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: Social determinants of health posit that negative outcomes are influenced by individuals living in underserved and underresourced neighborhoods.

Objective: This study examines a cancer diagnosis, race/ethnicity, age, geographic location (residence), education, and social economic status factors at disease onset and treatment.

Methods: A multivariable PO regression analysis was run for quality of care at testing or diagnosis, and quality of care at treatment and the quality of received care compared with another person.

Results: Participants are representative of the Southern Community Cohort Study (SCCS) of adults diagnosed with breast (n = 263), prostate (n = 195), lung (n = 46), colorectal (n = 105), or other cancers (n = 526). This study includes cancer survivors who completed the SCCS Baseline and Cancer Navigation Surveys in urban (73.13%) and rural (26.87%) areas. White participants reported a higher quality of received care for testing or diagnosis and care for treatment compared with Black participants. Participants with high school or equivalent education (odds ratio, 1.662; 95% confidence interval, 1.172-2.356; P = .0044) or some college or junior college education (odds ratio, 1.970; 95% confidence interval, 1.348-2.879; P = .0005) were more likely to report a better level of quality of received care for treatment.

Conclusions: The SCCS represents individuals who are historically underrepresented in cancer research. The results of this study will have broad implications across diverse communities to reduce disparities and inform models of care.

Implications for practice: Nurses are positioned to evaluate the quality of population health and design and lead interventions that will benefit underserved and underresourced communities.

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: Patients with breast cancer have an estimated 14% to 60% risk of developing lymphedema after treatment. Self-management behavior strategies regarding lymphedema are essential in preventing and alleviating the severity of lymphedema.

Objective: The aim of this study was to evaluate qualitative research evidence on the potential influencing factors for self-management behaviors of lymphedema in patients with breast cancer.

Methods: A systematic search of 10 electronic databases was conducted to identify qualitative studies on patient experience of lymphedema self-management. The following databases were included and appraised using the Joanna Briggs Institute Critical Appraisal Checklist: Cochrane Library, PubMed, EMBASE, Web of Science, PsycINFO, Scopus, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, Wanfang Med Online, and Chinese Biomedical Database.

Results: The literature search yielded 5313 studies, of which only 22 qualitative studies fulfilled the eligibility criteria. Five synthesized findings were derived encompassing personal characteristics, personal knowledge and experience, personal health beliefs, self-regulation skills and abilities, and social influences and support.

Conclusions: Patients with breast cancer are confronted with many challenges when performing self-management of lymphedema. Therefore, it is important to recognize potential facilitators and barriers to further offer practical recommendations that promote self-management activities for lymphedema.

Implications for practice: Healthcare professionals should receive consistent training on lymphedema management. On the basis of individual patient characteristics, tailored education and support should be provided, including transforming irrational beliefs, and improving related knowledge and skills, with the aim to promote self-management behaviors with respect to lymphedema.

Background: Adolescent and young adult (AYA) patients with cancer commonly experience psychological distress, with female patients experiencing higher levels of psychological distress.

Objective: The aim of this study was to investigate the relationships among circadian rhythm, sleep quality, inflammatory markers, and psychological distress in AYA patients with gynecological cancer in China.

Methods: This cross-sectional study enrolled 75 AYA patients in treatment for gynecological cancer, 64 of whom completed the Chinese version of the Morningness-Eveningness Questionnaire and the Distress Thermometer. Actigraphy was used to measure their objective sleep parameters: total sleep time, sleep onset latency, and sleep efficiency. Blood samples collected 3 times across 1 day were used to measure the average levels of interleukin 6, C-reactive protein, and tumor necrosis factor α.

Results: The mean score on the Distress Thermometer among respondents was 4.23, which was above the cutoff value for clinically significant psychological distress. High levels of psychological distress may be associated with circadian disturbances, poor sleep quality, and elevated inflammatory markers. In addition, total sleep time, sleep onset latency, and tumor necrosis factor α averages were the dominant predictors of these AYA patients' psychological distress.

Conclusion: Improving sleep quality and reducing the levels of inflammatory markers may relieve psychological distress among AYA patients with gynecological cancer.

Implications for practice: Healthcare professionals need to actively focus on circadian rhythm, inflammatory markers, sleep quality, and mental health status in AYA cancer patients to better meet their therapeutic and psychological needs.

Background: Person-centered care (PCC) should be promoted for patients with cancer and dementia who are likely to be hindered from pursuing a meaningful life owing to their will not being reflected in the cancer treatment process.

Objective: This study aimed to clarify the factors related to nurses' practice of PCC for older patients with cancer and dementia in designated cancer hospitals.

Methods: An online cross-sectional survey was administered to nurses working at designated cancer hospitals in Japan. The survey items included demographic data and factors assumed to be related to nursing practice and practice of PCC.

Results: A multiple regression analysis indicated that the factors related to the practice of PCC were attitude toward patients with dementia (β = 0.264, P < .001), holding conferences (β = 0.255, P < .001), knowledge about cancer nursing (β = 0.168, P < .001), knowledge about dementia (β = 0.128, P = .003), and participation in dementia care training (β = 0.088, P = .032).

Conclusions: Nurses' practice of PCC may not be sufficient to provide personalized care tailored to patients' cognitive function. The factors related to PCC are attitude toward patients with dementia, holding conferences, knowledge about cancer and dementia, and dementia care training.

Implications for practice: To promote PCC for patients with cancer and dementia, nurses should learn about these conditions with an interest in patients and collaborate with other professionals. Future studies should use cluster sampling and focus on the extent of cancer or dementia symptoms.

Background: Fear of cancer recurrence (FCR) significantly impacts the treatment and prognosis of lung cancer survivors. However, the mechanisms and factors contributing to FCR and its related consequences in lung cancer remain poorly understood.

Objective: To evaluate the validity of the Lee-Jones Theoretical Model of FCR in lung cancer survivors.

Methods: A cross-sectional survey was conducted among 257 lung cancer survivors who had undergone surgical treatment 1 year prior. The participants completed a comprehensive set of questionnaires, and the data were analyzed using structural equation modeling to test the proposed model.

Results: The analysis confirmed direct relationships between family resilience, coping behaviors, illness perceptions, FCR triggers, and FCR. Fear of cancer recurrence was also found to have a direct negative impact on quality of life (QOL). Furthermore, levels of family resilience, coping behaviors, illness perceptions, and FCR triggers indirectly influenced QOL through their association with FCR.

Conclusions: This study provides partial support for the validity of the Lee-Jones Theoretical Model of FCR in lung cancer survivors. The findings contribute to a better understanding of FCR in this population and lay the groundwork for targeted interventions. Effective strategies to reduce FCR in lung cancer survivors should focus on enhancing family resilience, improving disease cognition, minimizing FCR triggers, and guiding patients toward adopting positive coping styles, ultimately improving their QOL.

Implications for practice: Fear of cancer recurrence plays a vital role in relationships between internal and external cues and QOL. We can construct interventions to enhance the QOL of survivors based on the FCR influencing factors.

Objectives: The inaugural "Cancer Symptom Science Expert Meeting," held in Lausanne Switzerland on October 11-12, 2023, brought together 40 nurse scientists from seven countries. The event aimed to enhance collaboration across the global symptom science community; identify common research interests, gaps in knowledge, and opportunities for research; and develop strategies to address challenges and accelerate symptom science research internationally. This white paper summarizes the discussions and recommendations deliberated during the meeting and introduces the Global Research Alliance in Symptom Science (GRASS).

Methods: This 2-day meeting featured presentations that highlighted critical issues and unanswered questions in cancer symptom science. Four core topic areas based on knowledge gaps were reflected throughout presentations. The co-occurrence of cancer with other chronic conditions (eg, cardiovascular disease, diabetes) that may share similar contributors and underlying mechanisms was included. Four working groups (WGs) were formed to identify gaps and opportunities associated with each topic and to outline strategic directions and essential actions to advance symptom science.

Results: Working groups developed four recommendations. WG1 explored optimal approaches to collect, analyze, and use symptom data for research and clinical purposes. WG2 addressed the development of a minimum dataset or common data model for symptom science. WG3 focused on enhancement of best practices in implementation science strategies to improve uptake of evidence-based symptom management in routine care. WG4 addressed capacity building and infrastructure for the creation of a global research alliance in symptom science (GRASS).

Conclusions: The symposium established the groundwork for the development of GRASS, dedicated to symptom science in cancer and other chronic conditions. Future directions include establishing regular scientific meetings, fostering interdisciplinary collaboration, and engaging with symptom scientists.

Implications for nursing practice: The Global Research Alliance in Symptom Science is an alliance for symptom science and its implementation into clinical practice. Nurses are at the forefront of this work.