Cancer Nursing最新文献

Background: Nursing care, encompassing the physical, psychospiritual, sociocultural, and environmental aspects of care, should ensure patients' comfort in both chemotherapy and transarterial chemoembolization (TACE) treatment.

Objective: The aim of this study was to examine the canonical correlations between perceived symptoms and interferences, barriers to symptom management, and comfort care in nurses caring for chemotherapy and TACE patients.

Methods: This cross-sectional study surveyed 259 nurses caring for patients undergoing chemotherapy (n = 109) and TACE (n = 150). Fisher exact test, t tests, χ2 tests, Pearson correlations, and canonical correlations were performed.

Results: In the chemotherapy nurse group, higher perceived symptoms ( R values = 0.74), higher perceived interference ( R values = 0.84), and higher barriers to pain management ( R values = 0.61) were associated with higher physical ( R values = 0.58) and psychological ( R values = 0.88) comfort care. In the TACE nurse group, the higher the perceived symptoms and perceived interference, the lower the perceived barriers to pain management, and lower barriers to nausea/vomiting management were associated with higher physical, psychological, sociocultural, and environmental care.

Conclusions: Nurses caring for TACE patients reported lower perceived symptom interference and comfort care, including physical, psychological, and environmental aspects, than those caring for chemotherapy patients. In addition, there was a canonical correlation among perceived symptoms, symptom interferences, barriers to pain management, and comfort care, including physical and psychological care of nurses caring for chemotherapy and TACE patients.

Implication for practice: Nurses caring for TACE patients need to provide physical, psychological, and environmental comfort care for their patients. Oncology nurses caring for chemotherapy and TACE patients should coordinate treatment for co-occurring symptom clusters to enhance comfort care.

Background: The nurse-patient relationship represents a valuable connection in cancer care. Largely studied within inpatient settings, the nature and influence of this central relationship in ambulatory settings remain relatively unexamined. The notable shift to ambulatory settings like infusion centers warrants examination of the nurse-patient relationship in this context.

Objective: The aim of this study was to develop a grounded theory of the nurse-patient relationship in ambulatory cancer infusion care.

Interventions/methods: Using grounded theory methodology, 11 nurses were interviewed using a semistructured interview guide. Data collection continued until data saturation occurred with the primary concepts.

Results: The grounded theory, entitled Seeking Common Ground, includes 6 primary concepts. The concepts "we are all human"; "we work in a busy, complex environment"; "we seek common ground with patients"; "we use connections to support meaningful encounters"; "we find meaning in the relationships created"; and "we are governed by the push and pull of time" abstract the nurse-patient relationship from the nurses' perspective, emphasizing fundamental human connections.

Conclusions: The grounded theory Seeking Common Ground depicts the profound connection that nurses form with their patients in the ambulatory infusion setting. Underscoring the value of the nurse-patient relationship as foundational to the nursing profession must be driven through practice, education, and policy.

Implications for practice: Consideration of educational aspects within nursing across all levels to influence clinical practice will remain key.

Background: Cancer is a significant public health concern in the healthcare landscape. Amidst this challenging journey, the levels of hope, spiritual well-being, and resilience in patients with cancer have emerged as pivotal factors influencing the healing process.

Objective: This study aimed to evaluate the relationship between hope and spiritual well-being in cancer patients and the mediating role of resilience in the relationship between hope and spiritual well-being levels.

Methods: This study is a descriptive, cross-sectional, correlational study. The study included 152 cancer patients undergoing treatment. A patient information form, the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-SP-12) Scale, the Dispositional Hope Scale, and the Brief Resilience Scale were used to collect study data.

Results: Positive and meaningful correlations were observed between the Dispositional Hope Scale and FACIT-SP-12, Brief Resilience Scale, and FACIT-SP-12 (r = 0.390, P < .05; r = 0.246, P < .05). Mediation analysis indicated that Brief Resilience Scale scores partially mediated the relationship between the Dispositional Hope Scale and FACIT-SP-12 Scale scores; the indirect effect of hope on spiritual well-being through resilience was 0.351 (P < .05).

Conclusion: The study has indicated a direct relationship between hope and spiritual well-being, and resilience partially mediated the relationship between hope and spiritual well-being.

Implications for practice: It is significant to provide psychosocial care to cancer patients to increase their resilience levels and to support their hope and spiritual well-being.

Background: Balance impairment in cancer survivors can be a consequence of chemotherapy-induced peripheral neuropathy (CIPN). Previous meta-analyses suggested that exercise significantly improved balance, but the results were only based on 3 and 4 primary studies.

Objectives: This meta-analysis examined the effects of exercise on balance in cancer survivors with CIPN and investigated the moderating effects of source, methods, interventions, and participant characteristics.

Methods: We searched 12 electronic databases and 5 websites without date restriction through December 18, 2023, for primary studies examining the effect of exercise to improve balance in cancer survivors with CIPN reported in English. We retrieved 12 studies that provided 14 comparisons (N = 576), coded them, assessed quality indicators, and evaluated effect sizes across studies.

Results: Using the random-effects model, the estimated summary effect (Hedges' g) of exercise on balance was 0.68 (Knapp-Hartung adjusted 95% confidence interval, 0.41-0.94; P = .0001) compared with comparison groups. Subgroup analysis revealed that blinded data collectors, intervention fidelity examination, and difference in exercise protocol significantly influenced effect size. Meta-regression analysis showed that session minutes was associated with higher effect sizes.

Conclusion: Exercise with balance training significantly improved balance in cancer survivors. Balance training should be integrated into the current exercise guidelines for cancer survivors with CIPN.

Implications for practice: Nurses should encourage cancer survivors to engage in exercise with balance training when undergoing chemotherapy. Physical function and barriers to exercise should be assessed before delivering exercise interventions. Exercises should be tailored according to individual performance.

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.