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Author on Call

The function of the “Author on Call” blog is to allow our readers and authors to interact with each other in a unique way. A few select authors will be chosen to share on the blog aspects of their papers that were especially meaningful to them personally or points that may not have made it into their published report. Readers will then have the opportunity to provide comments and questions, to which the authors will respond.

At times, as seen in our first entry, we will also post separate entries to the blog on various special topics that we feel would be informational or that we welcome your feedback on.

Saturday, May 28, 2022

Differences in Quality of Life and Emotional Well-being in Breast, Colon, and Lung Cancer Patients During Outpatient Adjuvant Chemotherapy

A Longitudinal Study

Ulibarri-Ochoa, Ainhoa PhD; Ruiz-de-Alegría, Begoña PhD; López-Vivanco, Guillermo PhD; García-Vivar, Cristina PhD; Iraurgi, Ioseba PhD


“The interest in learning about the experience of people with cancer during outpatient adjuvant chemotherapy treatment arises from my clinical experience as a nurse in the oncology day unit. The moments and experiences shared with many of the patients made me realize the limitations that still exist in the assessment and follow-up of these people, and in their training for self-care and self-management of their process. This study therefore arises from a deep reflection and the concern to humanize and improve care for cancer patients, and comprehensively meet their needs during such a critical time in navigating the cancer control continuum as chemotherapy treatment.
 
Previous studies have shown the impact of the adverse effects of chemotherapy on physical quality of life (QoL); however, there is controversy about its impact on mental quality of life compared to the general population. Besides, there is a knowledge gap about QoL regarding differences between patients with cancer at different sites considering the specificities of each chemotherapy regimen used at each cancer site. Regarding emotional well-being, most studies have focused on psychological comorbidity, but few studies have examined emotional fluctuation such as changes in positive and negative affect in cancer patients, and none have explored these variables in patients receiving outpatient adjuvant chemotherapy, both overall and by cancer site. In addition, lack of longitudinal data leads to ignorance of possible fluctuations in QoL and well-being during the treatment phase.
 
This longitudinal study revealed different patterns in perceived QoL and affect in cancer patients at one of the three sites with the highest incidence (breast, colon, and lung) since the start of chemotherapy, the lung cancer group being the most vulnerable. Furthermore, in the complementary use of the Positive and Negative Affect scale, this study identified emotional changes that were not captured by the QoL scale. These results suggest new lines of research that delve into the emotional fluctuation of patients during chemotherapy treatment, considering the differences detected between cancer sites.
 
It is necessary to strengthen the coordination of interdisciplinary teams and consolidate the role of specialized cancer nurses in the assessment and follow-up of cancer patients undergoing outpatient adjuvant chemotherapy, from a comprehensive perspective that helps them improve their self-management, as well as mitigate negative emotions and maintain or increase positive emotions and consequently their perceived QoL."


 – Corresponding author Dr Ulibarri-Ochoa on her paper, “Differences in Quality of Life and Emotional Well-being in Breast, Colon, and Lung Cancer Patients During Outpatient Adjuvant Chemotherapy: A Longitudinal Study" published online ahead-of-print in CANCER NURSING. For a limited time, the full article text may be viewed below without a subscription.

Monday, April 25, 2022

Dear members,


ICCN has again been successfully delivered virtually from February 23-25, 2022 with nearly 300 oral/poster abstracts presented. Our theme was “Building Sustainability and Resilience: Global Perspectives on Cancer Nursing." Dr Nick Watts, NHS Chief Sustainability Officer opened the 3-day conference with a talk on “Climate Change and Health Impacts" highlighting the importance that healthcare implement strategies to reduce the impact of climate change. Mrs Elizabeth Iro, Chief Nurse WHO provided an inspiring speech on day 2 titled “Promoting and Strengthening Nursing Leadership." The plenary sessions focused on four major topics: how nurses can be engaged in the incorporation of nursing perspectives in health policies; how nursing leadership can enable challenges to be turned into opportunities for the profession; patient navigation for Indigenous peoples as a strategy in addressing cancer disparities and access to cancer care; and how some countries have had to be innovative with strategies to build workforce resilience and ensure sustainability of oncology clinical practices during the political challenges and a global pandemic. The educational sessions provided participants with new knowledge on three areas of cancer nursing, including end-of-life communication skills training, advancement of care practice for prehabilitation in acute myeloid leukemia, and strategies for addressing body image, sexuality issues and peripheral neuropathy from different cultural views. Finally, the instructional sessions focused on palliative care in an acute care ward, using patient-reported outcomes to improve the delivery of person-centered oncology care, and strategies for the development of health policies and positional statements.

If you missed ICCN2022, registration is still available for the virtual library, but only until the end of May 2022. For more information, please access https://www.iccn2022.com/registration/.  

 
Sincerely,


Suzanne Bishaw
Chairperson, Conference Management Committee, ICCN2022   


Friday, February 25, 2022

​Effects of Rehabilitation Program on Quality of Life, Sleep, Rest-Activity Rhythms, Anxiety, and Depression of Patients With Esophageal Cancer

A Pilot Randomized Controlled Trial

 

Chen, Hui-Mei PhD, RN; Lin, Yi-Yun PhD, RN; Wu, Yu-Chung MD; Huang, Chien-Sheng MD; Hsu, Po-Kuei PhD, MD; Chien, Ling-I RN; Lin, Yu-Jung MS, RN; Huang, Hsiu-Li MS, RN

 

"Patients with esophageal cancer experience severe symptoms and poor quality of life. Therefore, oncology nurses play a crucial role in collaborating with experts from various disciplines, such as chest surgeons, oncologists, radiologists, rehabilitation physicians, physical therapists, and dieticians, to develop and conduct a rehabilitation program to relieve patients' symptoms. We designed a rehabilitation program involving home-based exercise and dietary education and observed improvements in anxiety, sleep, and health-related quality of life in patients with esophageal cancer. During the study period, I was encouraged when patients expressed willingness to adopt a healthier lifestyle through exercise and dietary adjustments. Nonpharmacological treatment to relieve symptoms is low in cost, has no side effects, and is generally accepted by patients with cancer. Exercise and diet education booklets can be used to instruct patients with esophageal cancer. Furthermore, telecare, including home-based exercises instruction and telephone or Internet consultations, is preferable to hospital-based care during the COVID-19 outbreak."​


--Corresponding author Dr Hui-Mei Chen


This article was published in CANCER NURSING Volume 45, Issue 2. For a limited time, the article may be viewed below without a subscription.

 

Background 

Esophageal cancer patients experience severe symptoms and poor quality of life.

Objective 

We examined the effects of a rehabilitation program on quality of life, sleep, rest-activity rhythms, anxiety, and depression of esophageal cancer patients.

Methods 

Forty-four patients with esophageal cancer were randomly assigned to an experimental group, which underwent a 12-week brisk walking and diet education program, or a control group, which received standard care. Health-related quality of life, subjective and objective sleep quality, rest-activity rhythms, anxiety, and depression were assessed at baseline and post intervention.

Results 

A generalized estimating equation analysis revealed that, after intervention, compared with the control group, the experimental group exhibited significantly improved reflux (P = .022; effect size, 0.32) and marginally improved emotional (P = .069; effect size, 0.27) and social (P = .069; effect size, 0.27) functions; constipation (P = .050; effect size, 0.29), eating difficulty (P = .058; effect size, 0.27), anxiety (P = .050; effect size, 0.29), and total sleep time (P = .068; effect size, 0.39).

Conclusions 

The rehabilitation program may improve health-related quality of life and sleep and alleviate anxiety in patients with esophageal cancer.

Implications for Practice 

A rehabilitation program comprising exercise and diet education is a feasible and low-cost intervention for improving quality of life of patients with esophageal cancer. Healthcare team members may consider it as a nonpharmacological treatment option for patients.

 


Monday, January 24, 2022

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Monday, December 27, 2021

​Cognitive Dysfunction in Older Breast Cancer Survivors: An Integrative Review

Crouch, Adele PhD, RN; Champion, Victoria PhD, RN, FAAN; Von Ah, Diane PhD, RN, FAAN


"From my clinical and previous research experiences, I knew cognitive issues were a concern for many breast cancer survivors. Those concerns can range from increased forgetfulness, trouble paying attention, and/or difficulty thinking of words (word-finding). In addition, from my studies in my adult-gerontology clinical nurse specialist program, my doctoral minor studies in interdisciplinary gerontology, and my clinical experiences I knew cognitive issues were also a common concern among many older adults. These observations lead me to seek out studies from the literature regarding cognitive concerns among older breast cancer survivors specifically. From this search, I discovered most of the research regarding cognition and breast cancer thus far has focused on younger or all-age breast cancer survivors.


The studies and evidence we currently have in older breast cancer survivors are limited. As we found in this integrative review, most of the studies to date have been mostly focused on the more immediate cognitive concerns during and directly following diagnosis and treatment. However, due to our rapidly aging society and advances in prevention, diagnosis, and treatment of breast cancer the majority of breast cancer survivors are 60 years of age and older, and many breast cancer survivors are expected to live longer after diagnosis and treatment. 


This review highlighted a gap in our currently limited evidence regarding the more long-term dysfunction of older breast cancer survivors. A main takeaway from this review is the necessity of a comprehensive geriatric assessment for older breast cancer survivors that includes questions regarding cognitive concerns. Healthcare providers, especially cancer nurses, play an important role in assessing, discussing, and identifying cognitive concerns in older breast cancer survivors."

 

--Corresponding author Dr Adele Crouch speaks on her paper, " Cognitive Dysfunction in Older Breast Cancer Survivors: An Integrative Review," published in CANCER NURSING Volume 45, Issue 1.  The article may be viewed below without a subscription.




Abstract

Background

Approximately 60% of the more than 3.8 million breast cancer survivors (BCSs) living in the United States are 60 years or older. Breast cancer survivors experience many symptoms including cognitive dysfunction; however, little is known regarding how age affects these symptoms.

Objective 

This integrative review was conducted to synthesize the literature on cognitive dysfunction in older BCSs. The purpose was to (1) describe the prevalence of objective and subjective cognitive dysfunctions and (2) examine factors associated with cognitive dysfunction in older BCSs.

Methods 

Whittemore and Knafl's integrative review methodology was used to examine cognitive dysfunction in BCSs 60 years or older.

Results 

Twelve quantitative studies were included. Up to 41% of older BCSs experienced cognitive dysfunction on neuropsychological examination, and up to 64% reported cognitive dysfunction on subjective measures pretreatment. Approximately half of older BCSs experienced cognitive decline from pretreatment to posttreatment regardless of cognitive measure. The domains most impacted were memory, executive functioning, and processing speed. Objective and subjective cognitive dysfunctions were associated with age, comorbidities, chemotherapy receipt, sleep, neuropsychological symptom cluster, frailty, and quality of life.

Conclusions 

Cognitive dysfunction among older BCSs was common both prior to and following treatment. Cognitive dysfunction was associated with multiple factors that are compounded in the aging population and could be detrimental to quality of life and independent living.

Implications to Practice 

Early assessment and intervention by healthcare providers, including nurses, for cognitive dysfunction in older BCSs are essential. Future research should focus on evidence-based interventions for cognitive dysfunction incorporating the unique needs of older BCSs.