Cancer Nursing最新文献

Background: Gynecological cancer survivors often report unmet needs during follow-up, highlighting the necessity for innovative support approaches. Mobile health technologies, including smartphone applications, offer promising solutions to meet the needs of survivors and support them through follow-up. However, there is limited knowledge regarding cancer survivors' experiences with these technologies as part of posttreatment follow-up.

Objective: The aim of this study was to explore the experiences of gynecological cancer survivors using the Lifestyle Empowerment Techniques in Survivorship of Gynecologic Oncology (LETSGO) app as a supportive care tool for symptom self-assessment, physical activity goal setting, and encouraging a healthier lifestyle during follow-up.

Methods: A qualitative exploratory design was employed using individual semistructured interviews with 20 women at 5 Norwegian hospitals who had access to the LETSGO app during follow-up. Data were analyzed using Braun and Clark's thematic analysis approach.

Results: The LETSGO app contributed to an increased sense of safety by facilitating symptom monitoring and offering easy access to healthcare providers. It also motivated survivors to adopt a healthier lifestyle, including physical activity, and offered valuable, easily accessible, evidence-based knowledge, as described in the main themes: feeling safe, motivation for adopting a healthier lifestyle, and fostering health engagement through knowledge.

Conclusions: The findings suggest that gynecological cancer survivors experienced the LETSGO app as a supportive tool in managing their health by enhancing safety, encouraging healthier lifestyle behaviors, and providing relevant, evidence-based knowledge.

Implications for practice: Integrating lifestyle and empowerment applications, such as the LETSGO app, into routine survivorship care could contribute to addressing the unmet needs of gynecological cancer survivors and enhance patient-centered follow-up support.

Background: Postsurgery physical activity is crucial for lung cancer rehabilitation. However, patients often lack sufficient activity at home, and the types of activities they engage in have not been well studied in China.

Objectives: This study aimed to identify physical activity profiles and assess their relationship with demographic and clinical characteristics, postoperative symptoms, and health capabilities in Chinese patients with lung cancer post surgery at home.

Methods: A total of 370 home-based patients who had undergone lung cancer surgery 1 month prior participated. The MD Anderson Symptom Inventory, the Self-Rated Abilities for Health Practices Scale, and the International Physical Activity Questionnaire were used. A latent profile analysis was conducted to examine the energy expenditure of various types of physical activity. Influencing factors of various activity profiles were identified using univariate and multivariate logistic regression analyses.

Results: Three latent categories were identified. Patients presenting discomfort symptoms a month after surgery displayed a heightened propensity to embrace household-oriented physical activities. In comparison, younger patients engaged in more occupation-oriented physical activities. Patients who achieved elevated scores on the Self-Rated Abilities for Health Practices Scale tended to engage in more exercise routines.

Conclusions: The physical activity of home-based patients 1 month after lung cancer surgery was generally a medium or low level. Age, postoperative symptoms, and self-rated health status can be used to identify the types of physical activity of these patients.

Implications for practice: Healthcare providers should actively monitor patients with postoperative symptoms and low self-assessed health, and tailor home-based physical activity recommendations to suit specific age groups.

Background: Human papillomavirus (HPV) vaccination is a critical cancer prevention tool, yet uptake among young adults in the United States remains suboptimal. Understanding sociodemographic factors influencing vaccine uptake is essential to reducing HPV-related cancer disparities.

Objective: This study examined factors influencing HPV vaccine uptake among US young adults using the Social Ecological Model framework, focusing on individual-, interpersonal-, community-, and societal-level predictors.

Methods: A cross-sectional analysis was conducted using data from the 2022 National Health Interview Survey, including a weighted sample of 15 014 592 young adults aged 18 to 26 years. Multivariable logistic regression models examined associations between vaccination status and multilevel predictors, including healthcare access, internet use, gender, health status, race/ethnicity, and education.

Results: Having a usual healthcare provider significantly increased vaccination odds (odds ratio [OR], 1.99; P < .01), as did using the internet for health information (OR, 1.70; P < .01). Males had lower odds than females (OR, 0.41; P < .001). Unexpectedly, higher education was associated with lower vaccination odds, with graduate degree holders having the lowest odds (OR, 0.22; P < .05). Hispanic individuals showed higher odds compared with non-Hispanic Whites (OR, 1.40; P < .05).

Conclusions: HPV vaccine uptake is influenced by factors across multiple ecological levels. The inverse relationship between education and vaccination highlights the complexity in vaccination decision-making among young adults.

Implications: Oncology nurses should implement multilevel interventions, including systematic vaccination protocols, targeted male outreach, culturally tailored programs, and digital strategies, with specialized messaging for highly educated adults emphasizing universal cancer prevention benefits.

Background: Gastrointestinal dysfunction is a common complication in patients with liver cancer after surgery, affecting their recovery. The effectiveness of ultrasonic conductance acupoint penetration of Dachengqi decoction as a novel treatment method has not been confirmed in patients with liver cancer after surgery.

Objectives: This study aims to investigate the effect of ultrasonic conductance acupoint penetration into Dachengqi decoction on the recovery of gastrointestinal function in postoperative patients with liver cancer and to provide experience for clinical reference.

Methods: In this randomized controlled trial, participants with liver cancer were enrolled from a tertiary hospital in Shandong Province, China. The control group (n = 38) received basic nursing measures, and the intervention group (n = 34) received basic nursing measures combined with ultrasonic conductance acupoint penetration of Dachengqi decoction.

Results: Compared to the control group, the intervention group demonstrated a significantly shorter postoperative first flatus time, postoperative first defecation time, and time to initiation of food intake.

Conclusion: The application of ultrasonic conductance acupoint penetration of Dachengqi decoction can shorten the first postoperative flatus time, defecation time, and the time of food intake after surgery in postoperative patients with liver cancer.

Implications for practice: In postoperative patients with liver cancer, ultrasonic conductance acupoint penetration of Dachengqi decoction is a secure and straightforward therapeutic approach that can effectively promote the restoration of gastrointestinal function. Future large-scale studies are warranted to replicate the study findings.

Background: Caregivers of children with cancer receive new diagnosis education (NDE) to guide home care. Health literacy (HL) and social determinants of health (SDoH) may affect the caregiver-reported educational experience of receiving NDE.

Objective: To explore caregiver NDE experiences through the lens of HL and SDoH.

Methods: Caregivers with a child <18 years old receiving cancer treatment who completed a survey assessing their SDoH across 5 domains (≥1 = adverse), HL level (limited vs adequate), and NDE (favorable vs unfavorable) were purposively selected to participate in semistructured interviews. Two researchers independently coded transcripts and identified themes and subthemes.

Results: Data from 19 caregivers (78.9% mothers; median age, 35.3 years) of children (52.6% with leukemia; median age, 4.3 years) were included; 31.6% of caregivers had limited HL; 57.9% had adverse SDoH. Five themes emerged: (1) process of receiving NDE, (2) ways of learning, (3) sources of information, (4) caregiver readiness, and (5) deficits in provision of NDE. Caregivers shared many similar positive and challenging NDE experiences regardless of HL level or SDoH exposure. Differences in ways of learning were identified based on HL. Caregivers with adequate HL relied on written materials, whereas caregivers with limited HL relied on hands-on learning techniques and observation. No differences in NDE experiences related to SDoH were identified.

Conclusions: Caregivers shared many similar NDE experiences across HL levels and SDoH exposures; however, differences in ways of learning based on HL were identified.

Implications for practice: Caregiver HL level should be assessed prior to NDE to inform tailoring of educational strategies.

Background: Cancer survivors experience higher rates of anxiety and depression than the general population, negatively affecting treatment adherence and quality of life. Although studies have explored parental concerns among cancer survivors, minimal research exists on cancer survivors' relationships with their pets.

Objective: This study aimed to assess the benefits, challenges, and unmet needs of pet owners experiencing breast, colon, lung, and prostate cancer, examining the relationship between pet ownership, pet-related concerns, guilt, and quality of life.

Methods: An anonymous, cross-sectional online survey was administered between April and December 2024 to adult cancer survivors (stages 0-IV) who were primary guardians of at least one dog or cat for ≥6 months.

Results: Among 930 participants, guilt levels were highest in those recently diagnosed and those younger than 30 years. Quality of life was negatively associated with guilt (r = 0.437) and pet-related concerns (r = 0.350). Higher pet attachment was positively correlated with perceived support from pets but also with increased guilt and concerns about pet care during cancer treatment.

Conclusions: Cancer survivors experience significant guilt and concern regarding pet care during treatment, especially those recently diagnosed and younger.

Implications for practice: Oncology nurses should acknowledge the importance of human-animal bonds and incorporate discussions about pet care into supportive care planning. Developing resources to assist cancer survivors with pet care responsibilities and validating pet-related concerns could improve survivor well-being and treatment adherence. Further research is needed to create and evaluate interventions specifically addressing the needs of cancer survivors who are pet owners.

Background: Acute leukemia (AL) in adolescents and young adults (AYAs) disrupts critical developmental and social milestones, posing unique psychosocial challenges for this age group. There is currently a dearth of literature that addresses the distinct psychosocial impacts for AYAs with AL, particularly in an Asian context.

Objective: This study aimed to explore the lived experiences and psychosocial needs of AYAs who were newly diagnosed with AL and undergoing chemotherapy.

Methods: A descriptive qualitative approach was used, with individual semistructured interviews conducted among AYA patients newly diagnosed with AL at an academic medical center in Singapore. Thematic analysis based on Braun and Clarke's framework was conducted to identify recurring patterns in coping mechanisms and challenges.

Results: Participants (n = 10), aged 18 to 39 years, described 5 themes: (1) emotional impact of diagnosis, (2) rationalization and adaptation, (3) role of social support, (4) intrinsic barriers to coping, and (5) extrinsic barriers to coping.

Conclusions: The narratives revealed not only the profound physical, emotional, and psychological challenges AYAs encounter, but also their resilience and capacity for hope amid adversity. Comprehensive support frameworks should be developed and tailored specifically to the unique needs of this vulnerable population.

Implications for practice: Clinicians should prioritize phased, empathetic communication to help AYAs process their diagnosis. Enhancing access to age-specific peer support and providing engaging educational resources foster autonomy and coping. Addressing long-term psychological concerns and offering creative dietary solutions can further promote morale, resilience, and comprehensive support throughout their treatment journey.

Background: The nurse liaison within the Alliance for Clinical Trials in Oncology network supports the implementation of National Cancer Institute-supported multisite clinical trials by serving as a centralized point of communication for site research staff. In the context of large-scale studies involving over 100 enrolling sites, timely and effective email communication presents ongoing challenges.

Objectives: The aims of this study were to explore the communication, education, and support strategies used by a dedicated nurse liaison in a multisite clinical trial, and to examine how the nurse liaison's responses contributed to staff satisfaction, growth, knowledge, and confidence, while promoting patient safety and research fidelity through relationship-centered, caring communication.

Methods: We conducted a content analysis of email communications between research site staff and the study-dedicated nurse for a multisite clinical trial (Alliance A221805). The Quality-Caring Model provided the theoretical framework for this qualitative study and guided the codebook structure used for content analysis of email queries.

Results: Thematic saturation was reached after analyzing 318 emails from clinical research professionals between May 1, 2020, and March 21, 2023, representing 91 sites and 36 states. Most inquiries were from registered nurses (68%). Emerged themes revealed nurse liaison contributions-education, validation, and caring-which aligned with theoretical domains: research staff knowledge, patient safety, and research fidelity.

Conclusions: Nurse liaisons have a critical role in supporting multisite clinical trials by (1) educating/supporting study staff, (2) enhancing patient safety, and (3) ensuring high-quality research outcomes.

Implications for practice: Nurse liaisons' caring communication may have a positive impact on research staff knowledge and confidence.

Background: Acute myeloid leukemia (AML) is the most frequent form of acute leukemia in adults and the elderly. Standard AML treatment for achieving complete remission is intensive chemotherapy. However, few patients can tolerate the treatments and their toxic effects, and many decide to withdraw during treatments.

Objective: A hermeneutic phenomenological approach was used to elucidate the lived experiences of receiving intensive chemotherapy until treatment completion from AML survivors.

Methods: In-depth in-person interviews were conducted with 10 AML survivors recruited from a regional hospital in southern Thailand. Van Manen's phenomenological approach was used to guide the analysis.

Results: AML survivors made meaning of their experiences as described in a core theme of fighting for survival. Five existential themes were also identified: attempting to be ready for treatments, being surrounded by significant people, longing for a place to rest, looking forward to the day of successful treatment completion, and appreciating advanced technologies.

Conclusion: The lived experiences of AML survivors demonstrated that fighting for survival is a source of motivation to live on during their cancer journey. AML survivors tried to maintain both physical and mental strength while relying on spiritual and family support to endure suffering and achieve treatment completion.

Implications for practice: Understanding the lived experiences of AML survivors has implications for person-centered care. Health professionals, particularly nurses, should provide psychosocial support and consider digital-based interventions for patients with AML to help them cope with this challenging journey from diagnosis to treatment completion and thereafter.

Background: Penile cancer (PC) is a relatively rare malignant tumor due to the unique nature of the disease site. Existing studies about PC focus on the risk factors and surgical treatment; therefore, a significant gap in knowledge remains regarding patients' coping mechanisms, particularly their psychological adaptation and healthcare-seeking behaviors.

Objective: This study aims to investigate the coping mechanisms of patients with PC, focusing on their healthcare-seeking behaviors, psychological adaptation, and treatment expectations.

Methods: A qualitative study was conducted using semistructured interviews with purposive sampling. Thematic analysis was used to analyze the data and extract meaningful themes for qualitative analysis.

Results: Three major themes were revealed: (1) delayed medical treatment before diagnosis with related factors of deficient disease literacy and psychological resistance to genital exposure; (2) emotional experience after diagnosis, with 2 subthemes "negative emotional experience" and "self-efficacy reconstruction"; and (3) treatment expectations including life expectancy, more information about their disease, a good doctor-patient relationship, and peer support.

Conclusion: Patients with PC commonly experience delayed medical treatment due to various reasons. They encounter a journey of overcoming negative emotions and reconstructing self-efficacy after diagnosis and have specific treatment expectations.

Implications for practice: Nurses can promote PC health education to reduce misconceptions and encourage patients to seek timely medical treatment. Prioritizing the psychological well-being of patients through psychological care, supporting clinician-patient relationships and peer support can help to develop effective coping strategies. Future research is needed on public health education targeting PC and comprehensive social support models to improve quality of life.