is a process that begins with emotional reactions and ends with returning to the treatment path. The patient's psychological preparation, support systems, behavior of healthcare providers, and rebuilding trust are the determining factors in acceptance of recurrence.

Implications for practice: Nurses can compensate for the failures created in the primary treatment of breast cancer by spending time with patients and paying attention to their concerns, providing effective education, strengthening communication between patients with similar conditions and using the spiritual capacities of patients, and mobilizing the support of family and relatives.