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CA: a Cancer Journal For Clinicians 2023Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify,... (Review)
Review
Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty-four reviews were quantitative or mixed-methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost-effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost-effectiveness of navigation in screening programs.
Topics: Humans; Patient Navigation; Quality of Life; Systematic Reviews as Topic; Palliative Care; Neoplasms; Continuity of Patient Care
PubMed: 37358040
DOI: 10.3322/caac.21788 -
BMC Cancer Jul 2023Cancer is highly prevalent worldwide. Family resilience is a positive variable that helps families burdened by advanced cancer to cope effectively. This study aimed to...
BACKGROUND
Cancer is highly prevalent worldwide. Family resilience is a positive variable that helps families burdened by advanced cancer to cope effectively. This study aimed to describe the family resilience of advanced cancer patients and caregivers in dyads and identify its influencing factors at the individual and dyadic levels.
METHODS
This multisite cross-sectional study was conducted in oncology units in five tertiary hospitals in China. A total of 270 advanced cancer patient-caregiver dyads were recruited between June 2020 and March 2021. Patients' and caregivers' family resilience was measured by the Family Resilience Assessment Scale. Data on potential influencing factors, including demographic and disease-related characteristics as well as family sense of coherence, psychological resilience, perceived social support, symptom burden, and caregiver burden, were collected. Multilevel modeling analysis was adopted to control for the interdependence of the dyads.
RESULTS
A total of 241 dyads were included in the data analysis. The mean ages of patients and caregivers were 53.96 (SD 15.37) and 45.18 (SD 13.79) years, respectively. Most caregivers were spouses and adult children (45.6% and 39.0%, respectively). Patients reported a higher mean family resilience score than caregivers (152.56 vs. 149.87, respectively). Undergoing fewer than two types of treatment and a lower symptom burden of patients predicted higher patient (B = -9.702, -0.134, respectively) and caregiver (B = -5.462, -0.096, respectively) family resilience. Patients also reported higher family resilience under the following conditions: 1) were on a medical insurance plan other than the new rural cooperative medical system (B = 6.089), 2) had a better family sense of coherence (B = 0.415), 3) whose caregivers were unmarried (B = 8.618), perceived lower social support (B = -0.145) and higher psychological resilience (B = 0.313). Caregivers who were ≤ 44 years old (B = -3.221), had similar previous caregiving experience (B = 7.706), and had a stronger family sense of coherence (B = 0.391) reported higher family resilience.
CONCLUSIONS
Our findings highlight the importance of adopting a dyadic approach when caring for advanced cancer patients and their caregivers. Dyadic longitudinal research is suggested to discover more modifiable factors of family resilience and tailored interventions are needed to obtain optimal dyadic outcomes.
Topics: Adult; Humans; Adolescent; Caregivers; Resilience, Psychological; Adaptation, Psychological; Family Health; Cross-Sectional Studies; Neoplasms; Quality of Life; Family
PubMed: 37403053
DOI: 10.1186/s12885-023-11101-z -
Asian Pacific Journal of Cancer... Aug 2023Palliative care is the active holistic treatment of people of all ages who have serious health-related suffering as a result of severe illness, and especially of those... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Palliative care is the active holistic treatment of people of all ages who have serious health-related suffering as a result of severe illness, and especially of those who are close to the end of life. Palliative care is provided to cancer patients who experience serious suffering that cannot be relieved without professional intervention and that compromises physical, social, spiritual, and emotional functioning. A straightforward, low-risk, and affordable palliative care approach may be provided through aromatherapy, a type of complementary and alternative medicine. The study objective is to assess the comparative effectiveness of massage, aromatherapy massage, and massage combined with aromatherapy inhalation on cancer patients receiving palliative care.
METHODS
A total of 100 participants who were divided into four groups at random. The first group, designated as the control group, received standard hospital nursing care, the second group received massage only (using the odorless almond carrier oil), the third group received massage with lavender oil, and the fourth group received combined (inhalation and massage) aromatherapy. The Rotterdam Symptom Checklist (RSCL), given two weeks after aromatherapy, was used to examine participants' perspectives of care.
RESULTS
On the RSCL, combined aromatherapy performed best. In terms of reported physical symptoms, psychological symptoms, and activities, there were statistically significant differences between the scores of the control group and each of the experimental groups. Nonetheless, the total quality of life score showed no significant difference between the control group and the massage only group (t = 0.529, p = 0.60).
CONCLUSIONS
When paired with aromatherapy inhalation, massage has a positive effect on physical, psychological symptoms, activities, and overall quality of life for cancer patients receiving early palliative care. Nurses and other healthcare providers are recommended to support programs that provide message therapy to reduce reported bodily symptoms, psychological problems, and limited activities among cancer patients.
Topics: Humans; Aromatherapy; Mind-Body Therapies; Neoplasms; Palliative Care; Quality of Life
PubMed: 37642059
DOI: 10.31557/APJCP.2023.24.8.2729 -
BMJ Open Oct 2023To identify nursing support provided for the relief of breathlessness in patients with cancer. (Review)
Review
OBJECTIVE
To identify nursing support provided for the relief of breathlessness in patients with cancer.
DESIGN
A scoping review following a standard framework proposed by Arksey and O'Malley.
STUDY SELECTION
Electronic databases (PubMed, CINAHL, CENTRAL and Ichushi-Web of the Japan Medical Abstract Society Databases) were searched from inception to 31 January 2022. Studies reporting on patients with cancer (aged ≥18 years), intervention for relief from breathlessness, nursing support and quantitatively assessed breathlessness using a scale were included.
RESULTS
Overall, 2629 articles were screened, and 27 were finally included. Results of the qualitative thematic analysis were categorised into 12 nursing support components: fan therapy, nurse-led intervention, multidisciplinary intervention, psychoeducational programme, breathing technique, walking therapy, inspiratory muscle training, respiratory rehabilitation, yoga, acupuncture, guided imagery and abdominal massage.
CONCLUSIONS
We identified 12 components of nursing support for breathlessness in patients with cancer. The study results may be useful to understand the actual state of nursing support provided for breathlessness in patients with terminal cancer and to consider possible support that can be implemented.
Topics: Humans; Adolescent; Adult; Neoplasms; Dyspnea; Palliative Care; Physical Therapy Modalities; Walking
PubMed: 37827741
DOI: 10.1136/bmjopen-2023-075024 -
Annals of Palliative Medicine Sep 2023The specialty of oncology nursing has been evolving in North America for nearly a century, keeping pace with the rapid and dynamic developments in cancer care. This... (Review)
Review
The specialty of oncology nursing has been evolving in North America for nearly a century, keeping pace with the rapid and dynamic developments in cancer care. This narrative review outlines the history and development of oncology nursing in North America with a focus on the United States and Canada. The review highlights the important contributions that specialized oncology nurses have made to the care of people affected by cancer from time of diagnosis through treatment, follow-up and survivorship care, as well as palliative, end-of-life, and bereavement care. Keeping pace with the rapid evolution of cancer treatments throughout the last century, nursing roles have similarly evolved to meet the need for more specialized training and education. This paper discusses the growth of nursing roles, including advanced practice and navigator roles. In addition, the paper outlines the development of professional oncology nursing organizations and societies that have been established to help guide the profession with best practices, standards, and competencies. Finally, the paper discusses new challenges and opportunities regarding the access, availability, and delivery of cancer care that will shape future development of the specialty. Oncology nurses will continue to be integral to the provision of high-quality, comprehensive cancer care as clinicians, educators, researchers, and leaders.
Topics: Humans; United States; Oncology Nursing; North America; Canada; Quality of Health Care; Neoplasms; Growth and Development
PubMed: 37303211
DOI: 10.21037/apm-22-1121 -
Annals of Palliative Medicine Sep 2023There is a growing recognition that oncology nurses are vitally important for an effective cancer control system. Although there is variation among countries, oncology...
There is a growing recognition that oncology nurses are vitally important for an effective cancer control system. Although there is variation among countries, oncology nursing is being recognized as a specialty practice and seen as a priority for development in cancer control plans in many settings. Ministries of Health in many countries are beginning to acknowledge the role nurses play in achieving successful cancer control outcomes. Additionally, the need for access to relevant education for oncology nursing practice is being recognized by nursing and policy leaders. The purpose of this paper is to highlight the growth and development of oncology nursing in Africa. Several vignettes are presented by nurse leaders in cancer care from several African countries. Their descriptions offer brief illustrations regarding the leadership nurses are providing in cancer control education, clinical practice, and research in their respective countries. The illustrations offer insight into the urgent need, and the potential, for future development of oncology nursing as a specialty given the many challenges nurses face across the African continent. The illustrations may also provide encouragement and ideas for nurses in countries where there is little current development of the specialty about how to proceed to mobilize efforts aimed toward its growth.
Topics: Humans; Oncology Nursing; Education, Nursing; Africa; Nurse's Role; Growth and Development
PubMed: 37431222
DOI: 10.21037/apm-22-1323 -
Annals of Palliative Medicine Sep 2023Oncology nursing is increasingly recognized around the world as being vitally important for an effective cancer control system. Granted, there is variation between and...
Oncology nursing is increasingly recognized around the world as being vitally important for an effective cancer control system. Granted, there is variation between and among countries/regions regarding the strength and nature of that recognition, but oncology nursing is clearly seen as a specialty practice and as a priority for development in cancer control plans, especially for high resource countries/regions. Many countries/regions are beginning to recognize that nurses are vitally important to their cancer control efforts and nurses require specialized education and infrastructure support to make a substantial contribution. The purpose of this paper is to highlight the growth and development of cancer nursing in Asia. Several brief summaries are presented by nurse leaders in cancer care from several Asian countries/regions. Their descriptions reflect illustrations of the leadership nurses are providing in cancer control practice, education, and research in their respective countries/regions. The illustrations also reflect the potential for future development and growth of oncology nursing as a specialty given the many challenges nurses face across Asia. The development of relevant education programs following basic nursing preparation, the establishment of specialty organizations for oncology nurses, and engagement by nurses in policy activity have been influential factors in the growth of oncology nursing in Asia.
Topics: Humans; Oncology Nursing; Asia; Growth and Development
PubMed: 37211787
DOI: 10.21037/apm-22-1399 -
Asia-Pacific Journal of Oncology Nursing Apr 2024
PubMed: 38590913
DOI: 10.1016/j.apjon.2024.100401 -
Ecancermedicalscience 2023Climate change is impacting the lives of millions around the world and exacerbating existing challenges in healthcare globally. Although Africa contributes only 2%-3% of...
Climate change is impacting the lives of millions around the world and exacerbating existing challenges in healthcare globally. Although Africa contributes only 2%-3% of global greenhouse gas emissions, it suffers a disproportionate share of the environmental impact. High-income countries dominate the global discourse on climate change, while their continued utilisation of extractive policies exacerbates climate hazards and impacts economies in regions not responsible for the damage. Cancer is on the rise and constitutes a significant public health burden in low- and middle-income countries, yet little is known about the impact of climate change on oncology nursing on the African continent. To address the ways that climate change is exacerbating existing challenges and adding new difficulties for oncology care, it is essential that the expertise of professionals working in settings that are most impacted by the threats of climate change is amplified if climate crisis risks are to be effectively mitigated. Seven African oncology nurses from across sub-Saharan Africa were reflexively interviewed by voice over internet protocol (VOIP) in English to learn about their understanding of climate change and experiences with its impact on nursing care. Using a conceptual framework to map the impact of climate change on health and considering the vulnerability and social capacity of patients with cancer, our findings show how existing challenges to oncology nursing care are exacerbated by climate change on the continent. Food insecurity, national economic dependency on the agricultural sector, economic inequality, social vulnerability and isolation, transportation challenges, and the immunocompromised status of patients with cancer are all key concerns for oncology nurses in this context. We also present the nurses' specific recommendations for governments, hospital authorities, and oncology nurses regarding climate change mitigation, adaptation, and event response strategies. With this work, we aim to lay a foundation for further investigation and action to mitigate the oncoming challenges of climate disaster for oncology nurses across sub-Saharan Africa and the patients and families they care for.
PubMed: 38414956
DOI: 10.3332/ecancer.2023.1621 -
Asia-Pacific Journal of Oncology Nursing Mar 2024
PubMed: 38465238
DOI: 10.1016/j.apjon.2024.100399