European Journal of Oncology Nursing最新文献

Purpose: This study aimed to identify the potential subgroups of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients undergoing taxane-based chemotherapy and examine the association of the latent subtype with patient characteristics.

Methods: This multi-center, cross-sectional investigation was conducted between April 2022 and March 2023. CIPN was evaluated using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity scale. Latent class analysis was employed to identify distinct CIPN subgroups, and multinomial logistic regression was used to analyze the associations between these subgroups and patient characteristics.

Results: In total, 397 individuals were categorized into three subgroups: high symptoms with high dysfunction (Class 1; 25.4%), moderate symptoms with low dysfunction (Class 2; 39.2%), and low symptoms with low dysfunction (Class 3; 35.3%). Taxane type, chemotherapy cycles, fatigue, β-blocker use, and depression were significant predictors of the subgroups (P < .05).

Conclusion: CIPN symptoms in breast cancer patients are heterogeneous. Significant factors for the latent subgroups included taxane type, chemotherapy cycles, β-blocker use, fatigue, and depression. Identifying different subgroups of chemotherapy-induced peripheral neuropathy would help develop interventions tailored to the patients.

Purpose: In decisions relating to cancer treatment, the risks and benefits of treatment and the patient's preferences must be considered to ensure concordance with goals of care. Shared decision making (SDM) can facilitate these discussions and is associated with reduced decision conflict. This study aimed to characterise decision making for advanced cancer patients at a UK tertiary cancer centre and identify who may be at risk of suboptimal SDM and increased decision conflict.

Methods: Participants completed the SDM-Q-9, decision conflict and decision self-efficacy scale following a consultation where an advanced cancer treatment decision was made. Pearson's chi-square test identified patient characteristics associated with SDM-Q-9, decision self-efficacy and decision conflict score categories; odds ratios were calculated to determine which patients were at increased probability of experiencing suboptimal SDM, low decision self-efficacy or high decision conflict.

Results: Participant's (n = 211) scores indicated predominantly high SDM, high decision self-efficacy and low decision conflict. Patient gender and the presence of an informal caregiver in consultation were significantly associated with SDM-Q-9 score category (p > 0.05). Female patients (OR = 2.466, 95% CI: 1.223-4.974) and those attending consultations alone (OR = 0.440, 95% CI: 0.222-0.874) had greater odds of reporting lower SDM scores.

Conclusion: High SDM scores indicate either effective SDM behaviours or satisfaction with care biasing responses. Greater support to engage with SDM is required for female patients and those who attend alone in advanced cancer treatment decision consultations.

Purpose: To investigate the impacts of psychoeducational interventions in adjusting the physical and psychological statuses of caregivers of CRC patients.

Methods: Nine electronic databases, including Medline, Web of Science, Embase, Cochrane Library, CINAHL Complete, CNKI, Wan Fang Database, VIP Database, and CBM, were searched to identify eligible randomized controlled trials from January 2000 to July 2023. From 1498 articles, 9 articles that met the inclusion criteria were identified and systematically analyzed. Effect sizes and moderator variables were tested using both fixed-effect models and random-effect models.

Results: Our results clearly showed that although psychoeducational interventions could improve all aspects of the physical health of caregivers of CRC patients, resulting in improved quality of life, reduced caregiver burden, and enhanced caregiver ability, they only partly affect the psychological conditions of caregivers. For example, while it led to improved positive coping, alleviated negative coping, and decreased disruption in the caring schedule, there were quite a few key aspects of the psychological status that did not show responses, including perception of family support, financial burden, self-esteem, and distress.

Conclusion: Psychoeducational interventions can significantly improve the status of caregivers of CRC both physically and psychologically and encourage active lifestyles. However, there are still outstanding problems to be solved in the psychological aspects of caregivers, such as how to improve their social support, and how to relieve their financial pressure. Even so, we firmly believe developing a standardized psychoeducational intervention mode is of great significance in improving the general well-being of caregivers of CRC patients.

Systematic review registration: PROSPERO (http://www.crd.york.ac.uk/PROSPERO), number CRD42023484775.

Purpose: To identify Missed Nursing Care (MNC) and related factors, as well as analyze the influence of nurses' decision-making and personality traits on MNC in two Portuguese hospitals dedicated to cancer care.

Methods: A cross-sectional, multicentric, descriptive-correlational study was conducted using a convenience sample of 298 nurses working in two hospitals dedicated to cancer care. Data were collected in the first semester of 2023 using a questionnaire that included sociodemographic and professional questions and the Portuguese versions of the MISSCARE Survey, the Nursing Decision-Making Instrument (NDMI-PT), and the Ten-Item Personality Inventory (TIPI-P).

Results: Nurses missed care occasionally, namely in the dimensions related to Patient empowerment/autonomy care and Efficacy of feeding and medication. Staffing, Patient volume and acuity, and Management and organization were moderate to significant reasons for MNC. The flexible decision-making style was predominant (81.5%). The most prevalent personality traits were Conscientiousness, Agreeableness, and Openness to experience. Significant correlations were found between the four stages of the decision-making process and the personality traits and several dimensions of MNC. Data collection to assess a patient's condition was negatively correlated with Team communication and Material resources. Similarly, the Emotional stability trait was negatively correlated with Team communication and Patient volume and acuity.

Conclusions: This study identified MNC and factors that can influence the quality of care. It is crucial to promote nurses' training and specialization within healthcare teams, with a particular focus on enhancing some of their personality traits to make them more effective and efficient therapeutic agents.

Purpose: Cancer patients with pre-existing severe mental disorders (SMD), including moderate to severe depression, bipolar disorder and schizophrenia, have reduced life expectancy and are less likely to receive optimal cancer treatment. The aim of this study is to develop and pilot test a supportive care model, to enhance cancer care in this population.

Methods: The model was developed through three phases. In phase I, a barrier analysis and prototype of the model were conducted from reviewing the literature and through 162 informal interviews with healthcare professionals, patients and patient representatives. In phase II, the prototype was refined through four workshops with a total of five cancer nurses, four clinical oncologists, three psychiatrists, two general practitioners, one psychologist, and 16 patient representatives. Thereafter, a pilot test with 13 patients was carried out, where continuous adaptations to the prototype from phase II, were made. The quantitative and qualitative data were analysed focusing on components which were prominent and able to fit into the clinical setting.

Results: The final CASEMED supportive cancer care model included: Early identification of psychiatric comorbidity, engagement of significant caregivers, education of the oncological HCPs, securing continuity among staff and enhanced collaboration between sectors. The latter was achieved through an online psychiatric multidisciplinary team conference where the patient's general practitioner, a psychiatrist and the patient's oncologist participated.

Conclusion: This study indicates that the model can be implemented in practice and has the potential to optimize cancer care for patients with cancer and pre-existing SMD. A larger feasibility study is currently being conducted.

Purpose: This study aimed to assess the feasibility and acceptability of a couple-based self-efficacy (SE) intervention, and to examine the effects of the intervention on health outcomes for CRC couples.

Methods: An assessor-blinded, two-armed, randomized controlled design was used. The study randomly assigned 144 patients hospitalized for colorectal cancer to receive either the SE intervention or the usual care. SE was the primary outcome. The secondary outcomes included quality of life and mental health (positive emotions and negative emotions). Repeated measures analysis of variance was used to examine the data.

Results: The recruitment and retention rates were 80% and 87.5%, respectively. First, we found that patients scored significantly higher on anxiety (p = 0.001), depression (p = 0.001) and benefit findings (p = 0.009) than did spousal caregivers, whereas spousal caregivers scored significantly higher than patients on the quality of life (p < 0.001 for both physical scores and mental scores) in the SE group. Second, immediately after the intervention, the SE group showed statistically significant improvements were found in SE (p < 0.001 for both couples), quality of life (mental scores) (p = 0.002 for spousal caregivers), negative emotion (anxiety, p < 0.05 for both couples; depression, p = 0.03 for patients), and positive emotion (benefit findings) (p < 0.001 for both couple) when compared to the control group.

Conclusion: A couple-based SE intervention significantly improved SE, quality of life (mental scores), and psychological well-being, suggesting a short-term intervention effect.