Seminars in Oncology Nursing最新文献_第2页

The Relationship Between Perceived Comfort Level with Moral Sensitivity and Moral Distress Among Oncology Nurses: A Descriptive Correlational Study 肿瘤科护士对道德敏感性的舒适度与道德压力之间的关系：描述性相关研究

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151742

Samira Beiranvand , Kourosh Zarea , Shahram Molavynejad , Simin Madhooshi , Parisa Sheini Jaberi

Objective

This study aimed to investigate the relationship between perceived comfort level with moral distress and moral sensitivity among oncology nurses

Methods

This is a descriptive-correlational study on 210 oncology nurses. The samples were selected through the convenience method from September 2020 to February 2022 in the oncology centers of Ahvaz, Iran. Data were collected via a demographic form, Lutzen's Modified Moral Sensitivity Questionnaire, Corley's Moral Distress Scale, and Kolcaba's Nurses Comfort Questionnaire (NCQ). Data were analyzed using SPSS V24, descriptive statistics, Independent t, Mann-Whitney-U, Kruskal-Wallis, Pearson's correlation coefficient, ANOVA, and linear regression tests.

Results

Nurses experienced a moderate level of perceived comfort (67.91 ± 8.75), moral sensitivity (58.4 ± 13.3), and moral distress (57.54.8 ± 8.9). Moral sensitivity was significantly inversely related to the intensity of moral distress (P < .001). A statistically significant relationship was found between nurses' perceived comfort level with frequency of distress (P < .001) and moral sensitivity (P = .046). Moral distress explained 13.8% of changes in perceived comfort level (R2 = 0.138, F = 6.51, sig < 0.001, R = 0.371).

Conclusion

Nurses’ perceived comfort level, moral sensitivity, and moral distress were at a moderate level and intercorrelated. It is suggested that factors contributing to moral distress should be eliminated. Also, moral sensitivity should be refined as a decisive factor.

Implication for Nursing Practice

Oncology nurses are exposed to morally distressing situations that may be a source of discomfort. This study guides nurses, managers, planners, and policymakers to identify the contributing factors and use strategies and solutions to enhance nurses' perceived comfort level.

研究目的本研究旨在探讨肿瘤科护士感知到的道德困扰舒适度与道德敏感性之间的关系方法：本研究是一项描述性相关研究，研究对象为 210 名肿瘤科护士。样本于 2020 年 9 月至 2022 年 2 月在伊朗阿瓦士的肿瘤中心通过方便法选取。研究通过人口统计学表格、Lutzen's Modified Moral Sensitivity Questionnaire、Corley's Moral Distress Scale 和 Kolcaba's Nurses Comfort Questionnaire (NCQ) 收集数据。数据分析采用 SPSS V24、描述性统计、独立 t、Mann-Whitney-U、Kruskal-Wallis、皮尔逊相关系数、方差分析和线性回归测试：护士的感知舒适度（67.91 ± 8.75）、道德敏感度（58.4 ± 13.3）和道德困扰度（57.54.8 ± 8.9）处于中等水平。道德敏感度与道德困扰强度呈明显的反比关系（P < .001）。在统计学上，护士感知的舒适度与困扰频率（P < .001）和道德敏感度（P = .046）之间存在明显关系。道德困扰解释了 13.8%的感知舒适度变化（R2 = 0.138，F = 6.51，sig < 0.001，R = 0.371）：护士的感知舒适度、道德敏感性和道德困扰处于中等水平且相互关联。建议应排除导致道德困扰的因素。对护理实践的意义：对护理实践的启示：肿瘤科护士经常会遇到道德困扰的情况，这些情况可能会让她们感到不适。本研究指导护士、管理者、规划者和政策制定者识别诱发因素，并使用策略和解决方案来提高护士的感知舒适度。

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引用次数: 0

Beyond Index Conditions: Applying a Multimorbidity Approach to Renal Cancer Nursing 超越指数条件：在肾癌护理中应用多病症方法。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151743

Chris McParland , Muzeyyen Seckin , Bridget Johnston

Objective

This article aims to describe the key components of renal cancer nursing and multimorbidity nursing, and reflects on how adopting a multimorbidity approach to renal cancer nursing can help nurses provide holistic patient care.

Methods

This is a discussion paper drawing on relevant evidence and theory.

Results

Renal cancer nurses have a highly specialised knowledge base and are able to use this expertise to deliver excellent care to people with cancer. However, lots of people with cancer have other conditions as well. Adopting a multimorbidity approach to nursing care provides a more holistic framework for care delivery.

Conclusions

Cancer nurses are ideally placed to support patients in this way, so they are able to deliver care which accounts for factors such as treatment burden and how this impacts on patients and carers.

Implications for nursing practice

Nurses who care for people with renal cancer should view their patients through the lens of multimorbidity. This involves screening for other chronic conditions, considering polypharmacy, providing emotional support and continuity of care, and coordinating care in a way that accounts for the potentially burdensome nature of the patient's interactions with health care.

目的本文旨在描述肾癌护理和多病护理的主要内容，并思考在肾癌护理中采用多病护理方法如何帮助护士为患者提供整体护理：本文是一篇讨论性论文，参考了相关证据和理论：肾癌护士拥有高度专业化的知识基础，能够利用这些专业知识为癌症患者提供优质护理。然而，许多癌症患者还患有其他疾病。采用多病护理方法为提供护理提供了一个更全面的框架：癌症护士是以这种方式为患者提供支持的理想人选，因此她们能够提供考虑到治疗负担等因素的护理服务，以及这些因素对患者和护理者的影响：护理肾癌患者的护士应该从多病症的角度来看待患者。这包括筛查其他慢性疾病、考虑多药治疗、提供情感支持和持续护理，以及协调护理，以考虑到患者与医疗保健互动的潜在负担。

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引用次数: 0

Psychometric Characteristics of the Quality of Oncology Nursing Care Scale (QONCS): A Validation Study 肿瘤护理质量量表（QONCS）的心理测量学特征：验证研究。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151751

Ilaria Marcomini , Roberta Pendoni , Mattia Bozzetti , Maria Mallio , Francesca Riboni , Valerio Di Nardo , Rosario Caruso

Objectives

Quality care in healthcare settings shortens hospitalization, reduces infection rates and complication risks, and improves patients’ ability to manage their symptoms. Due to the absence of tools for assessing care quality in Italian oncology settings, this study aimed to evaluate the psychometric properties of the Italian version of the Quality of Oncology Nursing Care Scale (QONCS).

Methods

The study comprised 4 phases. Phase I involved cultural adaptation of the QONCS following Brislin's model. In phase II, 6 external experts assessed the instrument's face and content validities. In phase III, a cross-sectional study was conducted at 3 hospitals from February to September 2023. In phase IV, factor analyses were performed using exploratory structural equation modeling.

Results

The 5-dimensional structure of the adapted QONCS showed a good fit based on the following statistics: χ² (324, N = 219) = 704.690, P < .001; root mean square error of approximation = 0.059 (90% confidence interval [CI] = 0.52-0.66), P < .001; comparative fit index = 0.935; Tucker–Lewis index = 0.908; standardized root mean square residual = 0.026. McDonald's ω (0.968) indicated satisfactory internal consistency. The test-retest reliability demonstrated a high and significant positive correlation. Correlation analysis revealed that age, marital status, and employment status were significantly and positively associated with the QONCS score.

Conclusion

This study confirms the validity and reliability of the QONCS. We recommend using the QONCS to thoroughly assess nursing care quality and identify factors that influence the delivery of high-quality care in oncology settings.

Implications for Nursing Practice

Our findings highlight the value of the QONCS in helping nurses assess and improve perceived care quality among patients with cancer. Valid and reliable tools, such as the QONCS, are crucial for guiding policies to enhance patient care.

目标：医疗机构中的优质护理可缩短住院时间、降低感染率和并发症风险，并提高患者控制症状的能力。由于缺乏评估意大利肿瘤护理质量的工具，本研究旨在评估意大利版肿瘤护理质量量表（QONCS）的心理测量特性：研究分为四个阶段。第一阶段是按照布里斯林模式对 QONCS 进行文化适应性调整。在第二阶段，6 位外部专家对该工具的表面和内容效度进行了评估。在第三阶段，2023 年 2 月至 9 月在 3 家医院进行了横断面研究。在第四阶段，使用探索性结构方程模型进行了因素分析：根据以下统计数据，改编后的 QONCS 的五维结构显示出良好的拟合度：χ2 (324, N = 219) = 704.690，P < .001；均方根近似误差 = 0.059 (90% 置信区间 [CI] = 0.52-0.66)，P < .001；比较拟合指数 = 0.935；Tucker-Lewis 指数 = 0.908；标准化均方根残差 = 0.026。麦克唐纳ω（0.968）表明内部一致性令人满意。测试-再测信度显示出高度显著的正相关。相关分析表明，年龄、婚姻状况和就业状况与 QONCS 分数呈显著正相关：本研究证实了 QONCS 的有效性和可靠性。结论：本研究证实了 QONCS 的有效性和可靠性，我们建议使用 QONCS 全面评估护理质量，并找出影响肿瘤科提供高质量护理的因素：我们的研究结果强调了 QONCS 在帮助护士评估和提高癌症患者护理质量方面的价值。QONCS等有效可靠的工具对于指导加强患者护理的政策至关重要。

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引用次数: 0

Renal Cancer: Room for Optimism and a Key Role for Oncology Nursing 肾癌：乐观的空间和肿瘤护理的关键作用。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151754

Daniel Kelly

引用次数: 0

Nonpharmacological Interventions for the Fatigue–Pain–Sleep Disturbance Symptom Cluster in Lung Cancer Patients: Best Evidence Summary 肺癌患者疲劳-疼痛-睡眠障碍症状群的非药物干预：最佳证据摘要。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151727

Le Zhang , Yuanyuan Luo , Dongmei Mao , Benxiang Zhu , Zhihui Yang , Jingxia Miao , Lili Zhang

Objectives

This study aimed to summarize the most effective evidence on nonpharmacological interventions for the fatigue–pain–sleep disturbance symptom cluster in lung cancer patients and to provide evidence-based management methods for clinical team and lung cancer patients.

Methods

Guided by the "6S" pyramid model, we retrieved evidence on fatigue, pain, and sleep disturbance management from relevant websites and databases, and unpublished gray literature was also searched. The time frame of the search ranged from database establishment to September 30, 2023. Two researchers independently evaluated the literature quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) for guidelines, and the Assessment of Multiple Systematic Reviews II (AMSTAR II) for systematic reviews. Two people independently extracted and summarized the evidence according to the first principle of high-quality evidence and newly published evidence. The included evidence was graded by the JBI Evidence Pre-Grading System.

Results

A total of 52,238 articles were retrieved, of which 60 articles, including 18 guidelines, 18 JBI best practice recommendations, one Up To Date clinical practice, and 23 systematic reviews, were included. Overall, 49 pieces of evidence from six dimensions—screening, assessment, management, education, referral, and follow-up—were summarized. Forty-three pieces of evidence were level 1, three pieces of evidence were level 4, and three pieces of evidence were level 5.

Conclusions

The best 49 pieces of evidence on nonpharmacological interventions for the fatigue–pain–sleep disturbance symptom cluster in lung cancer patients were summarized in this study, and these nonpharmacological interventions are scientific and comprehensive.

Implications for Nursing Practice

This study can provide guidance for clinical team to improve the fatigue–pain–sleep disturbance symptom cluster management. These evidence items can be implemented by clinical team to reduce the symptom burden and improve the self-management ability of symptoms in lung cancer patients.

研究目的本研究旨在总结肺癌患者疲劳-疼痛-睡眠障碍症状群非药物干预的最有效证据，并为临床团队和肺癌患者提供循证管理方法：在 "6S "金字塔模型的指导下，我们从相关网站和数据库中检索了有关疲劳、疼痛和睡眠障碍管理的证据，还检索了未发表的灰色文献。检索时间范围从数据库建立到 2023 年 9 月 30 日。两位研究人员使用研究与评估指南评估 II (AGREE II) 独立评估了指南的文献质量，并使用多重系统性综述评估 II (AMSTAR II) 独立评估了系统性综述的文献质量。两人根据高质量证据和新发表证据的第一原则独立提取和总结证据。纳入的证据由 JBI 证据预分级系统进行分级：结果：共检索到 52,238 篇文章，其中 60 篇文章被纳入，包括 18 份指南、18 份 JBI 最佳实践建议、1 份 Up To Date 临床实践和 23 篇系统综述。总体而言，从筛查、评估、管理、教育、转诊和随访六个方面总结了 49 项证据。其中 43 项证据为 1 级，3 项证据为 4 级，3 项证据为 5 级：本研究总结了针对肺癌患者疲劳-疼痛-睡眠障碍症状群的非药物干预措施的49项最佳证据，这些非药物干预措施科学而全面：本研究可为临床团队改善疲劳-疼痛-睡眠障碍症状群管理提供指导。护理实践的意义：本研究可为临床团队改善疲劳-疼痛-睡眠障碍症状群管理提供指导，临床团队可通过实施这些证据项目来减轻肺癌患者的症状负担，提高其症状自我管理能力。

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引用次数: 0

Turkish Validation and Cultural Adaptation of the Family Care Ability Assessment Scale for Pediatric Oncology Caregivers 儿科肿瘤护理人员家庭护理能力评估量表的土耳其验证和文化适应性。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151726

Derya Akdeniz Uysal , Rana Yigit , Nezaket Bilge Uzun

Objectives

This study aimed to investigate the psychometric properties of the Turkish version of the "Caring Ability of Family Caregivers of Patients with Cancer Scale" in parents of children with cancer".

Methods

The current study has a methodological design. The study group consisted of 493 parents of children with oncological problems who were followed in the pediatric hematology-oncology departments of three university hospitals. Data were collected between January and December 2021 through convenience sampling. The face, content construct validity, internal consistency, and scale stability were evaluated. SPSS 26.0 and LISREL 8.80 package programs were used to analyze the data.

Results

In the confirmatory factor analysis; root mean- mean square error of approximation, comparative fit index, normed fit index, and non-normed fit index were determined to be 0.08, 0.93, 0.91, and 0.92, respectively. Cronbach's alpha reliability coefficient obtained from the entire scale was calculated to be 0.88, the stability correlation coefficient was 0.84 (p < .005) and the item-total correlation coefficient was calculated between 0.249 and 0.716.

Conclusions

The scale adapted to Turkish culture can be considered a valid and reliable tool for the assessment of the caring ability of family caregivers of patients with cancer.

Implications for Nursing Practice

The scale can be used to assess parents' caregiving abilities, to determine their strengths and weaknesses. In this respect, it can contribute to the creation of an education plan, the development of parents' caregiving abilities and the increase in the quality of care.

研究目的本研究旨在调查土耳其版 "癌症患者家庭照顾者照顾能力量表 "在癌症患儿父母中的心理测量特性：本研究采用方法学设计。研究小组由 493 名肿瘤患儿的父母组成，他们在三所大学医院的儿科血液肿瘤科接受随访。数据收集时间为 2021 年 1 月至 12 月，采用方便抽样法。对量表的面效度、内容建构效度、内部一致性和稳定性进行了评估。采用 SPSS 26.0 和 LISREL 8.80 软件包对数据进行分析：在确认性因素分析中，均方根近似误差、比较拟合指数、规范拟合指数和非规范拟合指数分别为 0.08、0.93、0.91 和 0.92。整个量表的 Cronbach's alpha 信度系数为 0.88，稳定性相关系数为 0.84 (p < .005)，项目-总相关系数在 0.249 和 0.716 之间：结论：根据土耳其文化改编的量表是评估癌症患者家庭照顾者照顾能力的有效、可靠的工具：该量表可用于评估父母的护理能力，以确定他们的长处和短处。对护理实践的启示：该量表可用于评估父母的护理能力，确定他们的长处和短处，从而有助于制定教育计划、培养父母的护理能力和提高护理质量。

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引用次数: 0

“I thought I was Probably Going to Die due to People Looking at me with Pity”: A Phenomenological Qualitative Study on the Lived Cancer Stigma Experiences of Breast Cancer Patients "我想我可能会因为人们用怜悯的眼光看我而死去"：关于乳腺癌患者癌症污名化经历的现象学定性研究》。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151747

Tuğba Pehlivan Sarıbudak , Esra Mertek , Dilara Kadriye Korkmaz , Gülsüm Duygu Acar , İrem Doğan

Objectives

It has been stated that there is a need for more recognition of the “stigma concept,” which negatively affects the lives of patients with breast cancer during the diagnosis and treatment process. There are no recent studies on the experiences of Turkish women with breast cancer about stigmatization that employ qualitative methods. This study aims to examine in depth the lived stigma experiences of women with breast cancer during the diagnosis and treatment process.

Methods

In total, 18 phenomenological semistructured in-depth individual interviews were conducted with patients with breast cancer between December 2023 and March 2024. Data were analyzed using Collaizzi's 7-step descriptive analysis approach.

Results

Four main themes and 8 subthemes developed from the phenomenological analysis of the interviews: (1) Cancer Metaphors: “A dark journey,” “A bomb falling on the house!” and “Cancer = death!”; (2) Social Stigma: “Cancer = an infectious disease,” “Negative and Disturbing Attitudes/Approaches of People”; (3) Internalized Stigma, and (4) Coping: “Acceptance” and “Social support.”

Conclusion

It was determined that the patients experienced social stigmatization due to negative attitudes of people toward cancer, perceiving it as infectious and approaching them with pity or demonstrating disturbing expressions. In addition, their social interactions were negatively affected due to the internalized stigma, and they were in an effort to cope with all the problems they experienced.

Implications for Nursing Practice

The study highlighted the psychological needs of patients with breast cancer related to “stigmatization.” Cancer nurses should monitor the stigmatization experiences of women with breast cancer, reveal their perceptions of internalized stigma, and implement programs to cope with stigma. It is also recommended that interventional studies, including coping programs with “stigma” for patients with breast cancer, should be conducted in future research.

目标：有学者指出，有必要进一步认识 "污名化概念"，它对乳腺癌患者在诊断和治疗过程中的生活产生了负面影响。近期还没有采用定性方法对土耳其乳腺癌女性患者的污名化经历进行研究。本研究旨在深入研究乳腺癌女性患者在诊断和治疗过程中的污名化经历：方法：2023 年 12 月至 2024 年 3 月期间，共对 18 名乳腺癌患者进行了现象学半结构式深度个人访谈。采用 Collaizzi 的 7 步描述性分析方法对数据进行分析：通过对访谈的现象学分析，形成了 4 个主主题和 8 个次主题：（1）癌症隐喻："黑暗的旅程"、"炸弹落在房子上！"和 "癌症=死亡！"；(2) 社会污名："癌症=传染病"、"人们消极和令人不安的态度/做法"；(3) 内化的污名和 (4) 应对："接受 "和 "社会支持"：结果表明，由于人们对癌症持消极态度，认为癌症具有传染性，并以怜悯的态度或令人不安的表情来对待他们，因此患者经历了社会鄙视。此外，他们的社会交往也因内化的污名化而受到负面影响，他们正在努力应对所经历的所有问题：本研究强调了乳腺癌患者与 "污名化 "相关的心理需求。癌症护士应监测乳腺癌女性患者的污名化经历，揭示她们对内化污名化的看法，并实施应对污名化的计划。还建议在今后的研究中开展干预性研究，包括针对乳腺癌患者的 "污名化 "应对方案。

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引用次数: 0

Faith, Meaning, and Quality of Life: Unveiling the Spirituality of Muslim Patients with Advanced Cancer Undergoing Active Treatment in the Gaza Strip, Palestine 信仰、意义和生活质量：揭示巴勒斯坦加沙地带接受积极治疗的晚期癌症穆斯林患者的精神世界。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151741

Hammoda Abu-Odah , Khawla El-Nems , Ka-Yan Ho , Katherine-Ka-Wai Lam , Shahenaz Najjar , Engle Angela Chan

Objectives

This study aimed to identify the level of spirituality, faith and meaning, and quality of life (QOL) among Muslim advanced cancer patients undergoing active treatment and to enhance the understanding of the relationships among clinical and socio-demographic factors, spirituality, and QOL of patients in the Gaza Strip.

Methods

A secondary analysis was conducted on a convenience sample of 298 advanced cancer patients. The Arabic versions of the Assessment of Chronic Illness Therapy–Spiritual Well-Being (FACIT–Sp) and the Functional Assessment of Cancer Therapy–General (FACT–G) were used for data collection. Descriptive statistics and generalized linear regression were utilized for data analysis, performed using SPSS 25.0.

Results

Participants reported high spirituality well-being scores (Mean = 31.25, SD = 6.25) and relatively high scores on the subscales of meaning/peace (Mean = 19.15, SD = 4.11) and faith (Mean = 12.03, SD = 3.50). Most patients indicated that their faith and spiritual beliefs increased due to their illness. Furthermore, a significant positive relationship was found between spirituality (including its subscales of faith and meaning in life) and QOL. Despite the generally high level of spirituality, special attention should be paid to patients with lung, bladder, and thyroid cancer, lower education levels, and higher cancer grades.

Conclusions

The Gazan Muslim patients with advanced cancer exhibit high levels of spirituality and faith. We acknowledged that spiritual well-being is a protective factor for QOL. The strong positive correlation between spirituality and QOL emphasizes the need to integrate spiritual care into cancer care.

Implications for Nursing Practice

It is imperative to incorporate spirituality into health practice and the daily routines of cancer treatment for patients whose spirituality is an important aspect of their identities. The incorporation of spirituality can contribute to the improvement of the quality of patients’ life and quality of cancer care.

研究目的本研究旨在确定正在接受积极治疗的穆斯林晚期癌症患者的灵性、信仰和意义水平以及生活质量（QOL），并加深对加沙地带患者的临床和社会人口因素、灵性和 QOL 之间关系的理解：对 298 名晚期癌症患者进行了二次分析。数据收集使用了阿拉伯语版本的慢性疾病治疗-精神健康评估（FACIT-Sp）和癌症治疗功能评估-一般（FACT-G）。使用 SPSS 25.0 进行描述性统计和广义线性回归分析：参与者的精神幸福感得分较高（平均值=31.25，标准差=6.25），在意义/平和（平均值=19.15，标准差=4.11）和信仰（平均值=12.03，标准差=3.50）分量表上的得分也相对较高。大多数患者表示，他们的信仰和精神信念因疾病而增强。此外，研究还发现精神信仰（包括其子量表信仰和生命意义）与 QOL 之间存在明显的正相关关系。尽管精神信仰水平普遍较高，但应特别关注肺癌、膀胱癌和甲状腺癌患者、教育水平较低的患者以及癌症等级较高的患者：加沙穆斯林晚期癌症患者的精神和信仰水平很高。我们认识到，精神健康是 QOL 的保护因素。灵性与 QOL 之间的强正相关性强调了将灵性护理纳入癌症护理的必要性：对护理实践的启示：将灵性融入医疗实践和癌症治疗的日常工作中，对那些灵性是其身份重要方面的患者来说是非常必要的。灵性的融入有助于提高患者的生活质量和癌症护理的质量。

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引用次数: 0

The Value of Renal Clinical Nurse Specialists: Future Potential and Current Challenges in the United Kingdom 肾科临床护士专家的价值：英国未来的潜力和当前的挑战。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151750

Shievon Smith , Michelle Greenwood

Objectives

The renal clinical nurse specialist (CNS) should be the main source of support and information for people affected by kidney cancer. The CNS is best placed to offer holistic care and often gets to know the patient, especially well as they progress on second- or third-line therapies. We discuss future potential and current challenges in the United Kingdom based on our health professional experiences.

Methods

This is a discussion paper based on clinical expertise and informed by current literature.

Results

The CNS role for uro-oncology in many centers covers a large patient population and all 5 tumor sites: prostate, bladder, renal, testis, and penile. Urology has a decreasing workforce and increasing difficulty in recruiting to the role in these services. A number of renal CNSs are new to post due to the recruitment crisis without dedicated CNS competencies. Renal CNSs can be proven to reduce costs through managing patients’ side-effect profile, ensuring people affected by cancer continue their maintenance therapies.

Conclusions

Therapies for kidney cancer have revolutionized treatment for patients and improved their overall survival in recent years. With longer prognoses and specialist therapies that include targeted and immunotherapy drugs, people affected by kidney cancer need dedicated renal CNSs to support them throughout the cancer pathway.

Implications for nursing practice

Educational projects and resources, such as the aspirant cancer career and education (ACCEND) project and RCC4Nurses, will be key to support both new and longer serving CNSs to pursue successful roles in uro-oncology while providing excellent patient care.

目标：肾脏临床专科护士 (CNS) 应成为肾癌患者获得支持和信息的主要来源。肾脏病临床护士最适合为患者提供整体护理，而且通常能够了解患者的情况，尤其是当患者接受二线或三线治疗时。我们根据医疗专业人员的经验讨论了英国未来的潜力和当前的挑战：本文是一篇基于临床专业知识并参考当前文献的讨论文章：在许多中心，泌尿肿瘤学的中枢神经系统角色涵盖了大量患者和所有 5 个肿瘤部位：前列腺、膀胱、肾脏、睾丸和阴茎。泌尿外科的员工人数在不断减少，而且越来越难招聘到这些服务领域的中枢神经系统医师。由于招聘危机，许多肾脏 CNS 都是新上岗的，没有专门的 CNS 能力。事实证明，肾脏 CNS 可通过管理患者的副作用降低成本，确保癌症患者继续接受维持治疗：结论：近年来，肾癌治疗方法发生了革命性的变化，提高了患者的总体生存率。随着预后时间的延长以及包括靶向药物和免疫疗法在内的专业疗法的出现，肾癌患者需要专门的肾脏 CNS，以便在整个癌症治疗过程中为他们提供支持：教育项目和资源（如有抱负的癌症职业和教育（ACCEND）项目和 RCC4Nurses）将成为支持新任和长期在职 CNS 在泌尿肿瘤学领域成功任职并提供优质患者护理的关键。

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引用次数: 0

Exploring the Experiences of Older Adults and Their Caregivers in Home-Based Palliative Care Setting: A Systematic Review and Meta-Synthesis 探索居家姑息关怀环境中老年人及其照护者的经历：系统回顾与元综合》。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-12-01 DOI: 10.1016/j.soncn.2024.151753

Hua Lin Ng , Xi Vivien Wu , Siat Yee Yap , Seo Ngee Brian Yeo , Michael Joseph Dino , Ying Jiang

Objectives

While Home-based palliative care might be the preferred choice of many, there has been little research exploring the experiences of older adults and caregivers in this setting. This systematic review aims to explore and synthesize the experiences of home-dwelling older adults (aged 60 and above) and their caregivers with Home-based palliative care.

Methods

A Systematic Review and Meta-Synthesis of qualitative and mixed-methods studies was conducted and reported in accordance with PRISMA guidelines. A systematic search across nine electronic databases, as well as grey literature, reference lists and citation lists were conducted. Studies were included with the following criteria: older adult palliative patients and/or their informal caregivers with the primary setting of palliative care delivery at home. Quality appraisal was conducted by two researchers independently using the Critical Appraisal Skills Programme Qualitative Research Checklist and Mixed Methods Appraisal Tool. Data analysis was facilitated by Braun and Clark's thematic analysis, and meta-synthesis was underpinned by Sandelowski and Barroso's guidelines.

Results

A total of 4,931 records were yielded through the electronic database search. After duplicate removal and screening of titles/abstracts and full-texts, a total of 25 studies were included. Five main themes and 11 sub-themes emerged: 1) Living in a diminishing world due to immobility, 2) Bittersweet caregiving process, 3) Navigating a fragmented healthcare system, 4) Maintaining normalcy amongst disruption, 5) Indispensable aspects of Home-based palliative care needed by families.

Conclusions and Implications for Nursing Practice

This meta-synthesis highlights the fundamental significance of embracing a dyadic approach to fully comprehend the intricate dynamics of Home-based palliative care. By recognising the older adult-caregiver dyad as an interconnected unit, future research, therapeutic interventions, and policy initiatives can integrate this dyadic perspective, resulting in more holistic and inclusive Home-based palliative care programs.

Registration

The protocol was registered on PROSPERO (Registration No. CRD42022376864).

目的：虽然居家姑息关怀可能是许多人的首选，但很少有研究探讨老年人和照护者在这种环境下的经历。本系统综述旨在探索和总结居家老年人（60 岁及以上）及其照护者在居家姑息关怀方面的经验：方法：根据 PRISMA 指南，对定性研究和混合方法研究进行了系统综述和元综合。在九个电子数据库以及灰色文献、参考文献目录和引用文献目录中进行了系统性检索。纳入研究的标准如下：老年姑息关怀患者和/或其非正式照护者，姑息关怀服务的主要场所在家中。由两名研究人员使用 "批判性评估技能计划定性研究核对表 "和 "混合方法评估工具 "独立进行质量评估。数据分析采用了布劳恩和克拉克的主题分析法，元综合则以桑德罗斯基和巴罗佐的指南为基础：通过电子数据库搜索共获得 4931 条记录。在删除重复内容、筛选标题/摘要和全文后，共纳入 25 项研究。得出了 5 个主题和 11 个次主题：1）因行动不便而生活在一个日渐衰弱的世界中；2）苦乐参半的护理过程；3）驾驭支离破碎的医疗保健系统；4）在混乱中保持正常状态；5）家庭所需的居家姑息关怀不可或缺的方面：本综述强调了采用二元方法来充分理解居家姑息关怀的复杂动态的根本意义。通过认识到老年人-护理者二元组合是一个相互关联的单元，未来的研究、治疗干预和政策措施可以整合这种二元组合视角，从而制定出更全面、更具包容性的居家姑息关怀计划：该方案已在 PROSPERO 上注册（注册号：CRD42022376864）。

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