Cancer Nursing最新文献

Background: The colorectal cancer (CRC) screening uptake rate is substantially lower in ethnic minority populations than in the general population. Racial and ethnic minority individuals experience more barriers in obtaining a screening test for CRC when compared with the non-Hispanic White population.

Objective: To examine the effectiveness of community health worker-led interventions in improving the CRC screening uptake rate in racial and ethnic minority populations.

Methods: Five databases, EMBASE, CINAHL, MEDLINE, Scopus, and PubMed, were systematically searched, and reference lists of the identified articles were manually searched for relevant articles in May 2022. Only randomized controlled trials were included.

Results: A total of 10 randomized controlled trials conducted in the United States were included in this review. The findings of the meta-analysis showed that CRC screening uptake was enhanced in participants receiving community health worker-led interventions compared with those receiving no intervention (odds ratio, 2.25; 95% confidence interval, 1.48-3.44; P < .001). The subgroup analysis by diverse racial and ethnic groups and number of components (single vs multiple) of the community health worker-led interventions showed that multicomponent interventions were more effective in increasing the CRC uptake rate among all racial and ethnic groups regardless of their background.

Conclusions: Multicomponent community health worker-led interventions can improve CRC screening uptake in racial and ethnic minority populations.

Implications for practice: The findings of the present review show that multicomponent community health worker-led interventions are shown to be effective to improve the CRC screening uptake targeting other racial and ethnic minority groups in other countries.

Background: Gynecological cancer survivors experience a variety of challenges after discharge from hospital treatment. Cancer support and rehabilitation are recognized as significant facilitators for quality of life in survivorship but are reported to be insufficient by gynecological cancer survivors.

Objective: To describe the lived experiences of gynecological cancer survivors and how their needs for follow-up should be met following recently completed treatment.

Method: This study used a phenomenological hermeneutic design with individual in-depth interviews with 20 women after recently completed cancer treatment. Transcribed interviews were analyzed with the Lindseth and Norberg phenomenological hermeneutic method.

Results: Four themes were identified: "a brutal transition to life after cancer," "fear of recurrence overshadowing the existence," "a need for professional support," and "information is not given unless asked for."

Conclusion: After completing gynecological cancer treatment, the fear of cancer recurrence is dominating, regardless of prognosis and diagnosis. At the same time, information and support from healthcare professionals are described as lacking. Participants expressed a need to be contacted directly as a formal routine by healthcare professionals after cancer treatment with cancer-specific information as this may alleviate the existential suffering that the cancer experience brings.

Implications for clinical practice: A person-centered, systematic follow-up rehabilitation is needed as a continuation of the care provided during cancer treatment. Future research is needed to explore the impact on women's quality of life when gynecologic-specific information is given in advance of hospital discharge after completing treatment.

Background: With the widespread use of peer support in the cancer field, more and more cancer survivors are becoming supporters. However, they may bear a huge psychological burden in the peer support project. There has been little effort to analyze supporters' experiences from a meta-perspective.

Objective: The aims of this study were to review the literature on the experience of patients serving as peer supporters, integrate qualitative data to explore the experiences of supporters participating in peer support programs, and provide suggestions for future researchers.

Interventions/methods: China Knowledge Network, Wanfang Database, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, CINAHL, and PsycINFO were searched. Titles, abstracts, and full texts were screened. Included articles (n = 10) underwent data extraction, the Joanna Briggs Institute Critical Appraisal Tool for qualitative researches (2016) quality evaluation, and thematic synthesis.

Results: The literature ultimately included 10 studies from which 29 themes were distilled and grouped into 2 main categories: benefits and challenges of peer support for supporters.

Conclusions: Peer supporters will not only gain social support, growth, and recovery but also experience various challenges when providing peer support. Both supporters' and patients' experiences of participating in peer support programs deserve the attention of researchers. Researchers need to be rigorous in controlling the implementation of peer support programs to help supporters gain and overcome challenges.

Implications for practice: Future researchers can use study findings to better develop peer support programs. More peer support projects are needed to explore a standardized peer support training guide.

Background: Patients with lung cancer experience multiple symptoms requiring self-management. Little is known about how self-management is influenced by interactive health literacy, defined as communicating with healthcare providers to obtain and process information.

Objective: This study explored how interactive health literacy relates to symptom self-management among patients with lung cancer. A second aim explored how interactive health literacy might be integrated into the Individual and Family Self-management Theory.

Methods: This study used a cross-sectional mixed-methods design. Quantitative data included demographics, the All Aspects of Health Literacy Scale, and the Memorial Symptom Assessment-Short Form. Qualitative data were collected using semistructured interviews. Data analysis followed a critical realist model.

Results: Twelve adults who recently received treatment for lung cancer reported an average of 14 symptoms that caused moderate distress. Average interactive health literacy of the sample was in the moderate range. Participants' experiences of self-management differed based on their interactive health literacy. A generative mechanism proposes that those with higher interactive health literacy who accessed online information used this information as a basis for engaging with providers regarding potential symptom self-management strategies.

Conclusions: Interactive health literacy skills may play a role in patients' ability and confidence in symptom self-management through interactions with oncology providers. Further research should clarify the relationship between interactive health literacy, self-efficacy, and collaboration with oncology providers.

Implications for practice: The patient-provider relationship is a key factor influencing how patients obtain and process symptom self-management information. Oncology providers should implement patient-centered strategies to engage patients in symptom self-management.

Background: Little knowledge exists on how late radiation tissue injuries (LRTIs) affect sexual health and health-related quality of life (HRQOL) in pelvic cancer survivors.

Objective: To explore sexual health and HRQOL in cancer survivors with pelvic LRTI.

Method: A descriptive cross-sectional study was conducted, including 83 pelvic cancer survivors with LRTI. Data on sexual health, LTRIs, and HRQOL were collected by validated questionnaires, whereas medical variables were collected from medical records.

Results: Participants' sexual health was severely impaired. Bowel and urinary LRTIs correlated with most of the symptoms of impaired sexual health (Pearson r = -0.241 to -0.376, P < .05-.01). Men and women reported different sexual challenges related to functional and symptomatic variables but not on the gender-neutral aspects of sexual health. Younger survivors, gynecological cancer survivors, or those who received external and internal radiation or additional chemotherapy reported significantly ( P < .05-.001) higher levels of sexual impairment. Participants' HRQOL was impaired. Several dimensions of sexual health correlated significantly ( P < .05-.001) with the functional dimensions of reduced HRQOL.

Conclusion: Cancer survivors with pelvic LRTIs experience severely impaired sexual health across genders, with negative consequences for their HRQOL.

Implications for practice: Healthcare professionals should include sexual health as an important part of individual patients' health and HRQOL throughout their treatment trajectory and follow-up, by screening sexual health, implementing measures and interventions to promote sexual health, and supporting survivors' coping and health-promoting strategies.

Background: Electronic patient-reported outcome measures (ePROMs) benefit adult cancer care, but their use in pediatric cancer care is limited.

Objectives: To explore the feasibility of collecting weekly ePROMs from pediatric cancer patients and/or their caregivers and to describe children's levels of symptom burden, distress, and cancer-related quality of life.

Methods: A prospective and longitudinal cohort study was undertaken at one tertiary children's cancer center. Children (2-18 years)/caregivers completed ePROMs with validated measures for distress, symptom burden, and cancer-related quality of life weekly for 8 weeks.

Results: Seventy children/caregivers participated in the study, and 69% completed ePROMs at all 8 weeks. Distress and cancer-related quality of life significantly improved over time. However, at week 8, almost half of the participants still reported high levels of distress. Symptom burden decreased over time, with the youngest and the oldest age groups (2-3 and 13-18 years) reporting the highest number of symptoms with severe burden.

Conclusions: Weekly collection of ePROMs in pediatric cancer care is feasible. Although distress, quality of life, and symptom burden improve over time, there is a need for timely assessment and interventions to improve symptoms, high levels of distress, and issues that negatively affect quality of life.

Implications for practice: Nurses are ideally placed to intervene, assess, and monitor symptoms and to provide symptom management advice to pediatric cancer patients and caregivers. Findings from this study may inform the design of models of pediatric cancer care to improve communication with the healthcare team and patient experience of care.

Background: There is no consensus on the best intervention for topical management of bleeding in malignant wounds. Although surgical hemostatic dressings are recommended, the use of calcium alginate (CA) is frequent among practitioners.

Objective: The aim of this study was to evaluate the hemostatic efficacy of oxidized regenerated cellulose (ORC) and CA dressing in the management of bleeding from malignant wounds resulting from breast cancer.

Methods: This was a randomized open clinical trial. The outcomes measured were total time to hemostasis and the number of hemostatic products used.

Results: Sixty-one patients were potentially eligible for the study, 1 did not consent, and 32 were assessed to be ineligible, resulting in a sample of 28 who were randomized to 2 study groups. Total time to hemostasis was 93.8 seconds in the ORC group, with an average of 30.1 seconds (95% confidence interval, 18.6-189 seconds), and 67 seconds in the CA group, with an average of 30.4 seconds (confidence interval, 21.7 seconds to imprecise upper limit). The main difference was 26.8 seconds. Kaplan-Meier log-rank test, and Cox model showed no statistical significance ( P = 0.894). A total of 18 hemostatic products were used in the CA group and 34 in the ORC group. No adverse effects were identified.

Conclusions: Although no significant differences were identified in terms of time, more hemostatic products were used in the ORC group, highlighting the effectiveness of CA.

Implications for practice: Calcium alginate may be the first choice in the management of bleeding in malignant wounds, favoring nursing in the most immediate hemostatic actions.

Background: Research led by nurses has evolved rapidly over the last 2 decades globally. Assessing the work that has been conducted so far can help the specialty to strategically shape future directions of nurse-led cancer research.

Objective: The aim of this study was to provide a comprehensive, up-to-date synthesis of all nurse-led cancer research published articles over 20 years.

Methods: A bibliometric analysis was used. Three databases were used to retrieve nurse-led cancer research publications for the period from January 1, 2004, to March 11, 2022.

Results: A total of 7043 original articles were retrieved. A significant increase in nurse-led cancer research over the past 2 decades was evident. The United States and United Kingdom were the most productive countries in terms of the number of published articles. Minimal international collaboration was observed among low- or middle-income countries versus high-income countries. Breast cancer, palliative care, and quality of life received the most attention in nurse-led cancer research, followed by education, pain, and communication. Very few publications addressed cancer prevention, breaking bad news, and cancer rehabilitation.

Conclusion: Areas to consider in the future include more international collaborations on commonly agreed research agendas, capacity building to allow more research beyond the few countries that dominate the publications, and more focus on low- or middle-income countries.

Implications for practice: The findings of this study provide direction for future research led by cancer nurses and the areas that warrant further investigation.

Background: Precision medicine initiatives are offering superior treatments for cancer, and equitable distribution of these care measures is desired. Gaining insight into the meanings and shared practices of individuals navigating a cancer diagnosis and treatment in a rural setting will help efforts to mitigate inequities in this domain.

Objectives: To (1) interpret individuals' common meanings of a cancer diagnosis including what contributes to that meaning; (2) explicate the shared practices of individuals with cancer regarding accessing oncology care, including provider visits, testing, and treatments; and (3) interpret common understanding of testing and treatment options in individuals with cancer.

Methods: Using hermeneutic phenomenology, interviews with individuals who have cancer who may benefit from precision medicine initiatives and who live in a rural area were recorded, transcribed, and analyzed by the research team until common meanings arose from the narratives.

Results: Fifteen participants provided in-depth interviews. Three main themes and a constitutive pattern emerged: (1) "Slipping through the cracks," (2) Traveling this distance: "Gee, is there something closer?" and (3) Evoking some resilience: "Hope is a powerful word." The constitutive pattern was: "The necessity of practicing and developing advocacy."

Conclusions: Access to care in the rural setting is a complex concept and includes challenges with receiving care at a distance, travel to larger cities for adequate care, and coordination of care from multiple providers.

Implications for practice: Efforts toward providing advocacy in the healthcare setting, as well as developing ways to make access to specialized cancer care more readily available, are important steps toward mitigation of inequities in rural areas.