Cancer Nursing最新文献

Background: Childhood cancer confronts the child and the parents with considerable degrees of stress. Because caring for the child is mainly the role of the mother in most families, her ability to take care of the affected child is very important.

Objective: To explore the caregiving ability of Iranian mothers who have children diagnosed with cancer.

Methods: In this present study, which was conducted using the Directed Qualitative Content Analysis Method, 11 parents having children diagnosed with cancer and 5 professional caregivers working at the Department of Hematology and Oncology of Mofid Children Hospital in Tehran, Iran, were selected using purposeful sampling method. Data were collected through semistructured interviews. Data analysis was performed simultaneously with data collection using the Directed Content Analysis Approach.

Results: Five main categories emerged, namely, care exhaustion, care confusion, spiritual conflict, care competence, and care preparedness that represent the beneficiaries' perception of the caring ability of Iranian mothers of cancer-afflicted children.

Conclusion: Study results revealed that the caregiving capacity of mothers nurturing cancer-stricken children can be evaluated across 5 domains, encompassing a spectrum of maternal requirements in child care. Improving these domains can elevate maternal caregiving proficiency, fostering self-care and enhancing care for the ailing child.

Implication for practice: A program can be developed based on the findings of the present study, in order to improve the caring ability of mothers of cancer-afflicted children, which results in improving the mother's care for her cancer-afflicted child.

Background: Psychosocial adjustment (PSA) in patients exhibits a positive correlation with dyadic coping (DC) and a negative correlation with fear of disease progression (FoP). However, few studies have explored how DC impacts PSA and whether FoP mediates this relationship.

Objective: To investigate the status of DC, FoP, and PSA in patients with malignancy and their caregivers and to explore the actor-partner and mediating effect of FoP on the association between PSA and DC.

Methods: This study employed a cross-sectional design with convenience sampling to select patients with malignancy and their caregivers from 2 hospitals in China. SPSS and AMOS were used for data analysis.

Results: The model showed the mediation effect accounts for 28.30% of the total effect. For the actor effects, patients' and their caregivers' DC influenced their PSA directly (both β = -.138, P < .05) or through their FoP (β = -.050 and β = -.55, both P < .05). As for partner effects, patients' DC influenced the caregivers' PSA directly or through the patients' FoP (β = -.118 and β = -.020, both P < .05). Caregivers' DC also influenced patients' PSA directly (β = -.118, P < .05) or through the patients' or caregivers' FoP (β = -.098 and β = -.018, both P < .05).

Conclusions: The model revealed a significant mediating effect of FoP on the association between the PSA and DC of patients with malignancy and their caregivers.

Implications for practice: Nurses should adopt a comprehensive perspective that includes caregivers in holistic care to improve their PSA by improving their level of DC or mitigating FoP.

Background: Many cancer patients require long-term self-care, both during and after treatment, and need to have self-care competence. Mindfulness and emotional regulation can enhance self-care competence among cancer patients.

Objective: To examine the effect of mindfulness and emotional regulation on self-care competence among cancer patients undergoing chemotherapy.

Methods: The data were completed by 106 cancer patients who were hospitalized at 3 long-term nursing hospitals. The instruments were the Mindfulness Scale, Korean Version of the Difficulties in Emotion Regulation Scale, and Self-As-Care Inventory Scale.

Result: Self-care competence was significantly correlated with mindfulness among cancer patients undergoing chemotherapy. Also, the relationship between mindfulness and emotional regulation was significant. However, emotional regulation did not significantly affect self-care competence.

Conclusions: It is important for cancer patients to focus on the present moment and maintain a balanced approach that keeps a distance from excessive worry. Development and application of interventions aimed at enhancing self-care competence among cancer patients should focus on a high level of mindfulness.

Implications for practice: It is necessary to support cancer patients in taking time out for mindfulness practice through meditation programs and to help them seamlessly incorporate this habit into their daily lives. Nurses can effectively assist cancer patients by being well-versed in mindfulness techniques and providing adept guidance. Offering personalized mindfulness guidance based on the patient's condition and needs is also beneficial. By developing programs that incorporate feedback from both patients and healthcare providers, nurses can help patients continuously apply mindfulness practices.

Background: A cancer diagnosis is a traumatic event. Youths, in the most crucial stage in a person's life course, are more susceptible to the influence of cancer. The diagnosis disrupts the original life and time plans of young adults with cancer, resulting in a reconstruction of time perception and changes in coping strategies.

Objective: The aim of this study was to explore the changes in time perception and coping strategies in young adults with cancer.

Methods: A phenomenological research methodology was used in the qualitative study. Thirty-one young adults with cancer were recruited. Semistructured interviews were conducted with them, and the interview data were analyzed using Colaizzi's 7-step analysis method.

Results: The study revealed 3 themes related to changes in time perception: perceived alterations in the speed of time, changes in remaining available time, and shifts in time preferences. Five themes were identified regarding coping strategies for changes in time perception: self-regulation of emotions, establishing spiritual beliefs, planning time effectively, returning to family life, and closure of the inner self.

Conclusions: Identifying changes in time perception among young adults with cancer through the speed of time, remaining available time, and time preference and guiding patients in adopting positive coping strategies can offer more effective cancer support and care for patients.

Implications for practice: Healthcare professionals should pay attention to the changes in time perception in young adults with cancer and guide them to cope positively.

Background: Breast cancer (BC) and its treatments decrease patients' psychological well-being. Peer support is one form of social support, but little is known about what gives rise to peer support.

Objective: The purpose of this study was to examine how peer support is constructed among recently diagnosed BC patients.

Methods: Eighteen women were randomly picked from 130 women who had received phone calls from a trained peer supporter and were invited to group interviews. In the interviews, patients discussed their cancer, peer support experiences, and social support. The transcribed data were analyzed using Braun and Clarke's thematic analysis approach.

Results: The construction of peer support among newly diagnosed BC patients was complex. It depended on the needs of the patient and the success of interactions. Once they had received a diagnosis, the lives of the patients changed suddenly, and patients dove into the I-we-others consideration and had a need to talk. Interaction with peer supporters gave them a chance to share their stories. At their best, interactions led to belonging, caring, and a sense of security.

Conclusions: The need to be heard and seen is strong in a patient's changing health situation. Peer support plays an important role in high-standard care and in strengthening patients' self-determination.

Implications for practice: Hospitals should create chances for supportive communication, and the supportive communication should be easily accessible and successful. The training of peer supporters should ensure that they have reflected on their own BC process and know how to consider the needs of newly diagnosed patients.

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.