Seminars in Oncology Nursing最新文献

Objectives: The development and use of novel systemic anticancer therapy (SACT) treatments are advancing rapidly. While cytotoxic drugs have traditionally been the cornerstone of treatment, they are increasingly used alongside novel agents. This study aims to assess factors affecting adherence to safe-handling precautions, enhance safety protocols, and minimize potential occupational exposure to hazards in clinical environments, increasing their capacity for novel treatments.

Methods: Cross-sectional, online survey of oncology nurses across the UK who handled SACT. Participants were asked to complete the Factors Predicting Use of Hazardous Drug Safe-Handling Precautions Questionnaire. Descriptive analysis, Spearman rank correlation coefficients, and regression analysis were performed to determine the predictors of precautionary use when handling HDs.

Findings: Analysis of (n = 675) participants revealed high knowledge of exposure, high self-efficacy, low perceived barriers, moderate perceived risks, high interpersonal influence, low conflict of interest and moderate safety climate in the workplace. The analysis of the data also indicated weak positive correlations between age and knowledge (rs = 0.093), self-efficacy (rs = 0.103) and safe-handling scores (rs = 0.082); the age of the participants has a weak negative correlation to perceived barriers (rs = -0.141), conflict of interest (rs = -0.116), and workplace safety climate(rs = -0.116). Notably, safe handling scores showed no significant correlation with other theoretical predictors. Comparison between government and private sector nurses (n = 76) demonstrated higher patient volumes F (15.807, 74), P < .001 and significantly lower safe handling scores in the government settings F (4.135, 74) P < .05.

Conclusions: Nurse-patient ratios between government and private sector settings predict global safe-handling precautions.

Implications for practice: Novel treatments for nurse-patient ratios are essential, as new therapies and schedules further create additional workload pressures that may reduce safe handling practices.

Objectives: The purpose of this study was to ascertain whether sleep quality is altered in patients with prostate cancer (PCa) during androgen deprivation therapy (ADT) and whether sleep impairment associates with depressive symptoms, cognitive function or frailty syndrome, and if this varies between patients with localized or metastatic disease. The pro-inflammatory cytokine, IL-1β is involved in sleep regulation, we assessed whether sleep quality, depressive symptoms, cognitive function or frailty syndrome are associated with IL-1β concentration.

Methods: Sleep quality was assessed using the Athens Insomnia Scale (AIS), depressive symptoms using the Yesavage Scale (GDS), and cognitive functions using the MiniMental State Exam (MMSE) and the level of frailty was measured based on the Fried criteria. Plasma IL-1β was measured by enzyme-linked immunoassay. Linear regression lanalyses were performed to determine which variables predict plasma IL-1β is involved in poor sleep quality and higher IL-1β concentration.

Results: A cross-sectional study was carried out between 2021 and 2023. Sixty-seven men with PCa (N=36 (53.7%) with localized disease and N=31 (46.3%) with metastatic disease) were enrolled in the study. Plasma IL-1β concentration correlated with poorer sleep quality in all sample and, men with metastatic PCa had poorer sleep quality compared to men with localized disease. Analysis of self-reported sleep quality revealed that half of them had insomnia symptoms and 19.4% reported clinically relevant insomnia disorder (mean value of AIS 3.39±0.44). Poor sleep quality significantly predicted the concentration of IL-1β in plasma. In contrast, a better cognitive function significantly (P = .037) predicted IL-1β concentration. Detailed analysis of AIS items showed that score in the item "Sleep induction" and "Sleepiness during the da) significantly predicted IL-1β concentrations (P = .001 and P0=.044, respectively).

Conclusions: Plasma IL-1β levels may be useful to address the presence of insomnia in patients with PCa who are receiving ADT and to monitor the effect of interventions to improve sleep problems in these patients.

Implications for nursing practice: Nurses will play a critical role in educating patients about their risk for specific symptoms based on an evaluation of specific biomarkers such as IL-1β and sleep quality. Nurses will be involved in using biomarker data to titrate medications and to evaluate the effect of nonpharmacological interventions to improve sleep quality in patients with PCa.

Objectives: To discuss the importance of educating healthcare professionals about oncological emergencies linked to novel systemic anticancer therapy (SACT) and the impact on acute oncology (AO) services.

Methods: This discussion is based on clinical expertise and informed by current literature.

Results: Novel SACT, such as immune-checkpoint inhibitors, have more complex toxicity profiles and can be challenging to recognize and treat. An increasing prevalence of toxicity is expected as new drugs are developed and the numbers of patients living with and beyond cancer expand; more data are required to capture the full extent of this. There are knowledge gaps within the healthcare workforce, particularly outside oncology-specialist settings. Focused research in this area will provide direction for targeted educational interventions.

Conclusions: Insufficient SACT education is a safety issue; severe toxicities can be fatal but initial symptoms can be subtle and may be missed. We argue that emergency care pathways can help to streamline the appropriate management of patients with SACT toxicity, but awareness of AO issues remains "everyone's business." Continuing clinical education is key to maintaining awareness of newly developed SACT. AO service models may vary, but AO competence assessment passports can provide a standardized method of evidencing AO knowledge and skills.

Implications for nursing practice: Oncology nurses, as a highly specialized and knowledgeable part of the healthcare workforce, are key in supporting interprofessional education. By using existing cancer nursing frameworks, this can support the implementation of the AO Passports. The learning and development of AO services in the UK can be transferred internationally.

Objective: This paper aims to explore the impact of checkpoint inhibitors, a novel cancer therapy, on cancer nursing, including aspects of education, research, and practical application.

Methods: Our discussion is grounded in clinical expertise and supported by relevant literature from peer-reviewed journals.

Results: This focused discussion on the nursing implications of immune checkpoint inhibitors as a novel cancer therapy highlights a significant transformation in cancer nursing practice. There is a pressing need to enhance the skills of the cancer nursing workforce and expand their knowledge regarding the mechanisms of action of immunotherapies, their toxicity profiles, including late effects, potential drug interactions, principles of administration, and the assessment and management of immune-related adverse reactions. The introduction of immunotherapy necessitates not only a collaborative multidisciplinary approach but also a multispecialty strategy due to the diverse nature of immune-related side effects affecting various body systems. The complexity of managing toxicities associated with immunotherapy, particularly when used in conjunction with other treatment modalities, imposes additional costs and strains on existing healthcare services. Some organizations, depending on their healthcare models, encounter challenges when these additional services are not appropriately funded.

Conclusion: In the case of immunotherapy as a novel cancer treatment, there are clear benefits to patients in terms of survival, but this has come with safety issues for patients and staff. The nursing workforce is key to safety around immunotherapy with regard to the safe delivery of treatment and the management of toxicity. This cannot be achieved without the education of the nursing workforce and underpinning research.

Aims: The intense emotional nature of cancer care makes it crucial for oncology nurses to effectively regulate their emotions, as this impacts their mental health, quality of care, empathy challenges, burnout, and workforce retention. The aim of this study is to determine oncology nurses' experiences with emotion regulation during patient care and how these experiences affect their well-being and the quality of patient care.

Methods: This descriptive qualitative study used a sample of 28 oncology nurses from various units, collected data through in-depth semistructured interviews, and analyzed it using content analysis.

Results: Emotion regulation challenges encompass situations related to perspective and skills, patient-related conditions, and work-related issues. Emotional responses differ between the first and later years in the profession. Methods used include avoidance, alleviating the emotional burden, and cognitive restructuring, while needs involve gaining awareness and skills to regulate emotions and improving working conditions.

Conclusions: This study provides insight into how oncology nurses regulate their emotions during patient care and discusses the positive and negative effects of the emotion regulation strategies used on their mental health. Nursing professionals who struggle with emotion regulation during their early years in the profession describe experiencing burnout and compassion fatigue in the later stages of their careers. Beginning nurses are inexperienced with challenging emotions. They should be trained to regulate their emotions.

Implications for practice: Oncology nurses struggle with regulating their emotions during patient care, which leads to mental health issues and burnout over time. Therefore, it is important to develop effective emotion regulation skills. The research findings can contribute to planning emotion regulation training for oncology nurses and help managers pay attention to working conditions.

Objectives: Anxiety and depression are common symptoms in oncology patients undergoing chemotherapy. Study purpose was to evaluate for differences in severity of common symptoms (ie, fatigue, energy, sleep disturbance, cognitive function, pain) and quality of life (QOL) outcomes among three subgroups of oncology outpatients with distinct joint anxiety and depression profiles.

Methods: Oncology outpatients (N = 1328) completed measures of state anxiety and depression, six times over two cycles of chemotherapy. Latent profile analysis was done to identify subgroups of patients with distinct joint state anxiety AND depression profiles. Patients completed measures of trait anxiety, morning and evening fatigue, morning and evening energy, sleep disturbance, cognitive function, and pain, as well as generic and disease-specific measures of QOL at enrollment. Differences among the classes in symptom severity scores and QOL scores were evaluated using parametric and non-parametric tests.

Results: Three distinct joint anxiety AND depression profiles were identified and named: Low Anxiety and Low Depression (57.5%, Both Low), Moderate Anxiety and Moderate Depression (33.7%, Both Moderate), and High Anxiety and High Depression (8.8%, Both High). All of the symptom severity scores showed a "dose-response effect" (ie, as the joint anxiety AND depression profiles worsened, the severity of all of the symptoms increased). Likewise, for both the general and disease-specific QOL (except spiritual well-being) measures, all of the scores decreased as the joint anxiety AND depression profiles worsened. Compared to the Both Low classes, the other two classes reported lower scores for the spiritual well-being domain.

Conclusions: More than 40% of patients receiving chemotherapy experience moderate to high levels of both anxiety AND depression. These patients report an extremely high symptom burden and significant decrements in all domains of QOL.

Implications for nursing practice: Clinicians need to perform comprehensive assessments of depression and anxiety and other common symptoms and QOL outcomes during chemotherapy. In addition, referrals for targeted interventions are needed to manage multiple symptoms and improve patients' QOL.

Objectives: Adoptive cell therapy using tumor-infiltrating lymphocyte (TIL) therapy has demonstrated promising results in clinical trials. Recognizing the growing potential of cell therapies for solid tumors, oncology services need to prepare for an increasing number of trials and, in the near future, optimize patient access to TIL. Consultation with clinical trials professionals in England, however, highlighted low organizational readiness and significant knowledge gaps for use of adoptive cell therapy. The aim of this discussion paper is to provide guidance about the role of the nurse in the delivery of TIL therapy.

Methods: Guidance was written based on peer-reviewed literature and best practice guidelines between 2006 and 2024 identified through electronic database searches on PubMed, CINAHL, and MEDLINE and expert experience of managing patients in clinical trials who are receiving TIL.

Results: TIL therapy is set to transform current care pathways with treatments that can potentially induce long-lasting tumor responses. There are, however, numerous challenges for successful and safe implementation of TIL therapy in practice. Nurses have a central role in coordinating the safe delivery and patient care of patients receiving TIL therapy. Nurses need knowledge and understanding about the regulatory processes and extensive treatment pathways involved whilst also managing novel side effects and patient expectations.

Conclusions: TIL therapy requires a specialist team to safely deliver these complex treatments and support colleagues nursing patients receiving TIL therapy. Specialist knowledge and skills and close coordination is required to ensure a smooth process from patient referral, product ordering, manufacturing, storage, and administration of the treatment to the patient.

Implications for nursing practice: Organizations planning to initiate TIL therapy should review their infrastructure, identify and address specialist knowledge and skills needs of oncology professionals, and seek guidance and support from expert teams. There needs to be a robust governance structure in place and ensure all healthcare professionals involved are trained and educated on a high level on how to care for these patients.

Objectives: To review the recent literature around the role of patient-centric prehabilitation for oncology patients undergoing complex systemic anticancer therapy (SACT) and the nurse's role in this area.

Method: A narrative review of recent peer-reviewed literature, national guidance, and government strategy for prehabilitation in oncology patients undergoing complex SACT.

Results/conclusion: Prehabilitation interventions in people receiving complex SACT are feasible and benefit patient outcomes. These results must still be viewed with caution; however, as of now, there are only small-scale studies in this area, although larger-scale studies are now being done. The role of the nurse is key here (as part of the interdisciplinary team) through the establishment of the therapeutic relationship underpinning patient screening, assessment, intervention implementation, and patient reassessment, ensuring care is dynamic, consistent, and tailored to patient needs.

Implications for nursing practice: The review has discussed the beneficial patient outcomes from prehabilitation in patients receiving complex SACT, but more research is warranted in the form of larger multisite trials to increase the validity of the prehabilitation interventions. The review advocates for the role of the nurse in the provision of prehabilitation in SACT oncology patients through the provision of personalized patient care.

Objectives: To investigate the evidence concerning the psychosocial functions among young adults (18-29 years) with a sibling diagnosed with cancer and the psychosocial interventions developed for this group.

Methods: Utilising the Joanna Briggs Institute's guidelines for scoping reviews, a comprehensive search across five databases, including PubMed, Scopus, CINAHL, PsycInfo, and the Cochrane Library, was conducted. A chain search and a search for grey literature in Google Scholar complemented the search.

Results: A total of 1937 titles and abstracts were screened, with 250 full-text articles read for inclusion. Seven studies met the inclusion criteria consisting of qualitative (n = 2), quantitative (n = 3), and mixed method (n = 2). Two of these described interventions; a family-centred intervention and a person-centred intervention specifically targeted at siblings. Through data analysis of the results from the seven studies, three themes emerged: (1) the sibling's inner struggle: coping strategies, emotional suppression, and ambivalent feelings; (2) informed understanding: the vital role of communication; and (3) seeking support: addressing social estrangement and strengthening familial bonds.

Conclusion: This scoping review highlights the profound emotional and psychosocial difficulties faced by young adult siblings when a sibling's cancer affects family dynamics. It summarizes findings from studies employing qualitative, quantitative, and mixed-methods methodologies. The interventions used were successful; however, the limited number of these interventions emphasizes the need for further research. This research is essential to develop strong support networks and communication strategies to help young adults aged 18 to 29 manage their complex emotional responses and family roles effectively.

Implication for nursing practice: To support young adults with a sibling diagnosed with cancer, a family-centered approach is essential for assessing their individual support needs. Developing interventions targeting young adult siblings and enhancing family communication may benefit both the siblings and the family as a whole.