European Journal of Oncology Nursing

Editorial Board

2012-02-01

Trajectories of anxiety in oncology patients and family caregivers during and after radiation therapy

2011-02-15

Abstract: Purpose: Anxiety is common in patients undergoing radiation therapy (RT) and in their family caregivers (FCs). Little is known about individual differences in anxiety trajectories during and after RT. This study aimed to identify distinct latent classes of oncology patients and their FCs based on self-reported anxiety symptoms from the beginning to four months after the completion of RT.Method: Using growth mixture modeling (GMM), longitudinal changes in Spielberger State Anxiety Inventory (STAI-S) scores among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 FCs were evaluated to determine distinct anxiety symptom profiles. STAI-S scores were assessed just prior to, throughout the course of, and for four months following RT (total of 7 assessments). Baseline trait anxiety and depressive symptoms (during and after RT) were also assessed.Results: The GMM analysis identified three latent classes of oncology patients and FCs with distinct trajectories of state anxiety: Low Stable (n = 93, 36.9%), Intermediate Decelerating (n = 82, 32.5%), and High (n = 77, 30.6%) classes. Younger participants, women, ethnic minorities, and those with children at home were more likely to be classified in the High anxiety class. Higher levels of trait anxiety and depressive symptoms, at the initiation of RT, were associated with being in the High anxiety class.Conclusions: Subgroups of patients and FCs with high, intermediate, and low mean levels of anxiety during and after RT were identified with GMM. Additional research is needed to better understand the heterogeneity of symptom experiences as well as comorbid symptoms in patients and FCs.

The coping process of patients with cancer

Pei Ying Chen, Hui-Chen Chang — 2011-03-07

Abstract: Purpose: The aim of this study was to investigate the implications of the alterations to lifestyle of cancer patients, from the onset of abnormal symptoms, followed by diagnosis and treatment, and then subsequent acceptance of the condition. Seven cancer patients from medical centers in Taiwan participated in the study.Method: Exploratory, qualitative study based on grounded theory methods. Each participated in a semi-structured interview with open-ended questions. All interviews were audio recorded and transcribed. Qualitative content analysis was used for the data.Results: Three themes emerged from the data analysis to exhibit the critical coping processes of the cancer patients. These included negative feelings, self-adjustment and self-reinterpretation.Conclusion: According to the results this study concluded that the coping processes used by some cancer sufferers enables them to draw upon various strengths and strategies to develop particular attitudes and skills to assist them to live with cancer. Overall, the findings tend to support the developmental interpretation, although the contextual interpretation also applies.

Antineoplastic agents extravasation from peripheral intravenous line in children: A simple strategy for a safer nursing care

2011-03-28

Abstract: Purpose: The antineoplastic agents infusion through peripheral lines may lead to several adverse events such as extravasation that is one of the most severe acute reactions of this sort of treatment. The extravasation prevention and management must be part of a safe and evidence-based nursing care. Due to this fact, two algorithms were developed with the purpose of guiding nursing care to children who undergo chemotherapy through peripheral line. The objectives of this study were to determine the content validity of both algorithms with pediatric oncology nurses in Brazil and United States of America, and to verify the agreement between the evaluations of both groups.Methods and Sample: A descriptive validation study was carried out through the Delphi Technique that has the following steps: development of the data collection instrument, application to the specialists, data analysis, algorithms’ review, re-evaluation by the specialists, final data analysis and content validity determination.Results: The data analysis was descriptive and based on the specialists agreement consensus equal or higher than 80% in every step of the algorithms. The process showed that the agreement with both instruments ranged from 92.8% to 99.0%.Conclusion: The algorithms are valid for application in nursing care with the main purpose of preventing and managing the antineoplastic agents’ extravasation.

Impact of walking ability and physical condition on fatigue and anxiety in hematopoietic stem cell transplantation recipients immediately before hospital discharge

Akiko Tonosaki — 2011-02-28

Abstract: Purpose: This study analyzed the influence of walking ability and physical condition on fatigue and anxiety at hospital discharge in patients receiving hematopoietic stem cell transplantation (HSCT).Method: A total of 25 subjects were assessed after receiving HSCT until discharge. The Japanese Cancer Fatigue Scale and the State-Trait Anxiety Inventory were used to assess fatigue and anxiety. Relationships of fatigue and anxiety status respective to walking ability variables: leg muscle strength (knee extension, ankle plantar flexion and ankle dorsiflexion strength) and average number of daily steps, and physical condition variables (food intake, febrile days, body mass index, and serum albumin) were examined with correlations and stepwise multiple regression analysis.Results: Subjects with later achievement of adequate food intake after HSCT (β = 0.62) and weaker knee extension strength per body mass at discharge (β = −0.42) reported higher fatigue (adjusted R2 = 0.53, p = 0.00). Knee extension strength per body mass at discharge was correlated with an average step-count from 51 to 80 days after HSCT (r = 0.51, p = 0.01). In subjects whose Body Mass Index was above 23.5, weaker ankle dorsiflexion strength per body mass prior to transplantation reported higher fatigue at discharge (adjusted R2 = 0.97, p = 0.00). Subjects with later achievement of food intake after HSCT (β = 0.59) and more days with fever reported higher anxiety (adjusted R2 = 0.47, p = 0.00).Conclusion: Post-HSCT fatigue was affected by a delay in adequate food intake and diminished muscle strength. The results of this study show the importance of encouraging walking for maintaining muscle endurance.

Significant others’ lived experiences following a lung cancer trajectory – From diagnosis through and after the death of a family member

Susanna Pusa, Carina Persson, Karin Sundin — 2011-03-23

Abstract: Purpose: The purpose of this study was to illuminate the meanings of significant others’ lived experiences of their situation from diagnosis through and after the death of a family member as a consequence of inoperable lung cancer.Methods: The data was collected through narrative interviews from eleven significant others and interpreted using a phenomenological hermeneutic approach.Keyresults: Four themes emerged: being unbalanced, being transitional, being cared for, and moving forward.Conclusion: The significant others’ experiences can be viewed as a transition process, beginning with a sense of dislocation in life and continuing through struggling, enduring and conquering the consequences of the altered life situation until finally approaching a point characterized by a sense of stability. Different strategies of adjustment and adaptation to the new living conditions are considered. Furthermore, the results indicate the need to develop a framework for family-centered health care in order to enhance the wellbeing for the significant others both in the anticipatory grief phase and during the bereavement phase.

Taking the lead – Sharing best practice in intravenous bisphosphonate use in urological cancers

2011-03-23

Abstract: Purpose: Bisphosphonates relieve metastatic bone pain, prevent, reduce and delay skeletal morbidity in metastatic bone disease and are recommended in European guidelines but safety concerns, specifically renal dysfunction and osteonecrosis of the jaw, necessitate specific precautions when administered intravenously. Pan-European guidance for nurses at the forefront of patient-focussed cancer care is required to minimise patient risk.Methods: A panel of urology and oncology nurses from seven European countries collaborated to decide what constituted best practice for bisphosphonate administration when indicated for prevention of skeletal-related events in patients with advanced urological malignancies.Results: The panel agreed that urology, oncology, and home-care nurses who are at the forefront of patient-focussed care are well placed to ensure best practice is followed but across Europe nurses have insufficient training on bisphosphonate administration for urological cancers. Based on extensive clinical experience in administering bisphosphonates the panel propose best practice for identifying those patients who could benefit, for example those with bone pain or at risk of fracture, and for minimising risk of adverse events by checking renal function, adjusting dosing, ensuring adequate hydration, and regularly assessing dental health, as well as providing information and support.Conclusions: Sharing this best practice across Europe could assist nurses who care for patients with urological cancers and bone metastases or indeed those caring for cancer patients in general, to take the lead, or at least be aware of what is the best practice that helps to ensure effective and safe IV bisphosphonates administration to patients under their care.

Efficacy survey of swallowing function and quality of life in response to therapeutic intervention following rehabilitation treatment in dysphagic tongue cancer patients

Yan Zhen, Jian-guang Wang, Duo Tao, Hua-Jun Wang, Wei-Liang Chen — 2011-03-28

Abstract: Purpose: This quasi-experimental parallel cluster study was carried out to investigate the utility of interdisciplinary swallowing therapy exercises in improving swallowing function and quality of life (QOL) in dysphagic cancer patients following tongue resection and subsequent rehabilitation treatment.Methods: All subjects in the experimental group underwent a structured swallowing training program. The subjects in the experimental group (n = 23) received 30 min of swallowing training each day, 6 days per week for 2 weeks. The control group (n = 23) received no training. Analysis of variance was used, and the M.D. Anderson Dysphagia Inventory (MDADI) discriminated between groups of subjects.Results: Patients who underwent structured swallowing training (n = 23) showed improvement in the overall MDADI score (P 0.05).Conclusions: This study used objectively timed swallowing tests, an interdisciplinary swallowing therapy protocol, and a swallowing questionnaire to evaluate the effects of swallowing training. We found that implementation of swallowing education and exercises improved dysphagia and QOL in cancer patients following tongue resection and rehabilitation. Furthermore, this study indicated that swallowing safety and dysphagia training for nursing professionals is effective.

The quality of life of women treated for cervical cancer

Edyta Barnaś, Joanna Skręt-Magierło, Andrzej Skręt, Mariusz Bidziński — 2011-03-31

Abstract: Objective: The objective of this work was to assess the quality of life of women treated surgically for early stage cervical cancer (FIGO IA2-IIA).Methods: Quality of life was evaluated at the preoperative period (T1), three months (T2) and six months after surgery (T3). The study employed two types of survey questionnaires: EORTC QLQ-C 30 and QLQ-CX 24. The study protocol was approved by the Bioethical Comitee at Rzeszów University. 100 women who signed an informed consent and completed questionnaires were included in the study.Results: Based on EORTC QLQ-30 it was found that global health status improved at T2. This improvement was stable until T3. The same was true in respect of emotional and cognitive functioning. Role and social functioning improved at T3. Stable improvement of insomnia, appetite and financial difficulties was noted at T2 and T3. Reduction of fatigue, nausea and vomiting, and diarrhea was observed until T3. Based on the modules of the QLQ-CX 24 questionnaire, a reduction in symptom experience was observed at T2 and T3. The opposite tendency was noted in the case of body image.Conclusions: The present study was carried out in a period of vulnerability for cervical patients up to six months from the start of treatment. The cancer itself, surgery and adjuvant therapy and their side effects together had an effect on quality of life.

“The Body Gives Way, Things Happen”: Older women describe breast cancer with a non-supportive intimate partner

Erika Metzler Sawin — 2011-04-13

Abstract: Purpose: Many women identify their intimate partner as important source of support during cancer diagnosis and recovery, but little is known about how women deal with breast cancer while in a relationship self-described as difficult. The purpose of this article is to describe the aging-related experiences of older women who were diagnosed with breast cancer while in a non-supportive, difficult intimate relationship.Method: Semi-structured qualitative interviews were conducted with a convenience sample of 16 women aged 55–84 years (mean 68.1 years) in community settings in the mid-Atlantic United States. Data were analyzed using hermeneutic phenomenological analysis.Results: Participants self-identified as being in a difficult intimate relationship (relationship length range: 1 year- 60 years, mean 35.6 years). Reasons for relationship difficulty ranged from intimate partner abuse to terminal illness. The findings included the themes: “At my Age”: participants reflect on aging and breast cancer; breast cancer, sexuality, and aging; and silence.Conclusions: Issues related to aging such as changes in sexual relationships, comorbidities, and partner illness complicated the women’s breast cancer experience. Despite relationship difficulties, these women coped effectively with breast cancer in various ways. Study findings will increase awareness about the unique, complex needs of older women facing breast cancer with non-supportive intimate partners. Nurses should assess older breast cancer patients keeping in mind physical functioning, comorbidities, social support network, and quality of intimate partner support.

The effect of web-assisted education and reminders on health belief, level of knowledge and early diagnosis behaviors regarding prostate cancer screening

Cantürk Çapık, Sebahat Gözüm — 2011-04-29

Abstract: Purpose of the research: The aim of this study was to investigate the effect of web-assisted education and reminders on health belief, level of knowledge and early diagnosis behaviors regarding prostate cancer screening.Methods and sample: In this pretest–posttest longitudinal study, Turkish men over 40 years of age were given an interactive educational session on prostate cancer and prostate cancer screening, and were then given related web-assisted education and consultation for a period of 6 months. As well as the Internet, reminders such as desk calendar, booklets, e-mails and cell phone messages were used in the study. Changes in the screening behaviors, the health belief and knowledge level of patients were examined 3 and 6 months after the interventions.Key results: During the study, participants’ prostate examination rate increased from 9.3% to 19.1% and PSA measurement rate increased from 6.7% to 31.4%. The interventions raised the susceptibility perception on prostate cancer and prostate cancer screening while decreasing the barrier perception (p < 0.05). No change was observed in other health belief components and the level of knowledge.Conclusion: Web-assisted education and reminders provided positive changes in the barrier and susceptibility perceptions of individuals. Participation in the screening also increased.

Specialist breast care and research nurses’ attitudes to adjuvant chemotherapy in older women with breast cancer

2011-05-09

Abstract: Purpose: Breast cancer largely affects older women (≥70 y) who have historically been excluded from clinical trials; consequently, treatment is often not evidence-based. Older women may not be offered adjuvant chemotherapy due to assumptions that they would not benefit, cannot tolerate it or do not wish to have it. Specialist breast care nurses (BCN) and research nurses (RN) play an important role influencing decisions. We report the roles, attitudes and involvement of such nurses regarding adjuvant chemotherapy in older women.Method: A questionnaire examined 259 UK BCN and RN’s views about efficacy and desirability of chemotherapy in older women, participation in decision-making in MDTs, and roles when chemotherapy was discussed with patients.Results: 72% of BCN and 48% of RN agreed that age should not be a factor influencing who is offered chemotherapy. BCNs indicated involvement in decision-making with older breast cancer patients, discussing chemotherapy with patients at different points following diagnosis and during treatment, and proposing chemotherapy in MDT meetings. RNs were involved to a lesser extent. 69% of all nurses had not received specific training in the area and 70% thought training would be beneficial. Nurses disagreed that older patients would not tolerate or did not want chemotherapy but 1/3 agreed or were uncertain that burdens of chemotherapy outweighed benefits. A third felt that older women had less control over treatment decisions than younger women.Conclusions: This study suggests a need to develop the role of specialist nurses to facilitate treatment decision-making relating to chemotherapy in older women.

The role of the clinical trial nurse in Italy

2011-05-03

Abstract: Purpose: To assess the role of the Clinical Trials Nurse (CTN) and to evaluate the quality of the job performed by Clinical Trials Nurses (CTNs) in Italy.Methods: The study design was descriptive. The sample included 30 CTNs in Italy who were involved in conducting clinical trials in the last years. Respondents completed the Italian Clinical Trials Nursing Questionnaire (CTNQ) developed to measure frequency and importance of clinical trials nursing activities. Data analyses included descriptive statistics, Student’s t-test and Chi–Square test.Results: Thirty out of 34 CTNs consented to participate. Respondents were more involved in the experimental drug management, in the protocol implementation and, partially, in the informed consent process. CTNs have a marginal position with respect to the protocol assessment and planning, subject recruitment, data management. CTNs reported high rates for the importance evaluation. Number of years in the nursing role was significantly associated with data management related activities (p = 0.016). Items with minor response rate differences between frequency and importance were not statistically significant (p values ranging from 0.087 to 0.911). The CTNs reported to be autonomous and competent; however, they lack and/or do not perform some nursing-related responsibilities and/or activities.Conclusions: Although CTNs are not involved in all of the activities listed on the CTNQ, most of them are fully aware to be a key member of research teams. Overall, the Italian CTN role is mostly practical task-oriented and focuses little on data management and organizational activities.

Noticeboard

2011-12-08

Individual nurses and other health professionals and conference organisers are invited to submit details of conferences, workshops, study days and lectures to: Anita Margulies BSN, RN (EONS Executive Board Member)

Oncology Nursing Bibliography

2011-12-07

Adherence to oral endocrine treatments in women with breast cancer: can it be improved? [Review] DOGGRELL SA. Breast Cancer Res Treat 2011;129(2):299-308 Biochemical recurrence after radical radiotherapy for localised prostate cancer - the Cardiff experience. TAN WS. Clin Oncol 2011;23(3):S55