Seminars in Oncology Nursing最新文献

Objective: The aim of this study was to investigate the effect of cold therapy on the prevention of chemotherapy-induced peripheral neuropathy in oncology patients.

Methods: This review was prepared based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The Medline, CINAHL, Embase, Cochrane Library, PubMed, Scopus and Web of Science databases were searched for studies published between January 1997 and June 2024. Two reviewers independently evaluated study suitability and extracted data. The Jadad critical appraisal scale and Methodological Index for Non-Randomized Studies (MINORS) risk of bias tool was used for quality assessment. The findings of this review are presented using a narrative synthesis.

Results: Overall, cold therapy was effective in preventing CIPN in more than half of the studies. Cold therapy methods such as cold hilotherapy, frozen gloves and socks, cold mitts and slippers, and cooling gloves/socks were found to be the most effective in six studies. In contrast, three studies that applied interventions like frozen gloves and socks, crushed ice, and various cooling methods did not show a significant effect.

Conclusion: Cold therapy was found to be a reasonable option for preventing CIPN in patients receiving taxane-based chemotherapy, as it does not result in serious side effects. Due to the heterogeneity of studies with different methods, sample sizes and measurement procedures for CIPN, it is difficult to make a clear statement about the duration and temperature of cold application that the patient can tolerate.

Implications for nursing practice: Cold therapy can provide a useful option for the prevention of CIPN in patients receiving taxane-based chemotherapy. Nurses should increase patient and provider awareness of the benefits of cold therapy for CIPN.

Prospero registration id: CRD42024619942.

Objectives: This systematic review aimed to explore and synthesize existing research on the barriers and inequalities in access to comprehensive care for pediatric oncology patients.

Methods: The search was conducted in five databases, including PubMed, Scopus, Web of Science, CINAHL, and APA PsycINFO in December 2024. This review followed PRISMA guidelines and included studies published up to December 2024. Study quality was assessed using Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields.

Results: Thirteen articles in this systematic reviews identified key barriers to healthcare access, including inadequate infrastructure, workforce shortages, and financial constraints. Socioeconomic disparities, geographic inequities, and racial and ethnic inequalities further exacerbated these challenges. Lower family income was linked to worse outcomes, such as higher chronic graft-versus-host disease rates and late-stage cancer diagnoses. Cross-border residency, clinical trial underrepresentation, and insufficient clinician training also contributed to disparities. Proposed solutions included psychosocial screening, workforce development, financial toxicity mitigation, and policy reforms.

Conclusions: This review highlights the complex and multifaceted barriers affecting equitable access to comprehensive care for pediatric oncology patients. Using a multidimensional perspective, such as the National Institute on Minority Health and Health Disparities Research Framework, our findings suggest that disparities stem from interconnected social, economic, and systemic factors. Addressing these challenges requires a comprehensive, structural, and patient-centered approach to promote equitable healthcare access.

Implications for nursing practice: This review underlines the critical role of nursing advocacy, education, and interdisciplinary collaboration in promoting equitable care and addressing disparities within this vulnerable population.

Objectives: We evaluated the psychometric properties of the Turkish version of the Adaptive Coping with Disease Scale (ACDS) questionnaire for Turkish patients with cancer.

Methods: A total of 175 patients with cancer aged 18 to 65 years were referred to a university hospital in Ankara, Türkiye. The patients, selected by convenience sampling in 2024, completed the Descriptive Form and Turkish versions of the ACDS questionnaire. The construct validity of the scale was assessed through confirmatory factor analysis and exploratory factor analysis. Pearson's correlation analysis was conducted to evaluate the relationships between item-total scores and item-subscale total scores. The reliability of the scale was determined using Cronbach's alpha coefficient. In addition, the scale language validity and test-retest reliability were evaluated. The data were analyzed using the IBM SPSS Statistics and AMOS 25.

Results: The scale demonstrated high validity (content validity index = 0.97, interclass coefficient = 0.721, P < .001), indicating high stability and consistency of test scores over time. The comparative fit index confirmed the six-factor structure of the ACDS scale, excluding item 13. The Kaiser-Meyer-Olkin coefficient was 0.738, and Bartlett's test yielded a value of 2305.623 (P < .001). Fit indices indicated a good model fit (χ²/degrees of freedom = 1.98, root mean square error of approximation = 0.074, comparative fit index = 0.815). The scale exhibited acceptable internal consistency, with an overall Cronbach's alpha of 0.78. The total explained variance ratio was 57.14%.

Conclusions: The Turkish version of ACDS in patients with cancer is a reliable and valid questionnaire that can be used in clinics and research.

Implications for nursing practice: Nurses can use the ACDS to assess the level of disease-related stress experienced by patients with cancer. In addition, they can guide the patients to develop effective coping methods and a better quality of life.

Objective: End-of-life conversations could improve anxiety, depression, and quality of life of patients and their families. Most patients believe it is important to discuss prognosis with their healthcare professionals, however only a minority reports to do so. The aim of this study was to describe healthcare professionals' wishes regarding end-of-life if they were in hypothetical end-of-life condition.

Methods: In this descriptive-correlational study, 467 healthcare providers were selected using the census sampling method. Physicians, nurses, or nursing assistants who worked in the oncohematology, internal medicine, intermediate care, surgical areas, or hospices of three hospitals in the northwest of Italy were included. All participants were included if they agreed to participate in the study and signed a written informed consent. A modified version of the guide "Your Conversation Starter Kit," the ConVita Questionnaire, was used. A logistic regression to analyze possible associations between personal and professional characteristics and end-of-life wishes of healthcare professionals was performed.

Results: Of the 747 professionals who agreed to participate, 467 questionnaires were returned. Compared to physicians, nurses (OR = 2.551 [95% CI 1.306-4.982], P = .006) and nursing assistants (OR = 2.755 [95% CI 1.218-6.23], P = .015) were more likely to prefer receiving treatments regardless the discomfort these might cause. This was less likely to occur when professionals attended palliative care courses (OR = 0.655 [95% CI 0.431-0.997], P = .048). Professionals with longer working experience in the same unit were more likely to give more importance to the quality of life than to the amount of medical care (OR = 1.041 [95% CI 1.006-1.078], P = .022). Compared to physicians, nurses were more likely to worry about not receiving sufficient treatments (OR = 2.883 [95% CI 1.526-5.446], P = .001).

Conclusions: This study contributes to a better understanding of healthcare professionals' wishes if they were in the hypothetical condition of end of life. Healthcare professionals need support to gain insight into end-of-life issues.

Implication for nursing practice: By better understanding healthcare professionals' perspective on end of life, this study may help build the support they need to feel better equipped to address end-of-life conversations with patients and families. Palliative care courses may raise healthcare professionals' awareness toward a timely start of end-of-life conversations.

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.