Cancer Nursing最新文献

Background: Neoadjuvant and adjuvant breast cancer chemotherapy have been shown to improve survival outcomes, highlighting the importance of timely therapy.

Objective: The study described the time to initiation of neoadjuvant or adjuvant chemotherapy among women with early-stage breast cancer and identified correlates of delay, including demographics, social determinants of health, patient factors, and symptom distress.

Methods: The study utilized baseline data from the Symptom Experience and Management of cancer Outcomes According to Race and Social Demographics of Health, a multisite, longitudinal study that racially compared the time to chemotherapy initiation with consideration of social determinants of health. Logistic regression models analyzed the factors influencing chemotherapy initiation within the recommended timeframes (35 days for neoadjuvant therapy and 60 days for adjuvant therapy) after biopsy (neoadjuvant) or surgery (adjuvant).

Results: Of the 256 patients included in the study, 56.5% (n = 145), received neoadjuvant therapy, and among them, 55.2% (n = 80) initiated chemotherapy within 35 days of biopsy. In the study, 43.4% (n = 111) received adjuvant therapy, with 77.5% (n = 86) initiating chemotherapy within 60 days. In univariate analysis, patients who began neoadjuvant therapy within 35 days had significantly higher Interpersonal Support Evaluation List appraisal scores. In multivariate regression analysis, symptom distress emerged as a significant predictor of the delay in initiation of adjuvant chemotherapy.

Conclusion: Social support and symptom distress are considerations in chemotherapy initiation delay.

Implications for practice: Targeted interventions to alleviate symptom distress and enhance interpersonal support may facilitate timely chemotherapy initiation.

Background: Accessible, real-time cancer-related cognitive impairment (CRCI) assessments remain limited.

Objectives: The aims of this study were to develop and validate the Single Item Mobile Cognitive Screening (SIM-Cog Screening) tool to detect CRCI, establish its concurrent validity and test-retest reliability, and assess feasibility through momentary assessments.

Methods: A secondary analysis was conducted on data from 175 newly diagnosed patients with non-small cell lung cancer. Participants completed in-person assessments, including the Montreal Cognitive Assessment Hong Kong version 5-Min Protocol and Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) measures, and a mobile survey with SIM-Cog Screening and ratings of anxiety, depression, fatigue, pain, and sleep disturbance. A subgroup of 10 participants completed the ecological mobile survey twice daily for 7 days. Receiver operating characteristic curve analysis used the Montreal Cognitive Assessment Hong Kong version 5-Min Protocol and FACT-Cog measures as reference standards.

Results: The receiver operating characteristic curve analysis revealed the area under the curve values of 0.928 when referenced against the FACT-Cog Perceived Cognitive Impairment-18. The optimal cutoff score of 4 on the FACT-Cog Perceived Cognitive Impairment-18 yielded a sensitivity of 88% and a specificity of 83.7%. Single Item Mobile Cognitive Screening scores correlated with measures of anxiety, depression, fatigue, and sleep disturbance. The test-retest reliability coefficient was 0.724, and participants reported high satisfaction with the ecological mobile survey.

Conclusions: This brief, ecological mobile cognitive screening measure can transform how CRCI is detected, monitored, and managed, enabling timely interventions.

Implications for practice: Utilizing tools like SIM-Cog Screening can facilitate timely interventions tailored to individual patient needs, ultimately enhancing quality of life and treatment outcomes.

Background: Suboptimal adherence to oral anticancer agents (OAAs) reduces therapeutic benefits among patients with gastrointestinal tract cancer. Self-regulation is an important mechanism to foster behavioral change, but little is known about how to utilize this mechanism to enhance adherence.

Objective: The aim of this study was to evaluate the feasibility, acceptability, and preliminary outcomes of an education program to promote self-regulation in managing adherence to OAAs.

Methods: A 2-arm pilot randomized controlled trial was adopted. Twenty-four participants were randomized to the control or intervention group with a 1:1 ratio. The control group received usual care. The intervention group received usual care and 4 sessions of education to promote self-regulation. Feasibility, acceptability, and preliminary outcomes were evaluated using descriptive statistics and Cohen's d.

Results: The consent and attrition rates were 64.86% and 8.33%, respectively. Most (83.33%) participants in the intervention group finished all education sessions. They were satisfied with the educational content and perceived the program as helpful. A favorable trend of better adherence (adherence rate: 90.91%), more self-management behaviors (Cohen's d = 0.915), less negative illness perceptions (Cohen's d = -0.714), higher medication self-efficacy (Cohen's d = 0.431), and necessity beliefs (Cohen's d = 0.451) was found in the intervention group.

Conclusions: The education program is considered feasible and acceptable. A full-scale randomized control trial is needed to explore its effectiveness in a larger sample.

Implications for practice: This education program to promote self-regulation is promising to support adherence to OAAs, self-management behaviors, favorable illness perceptions, and medication self-efficacy.

Background: Breast cancer is a common type of cancer in South Asian women. Early detection by mammographic screening plays a significant role in improving survival rates. South Asian minorities in many countries have reported low mammographic screening rates.

Objective: This study aimed to understand the factors that influence mammographic screening uptake among South Asian women in Hong Kong.

Methods: This was a qualitative exploratory descriptive study. South Asian women 40 years or older with no history of breast cancer were recruited. In-depth face-to-face interviews were conducted following a semistructured interview guide. Thematic analysis was conducted to analyze the data.

Results: A total of 31 South Asian women consented to participate. Among them, only 7 had ever undergone mammographic screening. The following themes of facilitating factors were identified: (1) influence of doctors, family, and friends; (2) strong sense of commitment to the family; and (3) accessibility and availability of mammographic screening information and services. The following themes for barriers to screening were identified: (1) beliefs about health management and social norms, (2) lack of knowledge and understanding of breast cancer and mammographic screening, (3) logistical barriers, and (4) physical barriers.

Conclusion: This study identified important facilitators and barriers that influence the uptake of mammographic screening among South Asian women in Hong Kong.

Implications for practice: The study findings can be used to guide the development and implementation of culturally relevant interventions to address barriers to screening, including the expected gender roles and responsibilities among women in their respective families.

Background: Having a cancer diagnosis during early adulthood can be a significant challenge for an individual. Nurses' supportive communication plays a vital role during the diagnosis and treatment period to lessen psychological distress and promote coping.

Objective: This exploratory study aimed to examine (1) the experiences of emerging adults with cancer (EAs) aged between 18 and 25 years in communicating with nurses during diagnosis and treatment and (2) nurses' experiences of providing supportive communication with this patient group.

Methods: Semistructured interviews were conducted with EAs and nurses with experience caring for this patient group. Thematic analysis was conducted, guided by interpretive hermeneutic perspectives.

Results: Eight EA participants and 7 nurse participants participated in interviews. Five themes emerged: (1) having casual conversations with nurses helped EAs cope during cancer treatment and (2) helped EAs fulfill the need for social connectedness, (3) nurses as a different form of peer-like support, (4) nurses used themselves as a therapeutic tool to foster trust and emotional safety of EAs, and (5) nurses needed to maintain professional boundaries while being compassionate.

Conclusions: This study highlighted a rather underdocumented aspect of supportive communication: meeting psychosocial needs through casual, day-to-day conversations.

Implications for practice: Having casual conversations with nurses appeared to help EAs' psychological coping during cancer treatment. These casual conversations, which on the surface seemed clinically insignificant, fulfilled their psychosocial needs. Considering the valuable interpersonal engagement that led to emotional benefits for EAs, communication training for cancer nurses needs to build their capacity to maintain both relational and emotional boundaries.

Background: Health-related self-disclosure has been studied in various aspects, as has self-disclosure of cancer patients. However, any theoretical models that comprehensively include self-disclosure events, factors associated with self-disclosure, and the outcomes of self-disclosure of cancer patients have not yet been presented.

Objective: The purpose of this study was to explore the relationships between self-disclosure, perception toward cancer, intention for self-disclosure, level and range of self-disclosure, social support, and well-being in adult patients with cancer.

Methods: Data were collected from adult cancer patients via an online survey using self-report questionnaires and analyzed using structural equation modeling. The data from 359 participants were included in the final analysis.

Results: Positive intention for self-disclosure was a significant predictor of both self-disclosure level and range, whereas negative perception toward cancer significantly decreased self-disclosure level. The self-disclosure level significantly improved both social support and well-being, whereas the self-disclosure range did not present a significant impact on social support and well-being.

Conclusion: Self-disclosure is closely associated with social support and well-being, and self-disclosure can be promoted by improving negative perceptions and positive intentions about self-disclosure. In addition, to improve the social support and well-being of cancer patients, it suggests increasing the self-disclosure depth level rather than widening the range of self-disclosure.

Implications for practice: The results of this study can be used as evidence for the development of nursing intervention programs to reduce negative perceptions toward cancer and improve positive intentions and levels of self-disclosure among cancer patients.

Background: Many studies have indicated that inadequate health-related behavior is associated with the progression of cancer and cardiometabolic disorders. Because patients with hepatocellular carcinoma may adopt inadequate health behaviors, they are at risk for cancer recurrence, mortality, cardiometabolic disease progression, and worse quality of life.

Objective: To explore the prevalence of cardiometabolic risks and health-promoting behaviors associated with quality of life among patients with hepatocellular carcinoma after treatment.

Methods: A cross-sectional study was conducted from October 2021 to August 2022. Data were collected through face-to-face interviews using a structured questionnaire, and cardiometabolic information was recorded from medical charts.

Results: In total, 115 patients with liver cancer after treatment were enrolled; 73% were male. The mean age was 67.7 years, and high prevalence rates of central obesity (72.2%) and metabolic syndrome (47%) were noted. Inadequate exercise, oral hygiene, and cigarette smoking were common. The health-promoting score was significantly associated with exercise, the number of remaining teeth, and metabolic syndrome, which correlated with quality of life, including positive functional and negative symptoms dimensions.

Conclusions: The findings demonstrated a high prevalence of cardiometabolic risks and inadequate health-related behaviors among patients with liver cancer after treatment. This study highlights the need for healthcare providers to help patients increase health literacy for preventing cardiometabolic risks at outpatient clinics.

Implications for practice: Findings from this study can be used to advise healthcare providers to educate patients with liver cancer during and after treatment on improving their health-promoting behaviors.

Background: Cancer-related fatigue is one of the most common symptoms of cancer patients. Psychoeducation is often used in the management of cancer-related fatigue.

Objective: The aim of this study was to synthesize the effects of psychoeducational interventions on cancer-related fatigue.

Methods: This article is a systematic review and meta-analysis of randomized controlled studies. The 11 electronic databases were searched, and studies using psychoeducational interventions to manage cancer-related fatigue were included. Data synthesis was performed using Comprehensive Meta-Analysis software version 3.0. The random-effects model was used to pool the effect size for intervention. The subgroup analysis was conducted to investigate the effect of the characteristics of psychoeducational interventions. This study was reported according to the Cochrane Handbook for Systematic Reviews of Intervention version 6.3 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.

Results: This analysis included 10 studies with a total of 1369 participants. Most of the included studies compared the psychoeducational intervention group with the passive control group. Our meta-analysis revealed that psychoeducational intervention has a positive medium effect on improving cancer-related fatigue with a low quality of evidence. Subgroup analyses indicated no difference between group and individual interventions, between face-to-face and digital interventions, or between ≤3 and >3 sessions.

Conclusions: Psychoeducational interventions can improve cancer-related fatigue. Additional well-designed randomized controlled studies are needed to upgrade the quality of evidence for psychoeducational interventions on cancer-related fatigue.

Implications for practice: Nurses may practice psychoeducational interventions to manage cancer-related fatigue and may use this study design for randomized controlled studies for psychoeducational interventions on cancer-related fatigue.

Background: Informal caregivers of cancer patients often experience high levels of stress and burden, leading to the adoption of ineffective coping strategies. This can result in psychological problems for the caregivers and inadequate care provision.

Objective: This study aimed to investigate the impact of Benson's relaxation technique (BRT) on coping strategies among informal caregivers of cancer patients.

Methods: This open-label randomized clinical trial enrolled 113 caregivers visiting the radiotherapy and chemotherapy departments of Vasei Hospital in Sabzevar, Iran, who scored ≥48 on the Novak and Guest Caregiver Burden Inventory. The participants were randomly allocated to either the intervention group or the control group. The intervention group received BRT, with participants performing the technique twice a day for 20 minutes each time over a 1-month period. The control group did not receive any intervention. Coping strategies were assessed using Endler and Parker's coping strategies inventory.

Results: The findings of the study revealed that the intervention group showed an increase in the utilization of problem-oriented coping strategies ( P = .076) and a decrease in the utilization of emotion-oriented coping strategies ( P < .001) and avoidance-oriented coping strategies in the intervention group compared with the control group ( P = .004).

Conclusions: Findings suggest that BRT, as a cost-effective and nonpharmacological intervention, effectively reduces the reliance on emotion-oriented and avoidance-oriented coping strategies among informal caregivers of cancer patients.

Implications for practice: Healthcare professionals working in oncology settings are encouraged to incorporate BRT into their care practices.