Cancer Nursing最新文献

Background: Interventions to foster resilience may promote mental health recovery after exposure to stressors. However, comprehensive systematic syntheses of such evidence in family members of pediatric cancer patients are lacking.

Objective: To systematically review and meta-analyze the evidence for the effects of psychological interventions at fostering resilience in family members of pediatric cancer patients.

Methods: PubMed, Cumulative Index to Nursing and Allied Health Literature, and 9 other databases were searched for articles published until March 2023. Empirical studies on psychological interventions to improve resilience in family members of pediatric cancer patients were included. Full-text and quality appraisals were performed independently by 2 reviewers. Pooled effect sizes were calculated using random-effects meta-analyses.

Results: Seventeen studies were included, of which 10 were included in the meta-analyses. There was a positive effect of interventions on resilience at postintervention time points, but no effects on depressive symptoms, stress, or well-being. The improvement in resilience was sustained in the short term (≤3 months) and medium term (>3 to ≤6 months), with delayed effects on depressive symptoms and stress. In the 6 studies that reported moderate effect sizes, the interventions comprised problem-solving skills, cognitive strategies, promotion of personal strength, and social resources.

Conclusion: The findings indicated that psychological interventions targeting resilience have the potential to positively affect the resilience and mental health outcomes of family members, particularly parents.

Implications for practice: Psychological interventions targeting resilience hold promise in improving the mental health of family members. Future interventions should clearly specify the characteristics of the intervention, such as mode of delivery, format, and duration.

Background: The influence of self-efficacy-enhancing interventions on quality of life (QOL) is not clear with recent randomized controlled trials (RCTs) because current reviews only evaluated self-efficacy as an outcome.

Objectives: We conducted a systematic review to examine the effect of self-efficacy-enhancing interventions on QOL among patients with cancer and to summarize the effective determinants for designing self-efficacy-enhancing interventions.

Methods: A systematic search was performed on studies published from January 2003 to May 2023 using PubMed, CINAHL, PsycINFO, and Web of Science. Included studies were RCTs, adults diagnosed with cancer, interventions with explicit self-efficacy components, and QOL as the outcome.

Results: Nineteen RCTs were included. Risk-of-bias assessment revealed 12 studies with some concerns and 7 with high risk of bias. The mean intervention adherence rate was 88.2%; the most frequently listed reason for dropout was medical conditions and mortality. Self-efficacy interventions were shown to significantly improve at least 1 subscale of QOL in 9 of 19 studies, of which 7 studies used Bandura's 4 sources of self-efficacy. The interventions with between-session intervals shorter than 2 weeks, of 12-week duration, and with an in-person delivery approach were the most effective.

Conclusions: Self-efficacy-enhancing interventions show potential beneficial effects on QOL among cancer survivors. Interventions that use Bandura's 4 sources of self-efficacy strategies and have between-session intervals shorter than 2 weeks, an in-person approach, and 12-week intervention duration are recommended.

Implications for practice: Properly designed self-efficacy-enhancing interventions can facilitate behavioral change and improve QOL in cancer survivors.

Background: Parents of children with cancer may experience posttraumatic growth (PTG). In clinical practice, this parental enhancement is more likely to be seen with a moderate-high PTG.

Objective: The aim of this study was to determine the moderate-high PTG prevalence of parents of children diagnosed with cancer at least 6 months and to investigate its relationship with hope, social support, and patient-parent characteristics.

Methods: This cross-sectional study was conducted with the parents of children with cancer admitted to the pediatric hematology-oncology unit using the Parent-Child Characteristic Questionnaire, Posttraumatic Growth Inventory, Multidimensional Scale of Perceived Social Support and Dispositional Hope Scale. Univariate and multivariate logistic regression analyses were performed to investigate the variables associated with moderate-high PTG.

Results: One hundred one parents were enrolled in this study, and the prevalence of the moderate-high PTG was 79.2%. There was a statistically significant difference between moderate-high PTG and children's age (P = .037). Multivariate logistic regression analysis showed that social support from significant others (odds ratio = 1.138, 95% confidence interval = 1.030-1.257, P = .011) was a predictor of moderate-high PTG.

Conclusions: Moderate-high PTG is common among parents of children diagnosed with cancer. Perceived social support from healthcare professionals and other patient parents is a predictive factor.

Implications for practice: Interventions that encourage the support of health professionals and interaction with the parents of other patients, such as peer counseling, group-based interventions, and expanding the social support network, seem to be clinically promising in helping parents to improve from the cancer experience.

Background: Soothing conversation (SC) is particularly promising for symptom management during outpatient chemotherapy. However, we know little about the profile of patients who are most likely to benefit from this intervention.

Objective: To gain a better understanding of the profile of patients most likely to benefit from SC to reduce symptom burden during outpatient chemotherapy.

Methods: We performed a multimethod secondary analysis of 2 data sets: the first gathered during a quantitative pilot trial investigating the impact of SC on patients' symptom fluctuations during chemotherapy perfusion (n = 24); the second derived from qualitative interviews about nurses' experiences with SC in this context (n = 6).

Results: Secondary quantitative analysis suggests that symptom control with SC is more effective in older patients, reporting lower education, widowed status, work incapacity, advanced cancer, and undergoing chemotherapy perfusion for less than 1 hour. According to nurses' interviews, SC could best benefit patients (1) prone to anxiety and fear, (2) with unalleviated pain, (3) who are unaccompanied during treatment, and contrary to what was shown with quantitative data, (4) undergoing longer perfusion duration.

Conclusion: Although this study provides valuable insights, much work remains to be done to fully understand the factors that predispose patients to respond positively to SC during outpatient chemotherapy.

Implications for practice: This study extends previous research on the effectiveness of SC for symptom management during outpatient chemotherapy by comparing nurses' experience with the intervention to patients' results. Results could be used to inform the assignment and delivery of supportive communication-based interventions during chemotherapy protocols.

Background: Hope has an influential role in oncology patients and is related to perceived social support and spirituality. However, studies on the extent to which the concepts of perceived social support and spiritual care needs affect hope are still limited.

Objective: To examine the effect of perceived social support and spiritual care needs in predicting hope in adult oncology patients.

Methods: Study questionnaires, a demographic form, the Herth Hope Scale, the Multidimensional Perceived Social Support Scale, and the Spiritual Care Needs Scale were administered to participants. Correlation and regression analyses were conducted.

Results: A total of 134 oncology patients completed the study questionnaires. Significant correlations were found between hope and perceived social support and between hope and spiritual care needs (P < .05). Perceived support explained 11.7% of the variance in hope scores. A 1-unit increase in the support score was associated with a 0.344-unit increase in the hope score. Spiritual care needs did not significantly predict hope.

Conclusion: In line with the results, interventions that promote social support may increase hope in oncology patients.

Implications for practice: Nurses could incorporate interventions into their care to improve social support as one way to enhance hope levels among oncology patients. Further studies are required to understand more about the impact of spiritual care needs on hope.

Background: The prevalence of patients with digestive system tumors has been high. In recent years, frailty has been considered to be associated with poor prognosis of digestive system tumors, but there are conflicting research results. A better understanding of the relationship between frailty and outcomes after chemotherapy can help advance the development of oncology care.

Objective: The aim of this study was to evaluate the effects of prechemotherapy frailty on chemotherapy toxicity, overall mortality, unplanned hospitalization, and overall survival in patients with digestive system tumors.

Methods: Up to April 2023, observational studies assessing the impact of frailty on chemotherapy outcomes in patients with digestive system tumors were collected through searching 10 online research databases. Two evaluators independently extracted literature based on the inclusion and exclusion criteria and evaluated the quality of the studies using the Newcastle-Ottawa Scale.

Results: Eventually, 11 cohort studies encompassing 2380 patients were included. The meta-analysis revealed that the frail group exhibited an increased risk of overall mortality, with poorer overall survival than the nonfrail group.

Conclusion: Frailty increases the risk of chemotherapy-induced toxic effects, unplanned hospitalization, and death in patients. However, because of this study's limited number of participants, large-sample, multicenter studies to verify these findings are required.

Implications for practice: This study provides theoretical support for incorporating frailty assessment into the nursing evaluation of patients with digestive system tumors before chemotherapy. This integration aids in predicting patients at a high risk of chemotherapy toxicity, mortality, and unplanned hospitalization, therefore providing corresponding interventions in advance to reduce adverse outcomes.

Background: Many children experience serious symptoms when they are diagnosed with and treated for cancer. Through appropriate parent-child communication, parents were able to identify children's physical and psychological problems, adjust their behavior, and help them cope with the disease.

Objective: This study aimed to systematically search for and integrate evidence from qualitative studies on communication between parents and children with nonterminal cancer from parents' perspectives.

Methods: A thorough systematic review and metasynthesis of qualitative studies were conducted. Articles were searched from PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, and PsycArticles from the database inception to November 6, 2022. After screening and quality appraisal, 14 articles were finally included in the metasynthesis.

Results: Three themes and 11 subthemes were identified: (1) communication content, including diagnosis, treatment, health management, health risk, and emotion; (2) factors influencing communication, including ages of children, parents' experience of communication, parents' awareness of protection, and culture; and (3) children's responses, including acceptance and resistance.

Conclusions: This systematic review found that parents were influenced by various factors during the decision-making process of parent-child communication about childhood cancer and its related issues. Parents tended to adjust their communication content and style to protect their children.

Implications for practice: Future research should be conducted to explore children's experiences of communicating with their parents and analyze the similarities and differences between the communication needs of parents and children. Healthcare professionals should provide professional communication guidance to facilitate the parent-child relationship and improve the mental health of both children and their parents.

Background: In Western countries, factors contributing to breast cancer presentation delay have been identified, but little is known about presentation delay in China, where culture and healthcare systems are quite different.

Objective: To describe the delay interval among newly diagnosed breast cancer patients in China and to identify factors influencing delay, including the COVID-19 pandemic.

Methods: Using a cross-sectional design, we recruited 154 participants within 3 months of pathological diagnosis of breast cancer. Data were collected using standardized scales and open-ended questions.

Results: We found 44.8% of participants delayed ≥1 month, and 24.7% delayed ≥3 months before presentation, after self-discovery of symptoms. Logistic regression analysis showed that factors associated with longer delay (≥1 month) included preferring female physicians for breast examination, fewer negative emotions (afraid, anxious, distressed) regarding breast symptoms, more competing priorities, believing folk therapy can help treat lumps, and visiting a secondary or tertiary hospital instead of primary healthcare providers (P < .05 for all). Interaction tests showed perceived seriousness of symptoms significantly predicted delay of ≥1 month only when perceived healthcare access or trust in physicians was low. Patients (14%) reported delaying due to fear of COVID-19 infection and inability to leave home.

Conclusions: Presentation delays were substantial and multilevel barriers to timely presentation were identified, which would be expected to contribute to later-stage cancer at diagnosis.

Implications for practice: Findings suggest that nursing interventions and improved health policies are urgently needed in China, including breast cancer education to increase awareness.

Background: With the increasing survival rates of childhood cancer, nurses' familiarity with published evidence has become crucial to care for this population and their families throughout the survival process.

Objective: To systematically identify and conduct a bibliometric analysis of nursing-related evidence concerning extended and long-term survival of childhood survivors.

Methods: A scoping review was conducted using bibliometric analysis with searches performed in the PubMed, CINAHL, SCOPUS, and Web of Science databases. A total of 300 studies on childhood cancer survival within the nursing field were included.

Results: The first study on this topic was published in 1975. American and Chinese researchers lead study publications, primarily publishing in nursing journals such as Cancer Nursing. Quantitative designs were prevalent, and the majority of the studies focused on physical late effects, overall quality of life, and survivor follow-up care.

Conclusions: This study has allowed us to map and synthesize the bibliometric evidence pertaining to the extended and long-term survivorship of childhood cancer survivors in the nursing field. Consequently, it identifies gaps in knowledge, research trends, and areas necessitating further exploration.

Implications for practice: The evidence presented in this review can facilitate academic and clinical discussions, offering a comprehensive synthesis of the published knowledge. More research needs to be developed on the topic, particularly in Central and Latin America, Africa, Southern and Eastern Europe, and in some regions of Asia. Furthermore, the scope of studies should extend beyond late effects and quality of life, encompassing the experience of surviving childhood cancer, including psychosocial and spiritual dimensions.

Background: In the era of evolving and emerging therapies, adolescents and young adults (AYAs) living with advanced cancer experience a high degree of uncertainty, making palliative care and end-of-life (PCEOL) discussions difficult. Clinical conversations determine values/preferences that guide shared decision-making and goals of treatment, including end-of-life care when cancer progresses. Initiating PCEOL conversations is challenging for clinicians.

Objective: This study describes the development and validation of an instrument that measures AYA readiness to engage in PCEOL clinical conversations.

Methods: A Ready-to-Talk Measure (R-T-M) was developed, guided by the revised conceptual model of readiness across 3 domains (awareness, acceptance, and willingness). Content experts evaluated validity, and 13 AYAs with advanced cancer participated in cognitive interviews. Acceptability (item applicability, clarity, interpretation, sensitivity, missingness) and experiences (benefit, burden) were analyzed.

Results: The scale content validity index was ≥0.90 for each domain. Forty-two of the 55 R-T-M items were acceptable without any change. Three items were deleted. Ten items were modified, and 3 were added. Adolescents and young adults wanted more items about friends/siblings and about AYA unique qualities for clinicians to know them better. Adolescents and young adults acknowledged benefit through talking about difficult, relevant topics.

Conclusion: Ready-to-Talk Measure validity was strengthened by deleting or modifying unclear or misinterpreted items and by adding items. Next steps include psychometric analysis to determine reliability/dimensionality and stakeholder input to make the R-T-M a clinically useful tool.

Implications for practice: Ready-to-Talk Measure assessment of readiness to engage in PCEOL conversations while identifying unique preferences of AYAs holds promise for facilitating ongoing discussions.