European Journal of Oncology Nursing最新文献

Purpose: Patients with ovarian cancer often experience significant psychological distress during postoperative chemotherapy, including anxiety and depression. Expressive writing of positive emotions has shown potential in improving psychological health and fostering post-traumatic growth (PTG) in cancer patients. However, its application to ovarian cancer patients undergoing chemotherapy remains under-explored.

Methods: A quasi-experimental study was conducted with 82 ovarian cancer patients undergoing postoperative chemotherapy at a tertiary hospital in Changchun, China. Patients were divided into an experimental group (n = 40) receiving expressive writing intervention and a control group (n = 42) receiving routine care. Outcomes were assessed using the Post-Traumatic Growth Inventory (PTGI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) at baseline and after a 6-week intervention.

Results: After the intervention, the experimental group exhibited significantly higher PTGI scores (mean ± SD: 73.43 ± 6.95) compared to the control group (63.19 ± 5.91, P < 0.001), with improvements observed across all five PTG dimensions (P < 0.05). The experimental group also showed a greater reduction in SAS (mean ± SD: 38.25 ± 4.31 vs. 45.12 ± 5.17, P < 0.001) and SDS scores (mean ± SD: 42.10 ± 3.86 vs. 48.75 ± 4.62, P < 0.001).

Conclusions: Expressive writing of positive emotions significantly enhances PTG and reduces anxiety and depression in ovarian cancer patients undergoing chemotherapy. This intervention offers a cost-effective and feasible approach for psychological support in clinical settings.

Purpose: Among all the types of cancer, breast cancer occurs most frequently in women. The diagnosis and treatments for this disease generate physical and emotional discomfort that affects the quality of life of both the woman and her intimate partners.

Aim: The aim was to establish the relationship between marital adjustment, depression and quality of life of both women with breast cancer and their intimate partners.

Methods: A cross-sectional study with 143 couples composed of women diagnosed with breast cancer and their respective intimate partners, living in Colombia and Italy, were evaluated about Sociodemographic characteristics, marital adjustment, depression, and quality of life. Measures of central tendency, correlational coefficients and both simple and multiple regression analysis were applied.

Results: Significant correlations were reported for the variable marital adjustment (t: 0.35; p < 0.001) and depression (t:0.49; p < 0.001) between women and their intimate partners in Colombia, while the variables depression (t: 0.77; p < 0.001) and quality of life (t: 0.50; p < 0.001) showed significant correlations between couples in Italy. Regarding the multiple regression model, it was found that the quality of life of the couples was not affected by the behavior observed in the variable depression and marital adjustment. However, when including the variable country of origin (Colombia and Italy), a significant effect on quality of life was observed (t = -2.126; p < 0.034).

Conclusions: The quality of life of the woman and her intimate partner was related to the country where they live, a variable that is related to the timeliness and quality of health services. This result invites all professionals who care for this group of women to offer the best possible care by optimizing the resources available.

Purpose: There is increased use of genomic testing in oncology care. Yet, individuals with hereditary cancer predisposition syndromes (CPS) experience challenges when navigating the lifelong CPS healthcare considerations. The purpose of this study is to describe the healthcare experiences of individuals living with CPS and their perceptions of genomic-informed nursing care.

Methods: Interpretive description (ID) was the qualitative approach used in this patient-oriented research study, conducted in partnership with two individuals with lived experience of CPS. Participants were recruited to participate in an interview using a variety of public and provider/patient network sampling sources. Inductive data analysis was guided by general steps for ID analysis as described by Sally Thorne.

Results: Thirty-seven individuals who self-reported a CPS participated in interviews between April and August 2023. Two primary themes were identified: 1), When genomic knowledge is power, and 2), Perceived acceptability of nursing roles in CPS care. Participants described genomic knowledge as a form of personal and family empowerment, but many reported that CPS-related knowledge is inaccessible in the healthcare system. This often resulted in healthcare experiences that were insufficient and fragmented. Although participants reported minimal nursing involvement in their CPS care, there was a consensus that enhanced nursing contributions could be beneficial. They particularly endorsed the potential value of a dedicated oncology genomic nursing role.

Conclusions: Findings highlight patient-endorsed opportunities for nurses at the generalized and specialized levels to contribute to improved cancer genomic care. Findings can be used to inform novel models of clinical care for individuals with CPS.

Purpose: To develop and pilot-test a novel training programme for nurses in acute care settings to improve their decision-making support skills, knowledge, attitudes, and confidence in conducting advance care planning (ACP).

Methods: A single-group repeated measures design was employed. This study was conducted in two phases. In Phase 1, a theory-driven and evidence-based ACP training programme for nurses was developed based on the results of a prior systematic review and qualitative interviews. In Phase 2, a pilot study was conducted to assess the feasibility and acceptability of the ACP training programme according to the Tickle-Degnen typology and to explore the programme's preliminary effects.

Results: Guided by the theory of planned behaviour and the experiential learning model, a multi-media experiential ACP training programme, the MEACP, was developed, comprising a 10-module mobile application and a 2-h, nurse-led skill-building workshop. The study had a high recruitment rate (91%), with 20 nurses consenting to participate in the MEACP. The nurses remained attentive and active during the workshop and were highly satisfied with the programme. The outcome evaluation results demonstrated preliminary positive effects of the MEACP in terms of improving the nurses' decision-making support skills, knowledge, attitudes, and confidence in conducting ACP.

Conclusions: The MEACP could feasibly be introduced in acute care settings and was found to be an acceptable educational intervention. This work contributes to nursing practice by providing information about the design of an innovative ACP training programme. Finding will highlight the importance of a paradigm shift regarding ACP in acute care settings.

Purpose: Hormone therapy (HT) is safe and effective in reducing breast cancer (BC) relapse rates and increasing disease-free periods. However, its various adverse physical and psychological effects could affect women's quality of life. These could be improved through a multimodal programme including physical exercise and health education. There is limited evidence regarding the experience of HT and the impact such a programme might have among women with breast cancer.

Methods: This is a qualitative phenomenological study with a descriptive approach. Data were collected using face-to-face semi-structured interviews; the content analysis technique was applied. The study population were women diagnosed with localized BC under treatment with HT, who were participating in a multimodal physical exercise and health education programme as a supplementary oncological therapy.

Results: Fifteen interviews were conducted. Four main themes emerged: adverse effects of the HT, experience with professionals, support from family and friends with the HT and the programme, and the impact of the multimodal exercise programme as a therapeutic complement.

Conclusion: The participants identified physical and psychological adverse effects of HT. Most of them reported that when receiving usual care, they received reduced attention to their mental health, observed a lack of time in their appointments with professionals, and an absence of information about HT and the self-care it entails to maintain health. The multimodal programme was seen as a tool for improving their physical, emotional and social health, reducing the adverse effects of the adjuvant HT, a comprehensive source of information and a motivational boost for performing their self-care.

Purpose: This study aims to investigate return to work (RTW) status and identify its predictors in the early post-treatment period among nasopharyngeal carcinoma (NPC) survivors.

Methods: A prospective observational study was conducted. A convenience sample of 209 NPC survivors were recruited from a tertiary cancer center in Southern China between July 2021 and March 2022. The research instruments comprised the Readiness for Return to Work Scale, M.D. Anderson Symptom Inventory - Head and Neck, Work Motivation Scale, and demographic, disease-related, and work-related questionnaire. Return to work status and current job characteristics were assessed via telephone interview three months after completing treatment. Logistic regression analysis was conducted to determine the predictive factors.

Results: Approximately 31.1% of NPC survivors returned to work in the early post-treatment period. Logistic regression analysis showed that NPC survivors who were male, had one child, had higher family monthly income per capita, were in the stages of prepared for action-self-evaluation/prepared for action-behavior, and had stronger work motivation were more likely to return to work in the early post-treatment period.

Conclusions: The RTW is low among NPC survivors in the early post-treatment period. Factors predicting RTW are complex under Chinese culture context. Healthcare professionals should prioritize the early identification of survivors with low RTW intention and provide culturally sensitive interventions to enhance their work motivation and readiness. These efforts are crucial to supporting NPC survivors in achieving successful early RTW.

Purpose: Lymphoma survivors who have received curative intent treatment are currently followed up at defined time points in medical and nurse-led clinics often indefinitely. The follow up protocol is often at the discretion of the treating physician. The aim of the study was to explore the clinical, biochemical and radiological presentation of patients with Diffuse Large B-cell Lymphoma (DLBCL) and Hodgkin Lymphoma (HL) treated with curative intent at the point of recurrence from first remission, and to understand if recurrence was detected at scheduled follow up.

Methods: A cross-sectional study of patients with DLBCL & HL on surveillance was carried out. Statistical analysis was performed to describe the clinical, biochemical and radiological characteristics of patients with DLBCL and HL at recurrence and to estimate the time to reoccurrence using the Kaplan-Meier estimator.

Results: There was a substantial number of patients with DLBCL & HL treated with curative intent on surveillance programmes (N = 226). Small numbers of this patient group relapsed (13%) with most of these occurring within 5 years of achieving remission (73%). In all cases relapse was detected at an unscheduled appointment, most often initiated by a patient reported symptom (97%).

Conclusion: The evidence for a benefit of routine follow-up, particularly beyond 5 years, for detecting relapse is unsupported. However, the multiple survivorship benefits of routine follow-up visits must also be considered. A personalised follow up Lymphoma pathway with direct access, provision of an end of treatment care plan, and signposting to survivorship services is recommended.

Purpose: This study aimed to examine the effectiveness of art-based interventions on anxiety, depression, fatigue, and overall quality of life (QoL), including its physical, psychological, and social dimensions in cancer patients.

Methods: The literature search included all studies published up to March 2024. Searches were conducted in the MEDLINE, Web of Science, EBSCO, and PubMed databases considering the updated Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The quality of the studies was assessed using the Revised Cochrane Risk of Bias Tool (RoB 2) and the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) developed by the Cochrane Collaboration. Data were analysed using the MAJOR package in JAMOVI 2.3.28.

Results: Fifteen studies conducted with 1113 cancer patients were identified and included in this study. Ten of the studies included women with breast cancer. The remaining studies involved chemotherapy patients with various cancers (n = 3), cancer patients in a blood and marrow transplantation unit (n = 1), and nasopharyngeal cancer patients (n = 1). Meta-analysis indicated that art-based interventions had a significant effect on anxiety, depression and physical aspects of QoL but no significant impact on fatigue, overall QoL, or the psychological and social dimensions of QoL.

Conclusions: This study provided clinical support for pursuing art-based research on anxiety, depression, and the physical QoL in cancer patients. However, the effect of art-based interventions on cancer patients' fatigue and their overall QoL, including its social and psychological dimensions, was insignificant.

Registration: The study protocol was registered in advance in the PROSPERO (CRD42024531397/April 13, 2024).

Purpose: Psychosomatic symptoms are frequently observed side effects in breast cancer (BC) patients and significantly influence cognitive function. However, limited research has addressed the role of psychosomatic symptoms in the relationship between physical activity and cognitive function. This study aimed to examine the mediating effect of psychosomatic symptoms on the relationship between physical activity and cognitive function in BC patients.

Methods: A cross-sectional study was conducted across 10 hospitals in China from April 2022 to February 2023. Cognitive function was assessed using the Functional Assessment of Cancer Therapy-Cognitive Function scale. Exercise frequency, sleep quality, fatigue, anxiety, and depression were measured using the Pittsburgh Sleep Quality Index questionnaire, Cancer Fatigue Scale, Generalized Anxiety Disorder Questionnaire-7, and Patient Health Questionnaire-9, respectively, among 741 BC patients. Correlation analysis and path analysis were performed to explore associations between variables.

Results: The prevalence of cognitive impairment in BC patients was found to be 9.58%. The path model demonstrated the best fit when age was included as a moderating variable, and the association between age and sleep disorders was controlled. Physical activity showed a negative correlation with both psychosomatic symptoms and cognitive impairment (p < 0.05). It exerted a direct impact on cognitive impairment (20.3%, p < 0.001) and an indirect impact mediated through anxiety and depression (6.3%, p < 0.001). The total effect in the model was 38.6% (p < 0.001).

Conclusion: Physical activity has a pivotal role in improving cognitive function in BC patients, both through direct mechanisms and indirectly by reducing anxiety and depression. While enhancements in sleep quality and fatigue levels were observed, their influence on cognitive function did not reach statistical significance, indicating the need for further research. These findings underscore the importance of incorporating psychological symptom management into supportive care plans to aid cognitive recovery. A combination of physical activity and psychological interventions could provide synergistic benefits, potentially boosting cognitive improvement and enhancing the overall quality of life in BC patients.

Purpose: To explore the symptom cluster management process from the perspective of patients with lung cancer within the oncological care context.

Methods: We used a constructivist grounded theory methodology to collect and analyze rich data from 15 patients with lung cancer via individual interviews and a two-dimensional symptom assessment scale.

Results: A situational theoretical model describes the symptom cluster management process through the main category 'To get through to survive', with the category 'Handling symptom clusters' together with six sub-categories concerning the patients' management strategies and the category 'Living with symptom clusters,' together with two sub-categories describing the outcome in their daily life. Impacting conditions are incorporated in the model.

Conclusions: Patients often feel left to their own devices to deal with symptom clusters and may not understand or foresee problematic circumstances as they manage their situations on a day-to-day basis. When symptoms are normalized and accepted, patients do not ask for support, or support is not being offered to them. Healthcare professionals should consider the peril of normalizing symptoms and the patients' altered time perspective that stems from their approach of living one day at a time, in further development of nursing interventions and person-centered care for this population.